Description

Patellofemoral (puh-tel-o-FEM-uh-rul) pain syndrome is pain at the front of the knee, around the kneecap. The patella of the knee is also known as the kneecap. Patellofemoral pain syndrome is sometimes called runner's knee. It is more common in people who run and participate in sports that involve running and jumping.

The knee pain often increases when you run, go up or down stairs, sit for long periods, or squat. Simple treatments, such as rest and ice-often help. But sometimes patellofemoral pain needs physical therapy.

Symptoms

Patellofemoral pain syndrome usually causes a dull pain in the front of the knee. The following factors can increase the pain:

  • Walk up or down stairs.
  • Kneeling or squatting.
  • Sitting with the knee bent for long periods of time.

When to see your doctor

If the knee pain doesn't improve within a couple of days or it becomes more difficult to move the knee, call your health care provider.

Causes

Patellofemoral pain syndrome can have several causes. It has been associated with:

  • The excessive use. Running or jumping sports put repeated stress on the knee joint, which can cause irritation under the kneecap.
  • Muscle imbalances or weakness. Patellofemoral pain can occur when the muscles around the hip and the knee not keep the kneecap in line. Movements of the knee inward during a squat has been associated with patellofemoral pain.
  • Of the injury. The Trauma of the patella of the knee, such as when the kneecap is out of place or breaks, it has been associated with patellofemoral pain syndrome.
  • Surgery. Surgery of the knee can increase the risk of patellofemoral pain. This is especially true of the anterior cruciate ligament repair by using the patellar tendon as a graft.

Risk factors

Factors that may increase your risk include:

  • Age. Patellofemoral pain syndrome typically affects adolescents and young adults. Arthritis is most often to blame for the problems of the knee in older people.
  • Sex. Women are two times more likely than men to develop patellofemoral pain. This may be because women have a wider pelvis. A wide pelvis increases the angle at which the bones in the knee joint meet.
  • In certain sports. Running and jumping sports can put extra stress on the knees. This is especially true when the addition of more training.

Prevention

Sometimes knee pain simply happens. But certain measures can help prevent the pain.

  • Build strength. Strong leg and hip muscles help to keep the knee balanced during the activity. Avoid deep squatting during weight training.
  • Move safely. Ask a physical therapist about exercises to help you jump, run, and rotate correctly. It is especially important to strengthen the exterior of the muscles of the hip. This will help to keep the knee from caving inward when squatting, land from a jump, or step down a step.
  • Lose excess pounds. If you are overweight, losing weight relieves stress on the knees.
  • The warm-up. Before running, or doing other exercise, warm up with five minutes or so of the activity of the light.
  • Stretch. Promote flexibility with gentle stretching exercises.
  • Slowly increase. Do not suddenly increase their workouts.
  • The mind of your shoes. Wear shoes that fit well and are designed for the activity.

Diagnosis

Your health care provider will ask about your history of knee problems, tap on your knee and move your leg in a variety of positions.

Sometimes imaging tests may help find the cause of your knee pain. Tests may include:

  • The x-ray. X-ray images show bones. X-rays are not so good for the visualization of soft tissues.
  • CTscans. The TC show the bones and soft tissues. But the CT scans involve much higher dose of radiation than do plain x-rays.
  • The magnetic resonance imaging. The use of radio waves and a strong magnetic field, magnetic resonance imaging scan shows detailed images of the bones and soft tissues, such as the knee, the ligaments and the cartilage. However, the MRI cost much more than the X-ray, ct scan, or ultrasound.
  • Ultrasound. This test uses sound waves to show images of the muscles and tendons.

Treatment

Treatment of patellofemoral pain often begins with simple measures. Rest of the knee as much as possible. Try not to do things that increase the pain, such as climbing stairs, kneeling, or squatting.

Medications

If necessary, take pain relievers that you can get without a prescription. These include acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Do not take more than 2 to 3 weeks.

Therapy

A physical therapist can suggest:

  • The rehabilitation exercises. Certain exercises to strengthen the muscles that support the knees and keeping parts of the leg in line. Keep the knee moves inward while the squat is a primary goal.
  • Support braces. Knee braces or arch supports can help to improve the pain.
  • The recording. Your physical therapist can show you how to tape the knee to reduce pain and to do that they can exert.
  • The formation of ice. Icing your knee after exercise can be helpful.
  • Orthotics. Made-to-measure or ready-made shoe could help take the stress off of the knee.
  • Knee-friendly sports. During recovery, it may help to stick to sports that are easier on the knees, such as cycling or swimming.

Surgical and other procedures

If those simple treatments don't relieve the pain, a health care provider might suggest:

  • Arthroscopy. During this procedure, a surgeon inserts a pencil-thin device in the knee through a small incision in the skin. This device, called an arthroscope contains a lens of the camera and the light. Tools to repair the problem can be inserted through other small incisions in the skin.
  • The realignment. In the most serious cases, a surgeon may need to operate at the knee to correct the angle of the patella of the knee or relieve the pressure on the cartilage.

Preparing for your appointment

You could start by seeing your primary care provider. Or you may be referred to a physical medicine and rehabilitation specialist, also known as a physiatrist, a physical therapist, an orthopedic surgeon, or a specialist in sports medicine.

Here is the information to help you prepare for your appointment.

What you can do

Before your appointment, make a list of the following:

  • Your symptoms and when they began.
  • Key personal information , including if you've ever injured your knee or had knee surgery and what type of exercise or sport that you play.
  • All medications, vitamins or supplements that you take, including over-dose.
  • Questions to ask your health care provider.

Have a friend or family member, if possible, to help you remember the information they give you. Also, if you've had X-rays or other imaging tests of your knees, trying to bring copies of them with you to your appointment.

For patellofemoral pain syndrome, questions include:

  • What is probably the cause of my knee pain?
  • What are other possible causes?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • What is the best course of action?
  • Do I need to limit my activities?
  • You should see a specialist?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Ask any other questions you have.

What to expect from your doctor

Be prepared to answer questions, such as:

  • How would you describe the pain in the knee?
  • Where exactly does it hurt?
  • What activities improve or worsen your symptoms?
  • Have you recently started exercising or exercising more?
  • What home treatments have you tried? Do they help?
Symptoms and treatment of Patellofemoral pain syndrome