The original author’s attribution accompanying this article contained an error and has been changed. See the bottom of the article for additional information.
By Dr. Dena Florczyk
Patellofemoral pain syndrome, commonly known as “runner’s knee,” is characterized by pain located underneath or around the kneecap.
The pain can result from overuse that accompanies a rapid increase in running mileage, or with activities such as walking, jumping or bicycling. Other factors that may contribute to the development of patellofemoral pain syndrome is having underdeveloped thigh and buttock muscles, wide hips or having flat feet. Patellofemoral pain syndrome is the most common diagnosis in patients who seek treatment for knee pain.
The kneecap (patella) fits in a groove at the end of the thigh bone (femur). The patella is attached to the quadriceps muscles in the thigh and to the shin bone (tibia) by the patellar tendon. With repeated bending and straightening of the knee, the undersurface of the kneecap may become irritated, causing pain. Additionally, if the kneecap is not tracking properly in its groove, this may cause irritation and pain.
Symptoms of patellofemoral pain syndrome include pain behind the kneecap stemming from prolonged walking, running or sitting. The pain tends to worsen while walking downhill or downstairs. The symptoms may include snapping, popping or grinding of the knee. Some people who have patellofemoral pain may have a history of a prior kneecap instability or injury.
Initial treatment for patellofemoral pain syndrome includes avoiding activities and movements that make the pain worse, icing the knee for 10 to 20 minutes every four to six hours and taking a non-steroidal anti-inflammatory medication, such as ibuprofen (Motrin, Advil) or naproxen (Aleve).
Other treatments may include wearing a neoprene knee sleeve to give support to the knee and kneecap, wearing shoe inserts for flat feet or for overpronation and avoiding positions with the knee bent at more than 90 degrees.
During recovery from patellofemoral pain syndrome, changing your activity may be helpful to allow for exercise and also to avoid worsening pain. For example, instead of running, it would be recommended to bike or swim. It is also recommended to work on strengthening the muscles around the knee and hips, including the quadriceps, hamstrings and gluteal muscles.
Additionally, working on the flexibility of the hamstrings, quadriceps and iliotibial band is important. Once the affected knee regains full motion and strength, as evidenced by your ability to walk, bend and squat without pain, you can begin a gradual return to previous activity. It is recommended to start at 25 to 50 percent of previous exercise volume with no more than a 10-percent increase in mileage or duration per week.
You should see your health care provider if your knee pain is associated with swelling, locking or catching, feelings of instability, giving way or if despite the above measures you are unable to return to your previous level of activity because of persisting knee pain.
Dr. Florczyk is a sports medicine physician at the Arthur Ashe Student Health Center.
Correction: Dr. Dena Florczyk is a sports medicine physician.