Patellofemoral Pain Syndrome (Runner’s Knee): Symptoms, Causes and Treatment
Patellofemoral pain syndrome, often called runner’s knee, is a common cause of pain around or behind the kneecap. It is a broad term for front-of-knee pain that comes from how the kneecap moves and loads during activity, rather than from a single injury. It is especially common in runners and other active people, but it can affect anyone, and it often improves with nonsurgical care.
If you have nagging pain at the front of your knee, the right diagnosis is the first step toward developing an effective treatment plan. The board-certified and fellowship-trained knee and sports medicine specialists at Resurgens Orthopaedics diagnose and treat patellofemoral pain syndrome at locations across metro Atlanta.
Overview
- What Is Patellofemoral Pain Syndrome?
- What Causes Patellofemoral Pain Syndrome?
- Patellofemoral Pain Syndrome Symptoms
- How Patellofemoral Pain Syndrome Is Diagnosed
- Patellofemoral Pain Syndrome Treatment
- Schedule an Appointment for Knee Pain
What Is Patellofemoral Pain Syndrome?
The kneecap, or patella, normally glides up and down in a groove at the end of the thighbone as you bend and straighten the knee. Patellofemoral pain syndrome develops when the way the kneecap tracks (how it moves within its groove) and the load it carries put uneven stress on the joint, irritating the surrounding tissues and causing pain at the front of the knee. It is considered an overuse and biomechanical problem (a problem with how the knee moves and functions) rather than a specific structural injury, which is part of why it is described as a broad, umbrella term.
Because several front-of-knee problems can feel similar, it helps to know how they differ. Patellofemoral pain syndrome refers to the pain pattern itself. Chondromalacia (cartilage wear or damage behind the kneecap) is a related but distinct condition, and pain in the tendon just below the kneecap is patellar tendonitis. A knee specialist can tell these apart, which matters because the treatment can differ.
What Causes Patellofemoral Pain Syndrome?
There is usually no single cause. Instead, a combination of factors changes how the kneecap moves within its groove and increases stress on the joint. Common contributors include:
- Overuse: Activities that load the knee, such as running, squatting, jumping or climbing stairs
- Muscle Weakness: Weak quadriceps and hip muscles that help keep the kneecap centered
- Tight Muscles: Tightness in the hamstrings, calves or iliotibial band (IT band)
- Leg Alignment: Differences in alignment from the hips down to the feet, including flat feet
- Training and Footwear: A sudden increase in training, or worn or unsupportive shoes
Runner’s knee is especially common in females and young adults who play sports, though it can affect people of any age or activity level.
Patellofemoral Pain Syndrome Symptoms
The main symptom is a dull, aching pain at the front of the knee, around or behind the kneecap, that comes on gradually. Common symptoms include:
- Activity-Related Pain: Pain that worsens with running, squatting, kneeling or going up and down stairs, especially downstairs
- Theater Knee: Pain after sitting for a long time with the knee bent
- Grinding or Clicking: A rubbing sensation when bending or straightening the knee
- Tenderness: Soreness around the kneecap
- Mild Swelling: Occasional swelling at the front of the knee
Please Note: Front-of-knee pain has several possible causes. Severe pain, significant swelling or pain that follows a specific injury may point to something other than patellofemoral pain syndrome. If knee pain does not settle with rest or keeps returning, a knee specialist can confirm the cause and guide treatment.
How Patellofemoral Pain Syndrome Is Diagnosed
A knee specialist can usually diagnose runner’s knee from your symptoms and a physical examination, without the need for extensive testing. Your physician will ask which activities bring on the pain, check the kneecap for tenderness and assess your strength, flexibility and alignment from the hips down to the feet. Movements like a squat may be used to reproduce the pain. Imaging such as an X-ray or MRI is not usually needed to make the diagnosis, but it may be ordered to rule out other causes of front-of-knee pain when the picture is not clear.
Patellofemoral Pain Syndrome Treatment
Many patients experience improvement in symptoms with conservative treatment. The goals are to calm the pain and, more importantly, correct the factors that led to it to help keep it from returning.
Nonsurgical Treatment
Conservative care is the foundation of treatment:
- Activity Changes: Modifying or briefly reducing the activities that trigger the pain, switching to low-impact options like cycling or swimming
- Ice and Medication: Ice and over-the-counter anti-inflammatory medication to ease pain
- Physical Therapy: Strengthening the quadriceps and hip muscles and stretching tight tissues, a key part of treatment
- Taping or Bracing: Support for the kneecap during activity
- Orthotics: Custom shoe inserts when foot alignment is part of the problem
When Surgery Is Considered
Surgery is rarely needed for runner’s knee and is considered only when a clear structural problem is found and symptoms do not improve after a thorough course of nonsurgical care. Your Resurgens physician will discuss whether any procedure makes sense for your situation.
Schedule an Appointment for Knee Pain
If front-of-knee pain is keeping you from the activities you enjoy, a knee specialist can find the cause and build a personalized treatment plan based on your goals and condition. Book an appointment online today with Resurgens Orthopaedics or call us at (404) 847-9999.