Patellofemoral Pain Syndrome
Overview
What is patellofemoral pain?
Patellofemoral pain is a common knee problem. If you have this condition, you feel pain under and around your kneecap. The pain can get worse when you're active or when you sit for a long time. You can have the pain in one or both knees.
Anatomy of the knee
Causes & Risk Factors
What causes patellofemoral pain syndrome?
The exact cause of patellofemoral pain isn't known. It probably has to do with the way your kneecap (patella) moves on the groove of your thigh bone (femur).
Treatment
How is it treated?
Usually, putting ice on your knee, changing your activities, and following a physical therapy program works best. This type of program may include exercises to make your muscles stronger and more flexible. Taping the knee or using shoe insoles can be helpful for some people. It may take weeks or months of treatment for the pain to go away.
Tips to help relieve your pain
- Take a break from physical activity that causes a lot of pounding on your legs, such as running, volleyball or basketball. If you want to keep exercising, try swimming or another low-impact activity. You may want to try working out on nonimpact elliptical trainers, which are popular at gyms. Because these machines support your body weight, they put less stress on your knees. As your knees feel better, you can go back to your normal sports. But do this slowly, increasing the amount of time you do the sports activity a little at a time.
- Talk to your doctor about footwear. It may help to bring your shoes in for the doctor to see. Proper walking or running shoes can help knee pain. Even a simple arch support insert from a shoe store can be helpful. This insert is less expensive than a custom-made support or brace.
- Ice your knees for 10 to 20 minutes after activity. This can ease the pain and speed up healing. To keep your hands free, use an elastic wrap to hold the ice pack in place. A medicine such as ibuprofen (one brand name: Motrin) may also help relieve your pain, but talk to your doctor before you take this medicine.
Exercises to help your knee pain
The exercises shown in this handout can help strengthen your muscles and relieve your pain. Each exercise should take a few minutes. Doing them twice a day is a good start. Your doctor will tell you which exercises are right for you. After you do the exercises as shown in the drawings, reverse your position, and do the exercises with your other leg, so both knees get the benefit of stretching.
Be patient! Keep exercising to get better. Patellofemoral pain can be hard to treat, and your knees won't get better overnight. Some people are lucky and get better quickly. But it might take 6 weeks or longer for your knee to get better. You'll be less likely to get patellofemoral pain again if you stay in good shape, but don't make sudden changes in your workouts.
Disclaimer: The drawings and animations of exercises displayed below are provided only to illustrate the exercises ... Read More
Quadriceps strengthening: Isometrics
Position yourself as shown below. Hold your right leg straight for 10 to 20 seconds and then relax. Do the exercise 5 to 10 times.
AnimateQuadriceps strengthening: Straight leg lift
Position yourself as shown below. Raise your right leg several inches, and hold it up for 5 to 10 seconds. Then lower your leg to the floor slowly over a few seconds. Do the exercise 5 to 10 times.
Iliotibial band and buttock stretch
Position yourself as shown below. Twist your trunk to the right and use your left arm to "push" your right leg. You should feel the stretch in your right buttock and the outer part of your right thigh. Hold the stretch for 10 to 20 seconds. Do the exercise 5 to 10 times.
Iliotibial band stretch
Position yourself as shown below, with your right leg crossed in front of your left leg. Hold your hands together and move them toward the floor. You should feel a stretch in the outer part of your left thigh. Hold the stretch for 10 to 20 seconds. Do the exercise 5 to 10 times.
Hamstring stretch
Position yourself as shown in the drawing below. Bend your left knee. Grip your thigh with your hands to keep the thigh steady. Straighten your left leg in the air until you feel a stretch. Hold the stretch for 5 to 10 seconds. Do the exercise 5 to 10 times.
Hip adductor strengthening
While sitting, squeeze a rubber ball between your knees. Hold the squeeze for 5 to 10 seconds. Do the exercise 5 to 10 times. (If you don't have a ball, put your hands or fists between your knees and then squeeze.)
Hip abductor strengthening
Position yourself as shown below, standing on your left leg with the knee slightly bent. Slowly raise your right foot about 30 degrees, hold for a few seconds, and then slowly lower the foot and straighten both legs. Do the exercise 10 times. Don't let your pelvis tilt (be crooked), and don't let your knees turn inward during bending.
Calf stretch
Position yourself against a wall as shown below. Keep your right heel on the ground to feel the back of the leg stretch. Hold for 10 to 20 seconds. Do the exercise 6 to 10 times.
Questions to Ask Your Doctor
- What is the likely cause of my knee pain?
- What is the best treatment option for me?
- Do I need to do any special exercises to help strengthen my knee and relieve my pain?
- How long before I can expect relief from my symptoms?
- Is it possible that my symptoms could return?
- Is it safe for me to exercise? What kind of exercise should I do?
Bibliography
Management of Patellofemoral Pain Syndrome by S Dixit, M.D., JP Difiori, M.D., M Burton, M.D., and B Mines, M.D. (American Family Physician January 15, 2007, http://www.aafp.org/afp/2007/0115/p194.html)
Patellofemoral Pain Syndrome: A Review and Guidelines for Treatment by MS Juhn, D.O. (American Family Physician November 01, 1999, http://www.aafp.org/afp/991101ap/2012.html)
Written by familydoctor.org editorial staff
Reviewed/Updated: 12/10
Created: 12/00