Patellofemoral pain: Understanding this common cause of knee pain in active people

Patellofemoral pain is very common among active people. The term refers to pain coming from the kneecap or front of the femur. There are a number of underlying causes for patellofemoral pain, including weakness of the muscles of the hip or quadriceps, patellar instability, alignment issues of the lower extremities, tightness of the tissue on the outside of the kneecap, and overuse of the knee with certain sports and activities.

Signs and symptoms of patellofemoral pain

You likely won’t remember a specific injury that started the pain. You might notice pain along the front of the knee that has gotten worse over time. Your pain might be worse with activities, such as running or jumping. Often the pain increases to the point that you feel it at rest.

Two classic complaints of patellofemoral pain

Patients often give two classic complaints with patellofemoral pain. You often have difficulty going up and down stairs, especially going down stairs. You will probably also have pain sitting with your knee bent for long periods of time. This pain often plagues people at movie theaters, on airplanes, etc. You might feel better standing up and straightening your knee out to relieve the pain. Other complaints include pain with deep squatting and pain standing for long periods of time.

Do you have knee pain, or have you suffered a knee injury? Watch this video series on knee injuries in sports and exercise!

Exam and x-rays by a doctor

Physical examination by a doctor can help to diagnose the cause of the pain. It can also reveal underlying issues that can contribute to the symptoms.

X-rays are usually negative, although they are important especially to determine if one patella tilts more toward the outside of the knee than the other. Also degenerative changes between the patella and the femur can be visualized on x-rays. MRI’s are rarely needed.

Treatment and rehab of patellofemoral pain

Fortunately treatment is almost always nonsurgical. Working with a sports physical therapist can help you learn exercises that can help you overcome the pain while getting back to sports or exercise.

In this video, I describe the common complaints of patients with patellofemoral pain and describe the steps patients can take to relieve it.

Also read:
5 common running injuries
Running injuries: 5 problems that often slow runners down

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david-headshot I am an orthopaedic surgeon and sports medicine specialist in Charleston, South Carolina.

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