This question is one I received after a recent talk I gave on knee injuries in female athletes. Since patellofemoral pain is so common among active people, I thought it would be a good question to answer here.

I recently had an acute onset of severe, bilateral knee pain after mountain biking that went away 6-12 hours later. It sounds very much like patellofemoral pain syndrome. Is there a knee brace I can wear to prevent it from coming back? Are there any other prevention options?

Before I discuss prevention options, I think it might be useful to discuss what patellofemoral pain syndrome is. I suggest many of you reading this post might even have had this problem at some point.

Patellofemoral pain is pain from the part of the knee between the patella (kneecap) and the front of the femur (thigh bone). There are a variety of underlying muscular and other anatomic factors that vary from patient to patient.

A person with patellofemoral pain has pain felt in the front of her knee or under her kneecap. She might feel pain diffusely throughout her knee instead.

Patellofemoral pain
The pain felt by athletes with patellofemoral pain is usually diffuse, all around the front of the knee (white circle).

Two classic complaints also accompany patellofemoral pain. The affected person might notice pain with stairs, especially going down stairs. She also might have knee discomfort sitting for long periods of time with her knee bent, such as in a car or theater.

Fortunately in most cases, physical therapy or a home exercise program performed daily can alleviate these symptoms. In rare cases, surgery can be performed.

Can a brace prevent patellofemoral pain syndrome?

Most knee braces are made for issues with stability, like ligament injury, or alignment, like unloader braces for early osteoarthritis. Knee sleeves are available for all types of knee pain, but I’m not aware of any studies that show that they definitely treat or prevent patellofemoral pain.

There is a newer brace that might be helpful for patellofemoral pain syndrome due to its effects on the muscle forces around the knee. I am not aware of any studies showing its results for this condition. Anecdotally, my one experience with it was positive. I had patellofemoral pain in high school, college, and early medical school. Occasionally it flares up. I wore it during such an episode to try make it through three hours of covering a high school football game. It did seem to help.

Physical therapy for patellofemoral pain

Other options for preventing patellofemoral pain

I think one of the main treatment options could also be the best prevention strategy. Those same home exercises done a few times a week might keep the pain from coming back. Most of these programs involve about 10 or 12 exercises that can be done anywhere and don’t require weights or fancy equipment. They strengthen the muscles around the knee, thigh, and hip and decrease pressure on the kneecap.

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