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What is the Patellofemoral Pain Syndrome?
Patellofemoral pain syndrome is a condition in which pain is felt under the kneecap (the patella). In people with patellofemoral pain syndrome, the patella rubs painfully against the femur especially during activity (running, jumping, climbing or descending stairs) or by prolonged sitting with knees in a moderately bent position (the so-called "theater sign" of pain upon arising from a desk or theater seat)
What is the cause of this syndrome?
It is caused by overpressure on the kneecap while the leg is flexed.
What are the symptoms?
The first symptom is pain around or under the kneecap which is the result of inflammation of soft tissues around it. The pain may first occur during high-impact activities. As the condition gets worse, the pain may be triggered by squatting, going down the stairs, kneeling, or long periods of sitting particularly at the movies. Other symptoms may include swelling of the knee, popping or grinding sounds in the knee joint during activity or a snapping sensation in the knee.
What is the treatment?
The initial step is to rest the knee. High-impact activities should be switched for lower impact exercise. For example, choose swimming instead of running (except breaststroke). Longer-term treatment involves a number of different strategies, including :
- Exercise and Physical Therapy : most people will benefit from strengthening the muscles around the knee. This includes the quadriceps muscles in the thigh as well as other muscles near the hip. Physical therapists will recommend specific exercises. This treatment is very helpful. It takes 6 to 12 weeks to see an improvement.
- Pharmacological Treatment : Nonsteroidal anti-inflammatory agents and pain killers are helpful in relieving the pain. They work best when combined with other treatments, such as physical therapy and ice application to the kneecap after activity.
- External devices : knee braces can also help decrease the pain. These devices typically have a cutout in the kneecap area. They are designed to hold the kneecap in place during activity and to hold the patella from going too far laterally.
- Surgery : is rarely indicated except in the rare cases in which people do not respond to other forms of treatment. Minimally invasive Arthroscopic surgery will correct the malalignment of the patella and check for any cartilage defects or other unexplained causes of knee pain.