Patellofemoral Pain Syndrome

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Many individuals experience pain in the front of the knee. There are many causes for this and Patellofemoral Pain Syndrome (PFPS) is one of the most common.

PFPS is diagnosed based on the exclusion of specific structural causes of anterior knee pain such as medial knee plica, osteoarthritis and quadriceps tendinopathy. This condition is more common in younger individuals and more in females.

The structures involved in this condition are the patella (kneecap) as it glides on the groove of the thigh bone (femur), and collectively they form the patellofemoral joint. This joint is put under load during activities such as climbing stairs, squatting, running and kneeling. Normally, the patella glides down and into the groove as the knee bends. However, in individuals with muscle imbalance in the knee and/or hips and structural malalignments of the lower limb (Peterson et al., 2013), the patella does glide properly and this increases stress in certain portions of the patella under loaded conditions, potentially resulting in PFPS.

Symptoms of PFPS include pain in the front of the knee on running, jumping, stair climbing, squatting, kneeling or sitting for long hours with the knee bent. There is usually no swelling or warmth in the knee but there may be crepitus (grinding/grating noises) heard on moving the knee.

Physiotherapy for PFPS is aimed at reducing pain and correcting the contributing faults. Your physiotherapist will first conduct a thorough assessment to identify the causes your symptoms. For treatment, they may use tape, manual therapy and exercise therapy strengthen muscles around the hip and knee which will correct the alignment of the patella and reduce excessive load on the patella femoral joint.

They may also assess your functional activities (running, stair climbing etc) and teach you methods to correct any movement errors. It is important to perform proper exercises and to address any lower limb faults to prevent this condition from recurring or worsening. An orthotic to correct lower limb alignment may be helpful and your physiotherapist will advise you as necessary.