Patellofemoral pain syndrome is one of the most common causes of pain at the front of the knee. It is sometimes called runner's knee, anterior knee pain or chondromalacia patellae. It is common in both men and women and can affect one or both knees.

What are the symptoms of patellofemoral pain syndrome?

There is often a gradual onset of patellofemoral pain. The pain varies and may be dull and aching, or sharp and shooting.

Common symptoms include:

  • Pain at the front of the knee, around and behind your kneecap
  • Worsening pain during or after increased activity or exercise
  • Pain after prolonged sitting
  • Pain going up and down stairs
  • Some people get a clicking or grinding noise when they bend or straighten the knee. This is not causing damage to your knee joint and it is important to keep moving to improve your symptoms.

What causes patellofemoral pain syndrome?

There can be many different factors that cause patellofemoral pain which vary from person to person. These may change the biomechanics of your leg (or the way your leg 'lines up' and moves in certain activities) and the way your kneecap glides.

These often include:

  • Muscle tightness or weakness around your hip and knee
  • Poor foot posture
  • Sudden changes to exercise or training programmes
  • Being overweight

How is it diagnosed?

Diagnosis is usually made from the patient's history and a simple examination without the need for further investigations. 

How can I manage patellofemoral pain syndrome?

There is self-management advice provided below to help minimise symptoms and facilitate the healing process:

Pain relief

Painkillers such as paracetamol and ibuprofen or anti-inflammatory gels may be helpful to control the pain and allow you to continue exercising. Discuss this with your GP or pharmacist.

Exercise

Exercise has been shown to be key in managing patellofemoral pain effectively. Basic exercises in lying or sitting may be helpful at first to help build muscle strength and function without causing discomfort. Then as pain allows exercising in standing postures helps to build strength in a way that mimics everyday activities.

It may take up to 12 weeks of exercise rehabilitation to make a significant improvement in the knee symptoms but you should see some gradual improvements along the way.

Patellofemoral pain syndrome exercise leaflet

Further management options

If there is no response to the self-management information above within four to six weeks, seek further advice from your physiotherapist or GP.  

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