Patellofemoral Pain Syndrome (PFPS)

10 Dec 2018 Physical Therapy


What is Patellofemoral Pain Syndrome (PFPS)?

PFPS is one of the most common causes of chronic knee pain. It is most common among young athletes, runners, bicyclists and less-active teenage females. However, anyone is at risk, especially those who tend to be more “knock-kneed” or overweight. It occurs when the outside of your hips are weaker than the inside of your hips and the front of your thighs. This muscle imbalance causes the knees to come together more than they should.

What are some of the symptoms of Patellofemoral Pain Syndrome (PFPS)?

Usually, pain is on the front of the knee, around and behind the kneecap. Sometimes there is popping and crackling, and in severe cases the knee may buckle. Chronic PFPS may lead to patellofemoral osteoarthritis

Symptoms are triggered by activities that load the knee-cap such as:

  • Going Up/Down stairs
  • Jumping
  • Running
  • Squatting
  • Prolonged sitting with the knees bent

What can I do to help resolve or prevent Patellofemoral Pain Syndrome?

  • Strengthen your hips! Your side hip muscles, called the abductors and external rotators are part of your glute muscles. These muscles balance your knee joint angle, bringing the knees out to reduce the pull of your inner leg muscles on your kneecap, which reduces pressure on the knee joint. These muscles also help stabilize your trunk when you walk and help with balance and strength on one leg, such as when you run, go up/down stairs, and jump during sports. Keeping them strong will help you rise from a chair, assist with climbing stairs, and help you walk faster. Exercises such as single leg balance and squatting, walking sideways with resistance bands, side-lying leg raises, or side planks can all help engage these muscles. Squatting by sending your hips far back and keeping the toes turned out with a wide stance target the side glute muscles as well.
  • Strengthen your front leg muscles! Your front thigh muscle, the quadriceps, help to decrease load and absorb forces through the knee joint. Work on strengthening the quadriceps by exercises such as squatting, lunging, leg press, straight leg raises, forward planks, terminal knee extensions, and step-ups are just a few ideas.
  • If you are overweight, trim off the fat! Focus on shedding excess weight with healthy eating choices and exercise. When walking, the forces going through your knee can be at least 1.5 times your body weight on even ground. So losing a few pounds can greatly help decrease the compression forces, and pain, in your knee.
  • Wear good shoes! Shoes that are worn down, don’t fit well or that aren’t supportive increase the stress to your knees. Pick up your shoe and look at the bottom of it. If one area is really worn down than other parts, consider it time to invest in a new pair of shoes to help your foot hit the ground evenly again. When your feet turn in towards each other, it changes the angle of your knees to come in together more, causing PFPS.
  • Warm up! Before doing more aggressive activities, warm up your body for 5-10 minutes to increase blood supply to your muscles. You are less likely to cause injury when muscles are more pliable and warm.
  • Plyometrics! Once your hips and thighs are strong enough, you can move into higher level activities such as jumping/hopping exercises called plyometrics.
  • Strengthen your core! Slowly stepping up and down a high step with mindful control, or holding a plank on elbows and toes are all great for strengthening both the core and hips.
  • Watch yourself! Using a mirror is helpful to ensure your knees are aligned properly because good form is key to strengthen the hips and thighs properly.
  • Ice! Ice your knees 15 minutes after activity to reduce the onset of inflammation that could lead to pain.