Patellofemoral pain syndrome – Runner’s knee

Quick Overview -Patellofemoral Pain Syndrome

What the Problem: Irritation in kneecap movement due to overuse, muscle imbalance, fatigue, etc. Runner’s knee is most common cause of anterior knee pain and the term is used to refer number of medical conditions.

Other Names: Patellofemoral pain syndrome and anterior knee pain syndrome

Knee Pain Location: Pain around the patella i.e. front region of Knee.

Common Causes: Bio-mechanical issue, injury, overuse, misalignment of patella, old shoes, foot problem/weak feet or ankles, weakness or tightness of muscles, etc.

Symptoms: Ache, pain in patella, popping sound (crepitus), grinding sensation, mild swelling and soreness.

Onset: Pain builds up gradually.

Treatment: Exercises, knee braces, sports orthotics, surgery (occasionally).

Exercises: knee strengthening exercises and stretches.

Recovery Period: 1 month – 6 months

Aggravating Activities: Repeated activities like running and climbing stairs.  Prolonged inactivity will also aggravate the pain.

Surgery Required: Rare

Braces Required: Yes

What is Patellofemoral Syndrome?


Patellofemoral pain syndrome (PFPS) or runner’s knee is distinguished by the pain causing owing to the contact of patella with femur. The epicenter of the pain is in the front (anterior) region of the knee. PFPS is one of the most misunderstood problems of all the knee pain conditions.

Since many other conditions also causes pain in the anterior region, it is commonly misdiagnosed with Chondromalacia patella, Iliotibial Band Syndrome or Patellar tendonitis. Athletes as well as non-athletes often complaint about runner’s knee.

What are Patellofemoral Pain Syndrome Symptoms? 

The main symptom of patellofemoral pain syndrome is pain around the kneecap, which will hinder your daily activities like sitting, running, squatting, hoping, jumping and stairs climbing. The worst scenario will be going down stairs, when you will feel intense pain. Prolonged sitting such as at cinema, journey, office or flight, can also trigger the pain and in order to get respite from the acute pain, straightening the legs will be the best relieving solution available for you at that moment. Squatting and kneeling will even exacerbate the condition and would cause the sensation of knee buckling wherein you will feel knee giving away or cannot hold your body weight, which is quite painful. The exact sensation will also caused during descending the stairs or skiing downhill.

The pain starts gradually upon increasing  the duration, frequency, or intensity of your daily activities such as runners trying to extend their usual distance or even when initiating a new activity. Sometimes, the ache will be followed with burning sensation with mild swelling. Popping sound (crepitus) and grinding sensation will also be felt during walking or moving your knees. Knee bending will also trigger the pain especially in case of weightlifting or any other jarring activities.

Rest the joint. Don’t run while it heals.


What are Patellofemoral Pain Syndrome Causes? 

The most common cause for patellofemoral patellofemoral-pain-syndrome-causespain syndrome is overuse or injury to knee during any sports or jarring activities. Misalignment of the knees also results in rubbing of patella rather than to glide over lower femur. Ignoring the above condition and continuing sporting activities will also cause runner’s knee and ever exacerbate the condition.

Weakness or tightness in muscles (muscle imbalance) on one side of knee will result in patella move to stronger side resulting in pain in patella.  Flat feet and hard shoes are also cause of PFPS. Prolonged repetitive activities will worsen the situation. Knee fractures, internal knee derangement, osteoarthritis of the knee (wear and tear) and bony tumors in or around the knee are also secondary causes of patellofemoral pain syndrome.


Healthcare professionals take complete medical history and physical examination on your knee. Some other diagnosis options for patellofemoral pain syndrome like X-rays, MRI, CT scan and blood test is carried out for accurate knee pain diagnosis.

Treatment Options:

There are many types of treatment for reducing patellofemoral pain syndrome but we will outline some of the best and effective treatments for patellafemoral pain syndrome, which are often recommended and practice by expert doctors.

  • Using the Rice Formula, which means rest, ice, compression and elevation.
    • Rest: Stop all the activities, which are causing or exacerbating the knee pain such as running or jumping.
    • Ice: Use ice-packs for short period of time i.e.10-20 minutes, several times a day.
    • Compression: Compression will reduce the swelling such as knee sleeves, elastic wraps, etc.
    • Elevation: Elevate your knee above the heart’s level using a pillow or folded towel.
  • Strengthening exercises: Strengthening the muscles around the knees, quad muscles and buttocks will improve the movement of patella.
  • Knee Stretches: Stretching will help loosen the tight muscles of leg but it will be uncomfortable. However, slowly carry on because the pain will stop immediately because according to research studies, it has been proven time after time that stretching exercises decrease knee pain and reduce the probability of knee injury.
  • Knee Braces: Knee braces provide much needed joint stability and helps in proper alignment of the patella. It will keep the patella to correctly sit in the groove on the femu
  • Orthotics: Orthotics are arch-supporting insoles that changes the biomechanical issues of the foot such as flat feet. They can provide much needed relief from the knee pain especially in patella in a number of ways.  They accurately distributes and reduces the force through the foot and ankle and also, change the alignment of the foot and ankle.patellofemoral-pain-syndrome-recovery
  • Avoiding Prolonged repetitive activities or inactivity: Stop or reduce all the repetitive activities which are causing pain. Try to take short intervals at work by straightening leg or taking a short walk.
  • Painkillers: Aspirin, advil, aproxen or ibuprofen can reduce the patellofemoral pain and swelling but consult your doctor prior to any medications.
  • Surgeries: If the condition is acute, then doctors may recommend surgery, but it is very rare. Anthroscopy and realignment surgeries are conducted for treating patellofemoral pain syndrome effectively.

Recovery Process:

The complete recovery may take 1 month to 6 months for effective treatment from patellofemoral pain syndrome. After the successful recovery, don’t try to quickly start your sporting activities, instead start fresh at slow pace. Many athletes switch to swimming, which doesn’t put stress on the knees for being in shape.


Always stay in good shape. If you are overweight, try reducing extra weight. Always do 5 minute warm up and stretching exercise before any activity. After the recovery, don’t suddenly increase the training. Using proper running gear like shoes and shoe insert will also prevent patellofemoral pain syndrome.


The outcome of the treatment of patellofemoral pain syndrome is quite good. You will  be on the path of recovery in about 6 weeks.