Joint, Ligament and Muscle Disorders

Patellofemoral Pain Syndrome (Runner's Knee)

Anatomy

The kneecap (patella) connects muscles in the front of the thigh to the shinbone (tibia). As you bend or straighten a leg, the kneecap is pulled up or down. This movement of the kneecap is accommodated by a V-shaped notch (femoral groove) at one end of the thighbone (femur). The medial patella femoral ligament (MPFL)—located on the inside (medial side) of the knee—helps hold the kneecap in place and stop it from sliding/popping off of the outer side (lateral side) of the knee.

Description

Patellofemoral pain syndrome is a broad term used to describe pain in the front of the knee and around the kneecap. Although it can occur in nonathletes, patellofemoral pain syndrome is sometimes called "runner's knee" or "jumper's knee" because it is most common in people who participate in sports—particularly females and young adults.

Symptoms

Common symptoms of patellofemoral pain syndrome include:

• Pain after sitting for long periods of time with knees bent, such as in a movie theater or when traveling on an airplane.
• Pain related to a change in activity level or intensity, playing surface or equipment.
• Popping or crackling sounds in the knee when climbing stairs or standing up after prolonged sitting.

Nonsurgical Treatment

Your doctor may recommend one or more of the following nonsurgical treatments:

• Activity changes—Modify your daily routine to avoid activities that cause or aggravate symptoms.
• RICE (Rest, Ice, Compression, Elevation)—Use of the RICE method may help relieve discomfort.
• Nonsteroidal anti-inflammatory medication (NSAIDs)—Drugs such as ibuprofen or naproxen may help reduce swelling and relieve pain. Most people are familiar with nonprescription NSAIDs such as aspirin and ibuprofen, however, whether using over-the-counter or prescription strength, they must be used carefully. Using these medications for more than one month should be reviewed with your primary care physician. If you develop acid reflux or stomach pains while taking an anti-inflammatory, be sure to talk to your doctor.
• Physical therapy exercises—Your physician may prescribe specific exercises, or a knee conditioning program to help you improve strength, endurance and range of motion. It is especially important to focus on strengthening and stretching the quadriceps because these muscles are the main stabilizers of the kneecap. Core exercises may also be recommended to strengthen muscles in the abdomen and lower back.
• Orthotics—Using shoe inserts can take stress off of the lower leg by helping to align and stabilize the foot and ankle. They can be custom-made for your foot, or choose from the standard types that are available for purchase at many retail stores.