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In the News, Sports Medicine | Mar 14, 2019

Pain in front of the knee and around the kneecap is very common, but often ignored for far too long among young athletes, particularly female sports enthusiasts. Knowing how to recognize when pain and stiffness is caused by an underlying serious injury and where to seek help can prevent serious damage to the knee joint.

What is PFPS?

Patellofemoral Pain Syndrome, or PFPS, is a broad term that is normally used to describe pain around the kneecap (patella) and in the front of the knee. Common terms related to PFPS are “runner’s knee” or “jumper’s knee” because this type of pain is often seen in athletes, but patellofemoral pain syndrome can also present in non-athletic people and in seniors. PFPS can make it difficult to walk on uneven terrain, to climb stairs, to crouch or kneel down, and do many other common daily activities.  

What Causes Injuries to the Kneecap?

Many different activities can contribute to the development of patellofemoral pain syndrome. In most cases, it is repetitive motion, but the condition can be aggravated by improper footwear, uneven running or sports playing surfaces, misalignment of the bones of the leg, tendon issues, or one set of leg muscles being overdeveloped and others being weaker. All of these scenarios can put strain on and around the kneecap. So can direct impact trauma, such as falling hard directly on the point of the knee, or being hit by a ball, foot, or leg of another player directly in the front of the knee.

Anatomy of the Knee

The lower end of the femur (thighbone) and the upper end of the tibia (shinbone) meet at the knee joint, behind the patella (kneecap). Tendons and ligaments connect the two bones, while cartilage and synovium, a thin lining of tissue that produces a small amount of fluid as lubricant, protect the patella. As the knee bends and straightens, the patella slides back and forth in the groove of the femur.

Patellofemoral Pain Syndrome

In most cases, PFPS is initially caused by an injury to the kneecap, or by overuse / repetitive motions, such as are common in many sports. If cartilage damage occurs around the knee joint, the synovium can become inflamed and produce excess fluid beneath the patella, causing pressure and pain in the surrounding bone. Cartilage damage is most commonly caused by repeated stress on the knee, such as is caused by jogging, running, jumping, and stair climbing. The patella can also be pushed out of alignment, so it grinds against one side or the other of the femoral groove, causing the interior of the joint to become inflamed and painful.  

Treatment for PFPS

For severe or long term knee pain, an orthopaedist or a sports medicine doctor should be consulted. They may recommend R.I.C.E. (rest, ice, compression and elevation), physical therapy, alternative treatments to relieve pain and assist healing, or arthroscopic surgery to debride the interior of the knee joint and remove pressure.

Dr. Strasburger can help determine if your knee pain is related to patellofemoral pain syndrome and create a treatment plan.