An Overview of Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is a common knee injury that most often affects runners and athletes involved in jumping activities. It also occurs in the senior athlete whose bones and ligaments have become weaker through sporting injuries and wear and tear over a long period of time.

Structural alignment, muscular weakness in the knee, imbalance, overuse, muscular tightness and “flat feet” are common causes of patellofemoral pain.  In the case of muscular weakness, this may cause the kneecap (patella) to place itself improperly on the thigh bone (femur).  All of these knee conditions lead to pain around the kneecap.  This pain tends to worsen with activity (e.g. going downstairs) and it may also create pain in the kneecap during periods of inactivity. This intense, dull, aching knee pain may occur in one or both knees.

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Other terms for patellofemoral pain are: retropatellar (behind the kneecap) pain, peripatellar (next to the kneecap) pain, anterior (in front of the kneecap) knee pain, and “runner’s knee.”

Different disorders that cause pain around the kneecap include:

  • Infrapatellar tendonitis: this is known as “jumpers knee” and affects the tendon just below the kneecap
  • Chondromalacia patella: This affects the tendon attachment just above the patella and involves damage to the cartilage surface of the patella
  • Plica syndrome: This occurs when tissues within the knee joint become inflamed and/or stiff, causing pain and tightness in the joint

Symptoms of Patellofemoral Pain Syndrome

Symptoms of patellofemoral pain syndrome include an intense, dull, aching pain, in and around the kneecap. Running down stairs, squatting, and standing after sitting for a long period of time with the knees bent will all cause generalized dull kneecap pain associated with this condition. Swelling of the knee may exist and a crackling noise coming from the knee may also occur during movement.

Treatment for Patellofemoral Pain Syndrome


Despite all of the variables that might cause the pain surrounding patellofemoral pain syndrome, there are some things patients can do to ease the symptoms.   Here are some recommendations:

  • Get plenty of rest
  • Consider switching to non-impact exercise, such as swimming, that will be less stressful on your knee and will allow it heal, while still maintaining your physical health
  • Wear high quality, shock-absorbed running shoes
  • Icing the knees after exercise
  • Taking anti-inflammatory pain medication for swelling and pain relief
  • Seek physical therapy


When conservative treatment and therapy has failed to relieve and alleviate symptoms associated with this knee injury, surgery can be considered.  Dr. Millett will perform arthroscopic surgery to examine and treat the inside of the knee joint.  During the procedure, rough or frayed spots in the cartilage will be shaved and smoothed and plica (thin tissue that lines the joint) can be trimmed. The patella may also be realigned.  Arthroscopic knee surgery is performed on an out-patient basis.

To learn more about the common knee injury patellofemoral pain syndrome, please contact the practice of Dr. Peter Millett.

Are you experiencing symptoms of patellofemoral pain syndrome?

There are two ways to initiate a consultation with Dr. Millett:

You can provide current X-rays and/or MRIs for a clinical case review ($250).

You can schedule an office consultation with Dr. Millett.