Patellofemoral Pain Syndrome

Patellofemoral pain syndrome occurs when the patella (kneecap) cartilage becomes overloaded due to overuse (often caused by high-impact activities), or as a result of poor alignment. High-impact sports such as football, basketball, soccer, tennis, and running can aggravate the patella cartilage. In addition, running on uneven surfaces, like hills or trails, or playing on multiple surfaces (such as hard and clay courts in tennis) also may increase the likelihood of patellofemoral pain.

The most common symptom of patellofemoral pain syndrome is a dull ache underneath the kneecap while walking down stairs, squatting, or getting up after sitting for long periods of time. In addition, your knee may catch when bending, and you may experience a painful grating or creaking sensation.


A doctor will assess the injury by feeling the knee area. Because the kneecap is easily accessible, he or she can quickly test for pain and tenderness by moving your kneecap and checking how well it tracks as you flex and extend your leg. After this brief exam, your doctor will be able to tell whether your discomfort is due to patellofemoral pain syndrome or another knee problem. Your doctor may request x-rays and/or an MRI for a closer look at the knee.


The best way to treat patellofemoral pain syndrome is to rest and stay away from activities that cause you pain. Ice and anti-inflammatory drugs such as ibuprofen can be used to treat any swelling or pain that may occur. Knee braces or sleeves can be used to provide the knee with more support and help prevent the knee from buckling. Bracing the knee stabilizes the kneecap and helps prevent symptoms from worsening.

If none of these treatments is effective and your symptoms continue to worsen, surgery may be needed to correct malalignment of the patella.


It may not be possible to totally prevent the development of patellofemoral pain syndrome; however, there are steps you can take to reduce your risk and avoid making the syndrome worse.

These measures include:

  • Proper warming up before exercising as well as stretching pre- and post-activity
  • Varying the types of activities that you participate in, such as alternating between running and swimming
  • Taking care of injuries immediately, which includes obtaining adequate first aid as well as resting the injury until it is healed before resuming an activity

Rehabilitation Exercises

  • Quad sets: Sit with legs extended and fully contract the muscles of the front thighs. Hold contractions for 10 seconds. Repeat 10 times for three sets.
  • Straight leg raises (hip flexion): Lie with one leg extended and the other bent at the knee. Lift the entire leg from the hip so that the heel is about five inches above the floor. Hold this position for five to 10 seconds and then slowly lower the leg. Repeat 10 times for three sets.
  • Backward leg raise (hip extension): Lie on stomach with legs straight. Lift one leg as high as possible and hold for five to 10 seconds, then slowly lower the leg. Repeat 10 times for three sets.
  • Hip abduction: Lie on side of uninjured leg, so that the injured leg is on top of the uninjured leg. Lift the injured leg at the hip away from the body. Lift the leg as high as possible and hold for five to 10 seconds, then slowly lower the leg. Repeat 10 times for three sets.
  • Hip adduction: Lie on side of injured leg, with uninjured leg bent at the knee and foot flat on the floor. Lift the injured leg at the hip toward the other leg. Hold for five to 10 seconds and then slowly lower the leg. Repeat 10 times for three sets.
  • Half-knee bends: Stand with feet shoulder width apart. Slowly lower the body weight by bending the knees. Do not perform a full squat, but rather stop at about half of the full squat position and then fully extend the knees. If there is pain before achieving the half-squat position, stop downward travel at that point. Repeat 10 times for three sets.
Content on this page is for informational purposes only. If injured, please consult a physician.

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