Patellofemoral Pain Syndrome

What Is PFPS?

Patellofemoral pain syndrome (PFPS) is pain at the front of the knee, around or behind the kneecap. It's caused by problems with how the kneecap (patella) moves in its groove on the thighbone. It's the most common knee problem, affecting 25% of the population.¹

Symptoms

• Dull, aching pain around/behind kneecap
• Pain with stairs (esp. down)
• Pain with squatting or kneeling
• "Movie theater sign" - pain after prolonged sitting
• Grinding or popping sensations
• Knee may give way

Contributing Factors²

• Weak quadriceps (esp. VMO)
• Weak hip abductors/external rotators
• Tight hamstrings or IT band
• Overuse/sudden training increase
• Flat feet or high arches
• Patellar malalignment

Treatment³

Exercise Therapy (Most Important)

• Quadriceps strengthening
• Hip strengthening (crucial)
• Stretching tight structures
• Gradual return to activity

Other Interventions

• Patellar taping (may help short-term)
• Knee brace
• Foot orthotics if indicated
• Activity modification

Prognosis

• Most improve with exercise program
• May take 6+ weeks
• Ongoing exercise important

References

1. Smith BE, Selfe J, Thacker D, et al. Incidence and prevalence of patellofemoral pain: a systematic review and meta-analysis. PLoS One. 2018;13(1):e0190892.
2. Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther. 2010;40(2):42-51.
3. Crossley KM, van Middelkoop M, Callaghan MJ, et al. Patellofemoral pain consensus statement. Br J Sports Med. 2016;50(14):839-843.