From the Guidelines
Patellofemoral syndrome typically presents with gradual onset diffuse retropatellar and/or peripatellar pain during activities such as squatting, stair ambulation, and running, as reported in a 2024 study published in the British Journal of Sports Medicine 1.
Symptoms
The symptoms of patellofemoral syndrome include:
- Pain around or behind the kneecap that worsens with activities that load the knee joint
- A dull, aching pain that may be accompanied by grinding, popping, or clicking sensations in the knee
- A feeling of the knee "giving way" or instability
- Swelling, which is usually mild
- Difficulty fully straightening or bending the knee without discomfort
- Pain that is frequently worse after prolonged sitting or at the beginning of activity, and may improve somewhat during exercise before worsening again afterward
Contributing Factors
Contributing factors to patellofemoral syndrome include:
- Muscle imbalances, particularly weak quadriceps and hip muscles
- Overuse
- Improper footwear
- Anatomical variations
- Biomechanical issues, such as excessive pronation of the feet or increased Q-angle at the knee According to a 2024 study published in the British Journal of Sports Medicine, people with patellofemoral pain are six times more likely to be anxious or depressed, and are on average less physically active, and have poorer health-related quality of life than their asymptomatic peers 1.
Diagnosis and Management
A 2024 study published in the British Journal of Sports Medicine provides guidance on the diagnosis and management of patellofemoral pain, including the importance of delivering knee-targeted exercise therapy, with supportive interventions as required, and education that underpins all interventions, adjusted to reflect the needs of the person 1.
From the Research
Symptoms of Patellofemoral Syndrome
The symptoms of patellofemoral syndrome include:
- Pain behind or around the patella 2
- Crepitations, provoked by activities such as:
- Impaired function in daily activities or sports 2
- Anterior knee pain 2, 3
Diagnosis and Treatment
Diagnosis of patellofemoral pain syndrome can be made with a thorough assessment of clinical history and risk factors, and a comprehensive physical examination 3. Treatment options include:
- Quadriceps muscle exercises, which have been shown to be effective in treating patellofemoral syndrome 4, 5, 6
- Hip strengthening exercises, which may also be beneficial 5, 6
- Pharmacological treatments, such as non-steroidal anti-inflammatory drugs (NSAIDs) and glycosaminoglycan polysulphate, although the evidence for their effectiveness is limited 2