Patellofemoral pain

• Patellofemoral pain:

  • Also called - anterior knee pain or runners knee
  • Common knee condition that causes pain at the front of the knee around the patellofemoral joint
  • Most commonly presents in teenage years or in young adulthood but can occur in active people of any age
  • It is the most common overuse injury affecting the leg
• Causes:

  • Overuse - new/increased intensity of activity
  • Muscle tightness or weakness around hip and knee
  • Injury to knee
  • Unsupportive footwear
  • Occupations with frequent/prolonged kneeling
  • Obesity
• Symptoms:

  • Anterior knee pain, often behind the patella that is:
  • Diffuse and aching (can become sharper)
  • Gradual in onset
  • Aggravated by ascending or descending stairs, squatting, running
  • Some people may report a sensation of giving way but this is not true instability which occurs in meniscal or ligament injury
  • There may be reported crepitus and/or stiffness
• Diagnosis:

  • No definitive clinical test for diagnosis
  • Best test is anterior knee pain reproduced by squatting
  • May be tenderness when palpating the patellar edges
  • Diagnosis is clinical and based on the typical history, reproduction of pain on squatting and exclusion of other pathology
• Management:

  • Mostly consists of exercise and lifestyle changes - surgery is rare
  • Modify activity - less intense
  • Physiotherapy
  • Wear supportive shoes
  • Weight management
  • Analgesia - paracetamol and NSAIDs
• Prognosis:

  • recent studies suggest that over 50% of people still report pain and difficulties with their knees 5-8 years after physiotherapy treatment