Patellofemoral pain syndrome (PFPS) is anterior knee pain seen most commonly in two age groups, teenagers and 30-40’s. In the adolescent, there are two distinct groups which get PFPS: active athletes especially those involved in jumping and kneeling activities, and non-athletic, inactive, often overweight adolescents, most commonly girls. The cause of this non-traumatic knee pain is unknown, but appears to be multifactorial.

What are some of the symptoms that go along with PFPS?
During the history, the patient will complain of poorly localized anterior knee pain that moves around the patella (kneecap). They will complain of increased pain with sitting (theater sign), going up and down stairs, and with increased activity. They will sometimes complain of giving way and swelling which is more “puffiness” than really being very swollen. The pain can be waxing and waning, and as such, this pain has usually been present for a long time before the patient seeks medical care.

What is the physical examination like?
The physical examination may involve the entire limb of the patient from the hip to the ankle. It is necessary that the patient be appropriately clothed in shorts, not pants with the leg rolled up, so that the physician can accurately assess the entire lower extremity.

Will x-rays be taken?
Depending on the history and the physical examination, x-rays may be taken. Other tests like a CT scan or MRI are usually not necessary.

What is the treatment?
The treatment for PFPS involves a course of non-steroidal anti-inflammatory medicine and physical therapy specifically geared toward PFPS. This means that the patient has to go to physical therapy and do the exercises very reliably. The patient must be an active participant in the treatment program. In order to successfully treat PFPS an aggressive daily home exercise program in addition to outpatient physical therapy 1-2 times a week is required. The longer that the pain has been present, the longer it will take to get rid of the pain. Sometimes your doctor will prescribe a brace that may make physical therapy and some activities easier. Also, specific orthotics may be necessary in some patients.
Continuing to be active in sports and physical education is encouraged but coaches and PE instructors must be aware of the ongoing therapy program and the patient’s limits.