Ultimate Guide to Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome is one of the most common knee problems diagnosed by physiotherapists.

When I tell someone they have Patellofemoral Pain Syndrome they generally respond with the same three questions:

What is it?
Why do I have it?
How do I get better?

What is Patellofemoral Pain Syndrome?

At its source, Patellofemoral Pain Syndrome is an issue of friction. Let's break down the name to better understand it.

"Patello" refers to the bone called the Patella — you'll know it as the knee cap. "Femoral" refers to the long bone in your upper thigh called the femur. "Syndrome" refers to the fact that it is an issue with these two bones and the pain they are causing you.

Why Do I Have Patellofemoral Pain Syndrome?

There is no short and simple answer. But there are answers, and those answers begin with the knee.

As you bend and straighten your knee doing things like running, climbing stairs, or even walking, your kneecap slides up and down the femur along two distinct grooves.

Trouble arises when the kneecap does not follow those grooves as smoothly as it should.

Think about trying to drive your car straight ahead while your wheels are set at a slight angle. You aren't going to get where you want to go as quickly or as efficiently as you would expect — and you can expect to end up with issues with your tires and your alignment. Things will begin rubbing and creating unwanted friction.

That is what happens when your knee cap doesn't track correctly. It creates additional friction along the kneecap and causes you pain.

But Why Does My Kneecap Track Poorly?

This can be caused by a number of things. However, the most common reason is that your knee is turning inward towards the midline. When the knee falls in towards midline the femur falls inwards as well. This changes how the kneecap tracks along its groove and ends up causing issues.

And Why Does My Knee Track Inwards?

The simple answer? A bunch of stuff. For instance:

A stiff ankle can force the knee to fall inward.
Weak hip muscles lead to poor control of both the knee and the whole lower limb.
Tightness in the muscles that surround the kneecap — like the quads and the IT band — can also cause the knee to track inwards.

How Do I Get It Better?

Because there are so many potential underlying causes the first challenge is to figure out what to do first. As with any medical issue, the first thing to do is get checked out by a healthcare practitioner you trust to gain a proper diagnosis.

After you've figured out what is really the problem, you can figure out what to do to correct it. This means finding out which exercises are best for you and your condition — whether you're seeing a physiotherapist in person or working through a structured online program.

To get started, here are some basic exercises to help address the underlying issues:

Hip strength: Get started with some glute strengthening like the Pac Man drill.
Quad tightness: Tackling the tightness in the front of your quads can do wonders for the pressure on your kneecap. Try the quad grinder with a foam roller.

Who Should I See to Treat Patellofemoral Pain Syndrome?

A wide variety of healthcare providers can help you treat this issue. If possible, seeing a sports medicine physician is a great place to get accurately diagnosed — and for most of you this will be covered.

For those with private health coverage or who prefer a one-on-one experience, find a licensed physiotherapist or orthopedic specialist to get assessed and get started.

Conclusion

Patellofemoral Pain Syndrome occurs when your kneecap rubs on the bones below and starts causing pain. This can happen for a variety of reasons, but ultimately they all amount to the same thing: your knee is falling inwards and causing knee pain. The good news is that with the right diagnosis and the right exercises, it's very fixable.