Picture this: You are working out at your favorite CrossFit class, and the WOD (“workout of the day”) includes box jumps. You jump onto the box, and OUCH! Your knee gives that painful twinge that you have come to associate with jumping. What could it be?
It could be Patellofemoral Pain Syndrome (PFPS). Patellofemoral pain syndrome is a broad term used to describe pain in the front of the knee and around the patella, or kneecap. It is often called “runner’s knee” or “jumper’s knee” because it is common in people who engage in sports and high-impact exercises. Although it is not exclusive to athletes, Patellofemoral Pain Syndrome can make it difficult to climb stairs, kneel, and perform other everyday activities for anyone who has it. To help you understand this common issue, the experts at Southlake Orthopaedics have created this comprehensive guide to clarify what PFPS is, why it occurs, the symptoms of PFPS, and the available treatment options for it.
So, what exactly is PFPS?
First, to understand Patellofemoral Pain Syndrome, you have to understand the anatomy of the knee. Think of the kneecap like a train that is supposed to run smoothly in a groove at the end of the thighbone when a person bends or straightens their leg. This smooth movement is helped by slippery cartilage on the back of the kneecap and in that groove. There are also cushiony pads called menisci between the thighbone and shinbone that act like shock absorbers, though they do not directly cushion the kneecap. When things are not moving quite right, or if the cartilage under the kneecap gets rough, it can irritate the tissues around the kneecap, like the tendons, the fat pad underneath, and the lining of the knee joint. Even though the damaged cartilage itself does not have nerves to feel pain, it can cause swelling and can lead to pain in the nearby sensitive areas.
How does PFPS occur?
There is a reason that Patellofemoral Pain Syndrome is known as “runner’s knee.” Overdoing activities like running, squatting, or stair climbing, or suddenly increasing the intensity or frequency of exercise, can overload the knee joint. Additionally, improper training methods or gear, and even changes in footwear or usual playing surfaces, can contribute to the condition. Another reason PFPS occurs is patellar malalignment, where the kneecap does not track smoothly within its groove. This poor tracking can be caused by leg alignment issues from the hips down to the ankles, leading the kneecap to shift too far inward, outward, or ride too high. Weak or imbalanced thigh muscles (quadriceps) and hip muscles, which are crucial for stabilizing the kneecap during movement, can also result in this abnormal tracking, causing increased pressure and irritation of the soft tissues around the kneecap.
What are the symptoms of PFPS?
The most common symptom of Patellofemoral Pain Syndrome is a dull, achy pain right in front of the knee or behind the kneecap. This pain comes on very gradually and is more noticeable during high-impact activities like exercise. This discomfort tends to worsen during actions that require repetitive knee bending, such as squatting, kneeling, climbing stairs, or running. Another frequent symptom is the onset of pain after prolonged periods of sitting with the knees bent, like during a long car ride or sitting on the couch for a long period with the legs crossed. Some individuals may also notice sensations of popping, grinding, or clicking within the knee joint, especially when standing up or climbing stairs.
What are treatment options for PFPS?
Thankfully, Patellofemoral Pain Syndrome can usually be treated with at-home methods. Simply stopping the activity causing the knee pain and switching to a lower-impact activity can reduce PFPS symptoms. Utilizing the RICE Method (which stands for rest, ice, compression, and elevation) can help relieve the immediate symptoms of PFPS, as can taking an over-the-counter medication such as ibuprofen.
However, if the pain associated with PFPS does not go away with rest and changes to activity, visiting an orthopedic specialist is the right move. Your orthopedist may fit you with a patellofemoral tracking brace or recommend physical therapy that will help you improve range of motion, strength, and endurance to address the root cause of PFPS. A typical treatment plan is bracing and physical therapy, possible knee injection, and prescribing medication (NSAIDS). Finally, an orthopedic specialist might even recommend surgery if a conservative approach does not work, although this is rare. Surgery in the case of PFPS may include arthroscopy with debridement, which is removing damaged articular cartilage from the surface of the patella; lateral release, which is a procedure that can loosen the tissue and correct the patellar malalignment; or tibial tubercle transfer, which allows for better tracking of the kneecap in the trochlear groove by moving the patellar tendon along with a portion of the tibial tubercle.
Knee pain relief via Southlake Orthopaedics
If you find yourself dealing with knee pain, the specialists at Southlake Orthopaedics are here to help you discover a solution. Our dedicated Sports Medicine team is committed to providing care that’s as unique as you are. Right from the start, you can expect a detailed evaluation, where our team will listen carefully and may use imaging or tests to get a clear picture of what is happening to your knee. From there, we will create a treatment plan specifically for you, drawing from several advanced options to get you back to doing the activities you love. Take the first step toward stopping your knee pain by contacting Southlake Orthopaedics today.
