Patellofemoral Knee Pain

What is patellofemoral knee pain?

Patellofemoral pain is an umbrella term for pain in the front or anterior of the knee. This is an all too common issue for many people.

The patellofemoral joint is where the patella (knee cap) sits on the femur (thighbone). Proper tracking of the knee cap requires balanced forces. If the force of the quadriceps muscle is excessively strong or tight, it can create abnormal stresses along the facet joints of the patella.

Opposite forces in the form of very tight hamstrings can cause the quad activity to reach terminal knee extension before the foot hits the ground when walking. When this happens the quad does not get to rest during the swing phase of gait. This leads to overuse and eventual knee pain.

Excessive activity can also overload the patellofemoral joint.

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This often occurs when activity is increased, such as training for a race, where there is constant and repetitive stress placed on the knee. Normal tissue homeostasis is disturbed and inflammation results. Some people report a clicking or catching of the knee. Symptoms can be exacerbated with activities like squats or stair climbs, where there are increased compression loads.

Patellofemoral pain can be caused by any of these factors:

  • Compression: Tight iliotibial band (IT-band) and retinaculum, laterally tilted

    patella, decreased medial glide. Instability is caused by a hyper mobile patella.

  • Instability: caused by a hyper mobile patella.

  • Biomechanical dysfunction: excessive foot pronation, excessive femoral

    internal rotation, muscle imbalances, and limb length discrepancy

  • Trauma: from a fall or sudden, unexpected impact

  • Overuse: Excessive training or daily repetitive movement

  • Soft tissue lesions: include bursitis, fat pad syndrome, place syndrome, and patellar tendon injuries.

  • Osteochondritis, and less common conditions.

What can be done to help/treat patellofemoral knee pain?

First, get a diagnosis. A qualified physical therapist can help determine the possible cause. Only after that can a proper course of action be taken, including: strengthening exercises, stretching exercises, hip bracing, knee taping, possibly orthotics, and the treatment of trigger points in hip abductors. There is a lot of research that shows strengthening, specific exercise, and mobility can help reduce and often eliminate patellofemoral knee pain.

If you are experiencing symptoms and looking for relief, contact me … Christine Miller (DPT, OCS, CSCS) at … For more information or to set up a consultation, visit my website