Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS) is a prevalent issue affecting many individuals, characterized by discomfort around or behind the patella during activities involving knee flexion. As the most common cause of knee pain seen in outpatient settings, it is essential to understand its causes, symptoms, diagnosis, and management strategies.

Causes and Risk Factors:

PFPS arises from imbalances in the forces that control patellar tracking during knee movement, particularly when the joint is overloaded. Various factors contribute to its development, including overuse, trauma, muscle dysfunction, tight lateral restraints, patellar hypermobility, and poor quadriceps flexibility.

Symptoms:

Typical symptoms of PFPS include pain around or behind the patella, which is exacerbated by activities such as running and knee flexion.

Diagnosis:

Diagnosing PFPS involves a thorough examination of the knee, focusing on the patella and surrounding structures. While imaging studies are often unnecessary for initial treatment, they may be recommended for patients with specific risk factors, such as a history of trauma or surgery, effusion, or lack of improvement with conservative treatment (after ~6 weeks).

Treatment and Management:

Recent research has highlighted the effectiveness of physical therapy in treating PFPS. Comprehensive rehabilitation programs, including exercises to strengthen muscles and improve flexibility, are essential for successful management. Knee braces and nonsteroidal anti-inflammatory drugs (NSAIDs) have limited evidence supporting their routine use and may not be necessary for all patients. Surgery is rarely considered and often not recommended. 

Prevention:

Educating patients about modifying risk factors is crucial in preventing the recurrence of PFPS. This may include guidance on appropriate footwear, training techniques, and strategies to improve muscle strength and flexibility in the upper and lower leg.

In conclusion, PFPS is a common cause of knee pain that can significantly impact an individual's quality of life. By understanding its causes, recognizing its symptoms, and implementing appropriate management strategies, individuals can effectively manage PFPS and reduce the risk of recurrence. Working closely with healthcare professionals can provide personalized care and support throughout the treatment process.

Stay informed, stay active, and take steps to protect your knee health for a pain-free lifestyle.