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 sometimes called “runner’s knee” or “jumper’s knee” because it is common in people who participate in sports—particularly females and young adults—but patellofemoral pain syndrome can occur in non-athletes, as well. The pain and stiffness it causes can make it difficult to climb stairs, kneel down, and perform other everyday activities.
Many things may contribute to the development of patellofemoral pain syndrome. Problems with the alignment of the kneecap and overuse from vigorous athletics or training are often significant factors.
Symptoms are often relieved with conservative treatment, such as changes in activity levels, a therapeutic exercise program, and chiropractic care.
Different disorders that cause pain around the kneecap include:
- infrapatellar tendonitis (jumper’s knee), which affects the tendon just below the kneecap
- chondromalacia patella, which involves damage to the cartilage surface of the patella
- quadriceps tendonitis, which affects the tendon attachment above the patella
- plica syndrome, in which joint tissue becomes inflamed and/or stiff, causing pain and tightness in the jointWhat is patellofemoral pain syndrome and what can cause it
Repeated abrasion on any of the surfaces of the patella and femur stresses the soft tissues of the patellofemoral joint and may even lead to a bone bruise. In some cases, the pain is caused by a weakening of the articular cartilage and/or swelling within the joint.
One or more of the following factors can lead to patellofemoral pain:
- Overuse: the repetitive bending and straightening of the knee that occurs in running may lead to the disorder because of the increased pressure points between the patella and femur when the knee is bent. A constant bending motion, especially on the weighted leg, can irritate the patella and cause a bone bruise to form.
- Alignment: The quadriceps alignment between the hip and the knee (the Q angle) is thought to affect patellar tracking. Patients with a larger than normal Q angle (greater than 20 degrees) may be more susceptible to patellofemoral pain because the patella has a tendency to track more laterally (to the outside). Pain may be felt more on the outside of the patella and femur because of increased pressure on these contact areas. The Q angle of growing female athletes enlarges as the pelvis widens during the maturing process, increasing the risk for patellofemoral pain.
- Muscular weakness: A weakness or strength imbalance of the quadriceps muscles may alter the tracking of the patella.
- Muscular tightness: Tight muscles and tendons may also affect patellar tracking. The muscular structures that cause movement in the knee and hip must be flexible. If any one muscle or muscle group is tighter than the rest, patellar instability can occur.
- Flat feet (excessive foot pronation): Patients with little or no arch in the foot are also likely candidates for patellofemoral pain. As the foot rolls inward, the tibia compensates by rotating inward, disturbing the normal mechanics of the patellofemoral joint.
- A decrease in patellar mobility: the kneecap tightens, losing its normal ability to move in many directions
If you are suffering from any of these issues, please give our office a call at (317) 776-1061 and make an appointment. We can help you.