Definition of Patellofemoral Syndrome

Patellofemoral syndrome is Pain at or around the patella (kneecap) that often is worse when walking or running downhill or going down steps.

Many people also experience the same kind of pain when sitting with the knees bent for a prolonged time. Doctors believe patellofemoral syndrome results from a combination of factors that include anatomy (individual variations in the structure of the knee), biomechanics (the function of the knee), and the kinds of activities the person conducts.

The more inactive an individual is, the more likely he or she is to develop patellofemoral syndrome. However, most doctors do not believe this condition is one of overuse. Some experts believe an imbalance of strength among the four parts of the quadriceps permits dysfunctional tracking of the patella, contributing to the syndrome.

Most athletic activities that use the quadriceps, such as running and bicycling, strengthen the lateral (outer) muscles more than the medial, pulling the patella off track.

Symptoms and Diagnostic Path

The main symptom of patellofemoral syndrome is pain going down steps or downhill and when sitting for long periods of time with the knees bent (flexed). The characteristic and specific nature of these symptoms allow the doctor to make a straightforward clinical diagnosis. X-rays and other diagnostic imaging procedures are not necessary unless there is reason to suspect another reason for the symptoms.

Treatment Options and Outlook

Treatment often combines one of the nonsteroidal anti-inflammatory drugs (NSAIDS) to relieve inflammation and pain with physical therapy to strengthen the quadriceps, particularly the medial (inner) muscles of this group. Most people experience relief from this treatment approach within two weeks and can return to their regular activities, including most sports, in four to six weeks.

Risk Factors and Preventive Measures

Women, particularly those in their late teens and early 20s who are inactive, are more likely than men to develop patellofemoral syndrome. Researchers do not know why this is. Exercises to maintain balanced strength in the quadriceps muscle appears to prevent further occurrences of symptoms.

A soft knee brace that holds the patella in position may also help maintain proper tracking of the patella. Some athletic trainers advocate wrapping or taping the knee before participation in an athletic event, which accomplishes a similar purpose.

See also KNEE INJURIES.

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