Patellofemoral Pain

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Patellofemoral Pain is a common knee problem. If you have this condition, you feel pain under and around your kneecap. The pain can get worse when you're active or when you sit for a long time. You can have the pain in one or both knees.

The pain usually is located in the section of your patellar tendon between your kneecap (patella) and the area where the tendon attaches to your shinbone. During physical activity, the pain may feel sharp — especially when running or jumping. After a workout or practice, the pain may persist as a dull ache.

The pain in your knee may:

  • Initially be present only as you begin physical activity or just after an intense workout
  • Increase as you step up the intensity of your activity
  • Progress to be present before, during and after physical activity
  • Make going up and down stairs painful
  • Become a constant ache that can make it difficult to sleep at night

  • Although many active people notice symptoms when starting new activities or increasing their level of intensity, especially with respect to high-impact sports, non-active people can suffer patellofemoral pain during routine daily activities as well.

    While the exact cause of patellofemoral pain isn't known, it likely has something to do with the way the patella tracks along the groove of the femur. The patella can move up and down, side to side in the groove, as well as tilt and rotate. All this movement means that the patella can have contact with many of the articular surfaces of the knee depending upon a variety of factors such as muscle strength and balance, overuse, and incorrect tracking. It also means that the cause of the pain may be from a variety of different factors.

    Usually, putting ice on your knee, changing your activities, and following a physical therapy program works best. This type of program may include exercises to make your muscles stronger and more flexible. Taping the knee or using show insoles can be helpful for some people. It may take weeks or months of treatment for the pain to go away.
  • Take a break from physical activity that causes a lot of pounding on your legs, such as running, volleyball or basketball. If you want to keep exercising, try swimming or another low-impact activity. You may want to try working out on nonimpact elliptical trainers, which are popular at gyms. Because these machines support your body weight, they put less stress on your knees. As your knees feel better, you can go back to your normal sports. But do this slowly, increasing the amount of time you do the sports activity a little at a time.
  • The exercises shown in this handout can help strengthen your muscles and relieve your pain. Each exercise should take a few minutes. Doing them twice a day is a good start. Your doctor will tell you which exercises are right for you. The first 2 are usually the most important ones. These 2 exercises make your front thigh muscles ("quads") stronger. This is important because your quad muscles control the movement of your kneecap.
  • Talk to your doctor about footwear. It may help to bring your shoes in for the doctor to see. Proper walking or running shoes can help knee pain. Even a simple arch support insert from a shoe store can be helpful. This insert is less expensive than a custom-made support or brace.
  • Ice your knees for 10 to 20 minutes after activity. This can ease the pain and speed up healing. To keep your hands free, use an elastic wrap to hold the ice pack in place. A medicine such as ibuprofen (one brand name: Motrin) may also help relieve your pain, but talk to your doctor before you take this medicine.

  • If there isn't enough relief from patellofemoral pain after 3 or 4 weeks, call your doctor.


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