Sports Medicine: Patellofemoral Pain Syndrome (PFS)

Patellofemoral Pain Syndrome (PFS) is pain in the knee due to increased pressure between the kneecap (patella) and the thigh bone (femur). Usually a result of poor alignment or sudden growth spurts, this pain may also come from an injury to the knee. The patella sits in a groove (trochlea) of the thigh bone and moves up and down as the leg bends and straightens. Pain can result when the kneecap moves side to side.

Signs and Symptoms

• pain around or underneath the kneecap
• pain that gets worse with standing or sitting for long periods
• pain when jumping, running, squatting or climbing stairs
• usually achy pain but it can also be sharp
• the knee feels like it gives way or catches

Increased Risk

• tight or weak muscles in the leg and hip
• poor warm-up before activity
• flat feet
• sports that involve running, jumping or squatting
• poorly formed trochlea at birth
• recent growth spurt

Treatment

• Medicine
  • Anti-inflammatory medicines, such as ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) may be recommended. Take these as directed by your health care provider.
  • Other minor pain relivers, such as acetaminophen (Tylenol®), may be used.
• Use of cold and heat
  • Cold should be applied for 10 to 15 minutes every 2 to 3 hours and after any activity that makes symptoms worse. Use ice packs or an ice massage.
  • Heat should not be used on a new injury but may be used before doing stretching and strengthening activities prescribed by your health care provider or athletic trainer. Use a heat pack or a warm soak. Apply for 10 to 15 minutes.
• Rehab
  • Rehab exercises to improve strength and flexibility in the hip and leg are helpful to improve pain and function. These are often done under supervision of a physical therapist or athletic trainer.
• Orthopedic aids
  • A brace may be recommended to help the kneecap track properly.
  • An arch support (orthotic) may be recommended for those with flat feet.

How to Prevent

• Do correct warm-up and stretching before practice or competition and use proper technique.
• Gradually increase training intensity.
• Maintain thigh, knee and lower leg flexibility, conditioning, muscle strength and endurance.
• Wear arch supports if you have flat feet.

When to Call the Health Care Provider

Call your health care provider or the Sports Medicine team at 614-355-6000 if:

• symptoms get worse or do not improve after 6 to 8 weeks despite treatment
• new, unexplained systems develop 

Sports Medicine: Patellofemoral Pain Syndrome (PFS) (PDF)

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