Synonyms for patellofemoral syndrome

• Patellofemoral syndrome
• Runner's knee

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What is patellofemoral syndrome?

There is no clear definition of patellofemoral syndrome. It occurs when there is an overload between the femur and the patella due to a compression effect, which leads to irritation of this joint.

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What is the kneecap?

It's a bone called a 'sesamoid' because the bone is located within a tendon. The patella is located in front of our knee. Its main role is to allow our quadriceps tendon to have a greater lever arm for making knee movements. The patella, therefore, acts as a pulley for our quadriceps and allows our quadriceps to have more strength.

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What is the femur?

It's the large bone in the thigh.

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What are the causes of patellofemoral syndrome?

Patellofemoral syndrome is caused by an overload on the structures in front of the knee (the patella and the patellar tendon).

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"In other words, if we put more stress on our knee than it is used to receiving, we can develop patellofemoral syndrome."

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Here are some classic examples of developing patellofemoral syndrome:

• Going on a full day of mountain hiking when you are not trained for it
• Starting our running or cycling season without pacing the progression (or rapidly increasing the volume of running training)
• Starting a new sport that requires jumping or running without pacing the progression (soccer, basketball, volleyball)

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What are the risk factors for developing patellofemoral syndrome?

Here are some elements that are risk factors:

• Boys are more affected than girls.
• Having a significant and sudden growth spurt.
• Participating in sports with repetitive jumping or sprinting.

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What are the symptoms of patellofemoral syndrome?

The most common symptoms are:

• Pain in the front of the knee that can also be behind or around the patella
• The pain generally appears gradually, without a specific cause reported by the patient.
• The pain may be increased by:
  
  • Doing a squat
  • Going up or down stairs
  • Running
  • Walking
  • Jumping
  • Sitting for long periods

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Note that the pain is often diffuse and difficult to pinpoint.

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How is patellofemoral syndrome diagnosed?

Diagnosis is possible based on the history of symptoms and a clinical examination. X-rays cannot detect patellofemoral syndrome.

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When should you see a physiotherapist for patellofemoral syndrome?

You should consult a physiotherapist if you have symptoms as described above or if your doctor has already ruled out any other cause that may be responsible for your pain.

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You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

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What physiotherapy treatments are available for patellofemoral syndrome?

Your physiotherapist will perform an evaluation to determine the cause of your patellofemoral syndrome and will assess the following elements:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your strength and stability

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Based on the assessment results, your physiotherapist will:

• Mobilize your knee to reduce pain and improve your movement
• Give you specific exercises to retrain the control of your knee movements.
• Give you exercises to regain mobility, reduce pain and regain your muscle strength.
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your posture and movements.

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What can you do at home for patellofemoral syndrome?

Temporarily stop doing movements that cause too much pain, and then gradually start doing them again.

Here are some tips that may help:

• Engage in transfer activities that reduce stress on the area, such as swimming or pain-free cycling.
• Do strengthening exercises for your glutes.
• Wear a knee brace or compressive bandage temporarily for painful activities.

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If you don't see any improvement after 10 days, you should consult a physiotherapist.

If you are a runner, please refer to the blog article on running (link to come) for concrete tips for running.

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‍To learn more…

You can listen to the podcast PARLE-MOI DE SANTÉ created by one of our physiotherapists, Alexis Gougeon.

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Episode #1 discusses the prevention and treatment of running injuries.

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Find the episode on YouTube:

Click below to listen to episodes on podcast platforms:

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Sources

• Gaitonde DY, Ericksen A, Robbins RC. Patellofemoral Pain Syndrome. American Family Physician. 2019 Jan 15;99(2):88-94.
• Bump JM, Lewis L. Patellofemoral Syndrome. InStatPearls [Internet] 2020 May 24. StatPearls Publishing.
• Dubois, B. (2019). La clinique du coureur, la santé par la course à pied. Mons Eds.

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