About patellofemoral pain syndrome
Patellofemoral pain syndrome describes pain where the kneecap glides over the end of the thigh bone. The joint surfaces are usually healthy on imaging, but the area has become sensitive to the forces placed on it during bending activities.
It is one of the most common causes of knee pain in runners, teenagers, and active adults. Pain often builds after a change in training, such as more hills, more mileage, or a new sport, and it can linger when the muscles that control the hip and knee are not keeping up.
The good news is that the knee is not damaged in most cases. With the right plan, people usually return to running, jumping, and daily activities without needing a procedure.
Common symptoms
- A dull ache around or behind the kneecap
- Pain with stairs, especially going down
- Pain with squatting, kneeling, or lunging
- Pain after sitting for a long time with the knees bent, sometimes called the theater sign
- Occasional clicking or grinding without significant swelling
Common causes and risk factors
- A sudden increase in running, hills, or jumping
- Weakness in the hip and thigh muscles that control knee alignment
- Reduced flexibility or ankle stiffness that changes how the knee moves
- Too little recovery between training sessions
How we diagnose it
Dr. Chen takes a careful history of your training and examines how your hips, knees, and feet move during tasks like squatting and stepping. Diagnostic ultrasound at the exam table helps rule out other causes of front-of-knee pain, such as patellar tendinopathy, fluid in the joint, or bursitis. X-rays or MRI are used only when the exam suggests another problem.
How Propel treats patellofemoral pain syndrome
Treatment centers on progressive strength training for the hips and thighs, gradual reintroduction of running and jumping, and practical changes to training volume. We look at sleep, recovery, and nutrition as part of the plan, and we aim to keep you active while the knee settles.
Most people do well with rehab alone. If pain does not improve as expected, Dr. Chen reassesses with ultrasound and further imaging when needed to make sure nothing else is being missed, and adjusts the plan to fit what we find.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about patellofemoral pain syndrome
- Does runner's knee mean my cartilage is damaged?
- Usually not. Patellofemoral pain syndrome is typically a sensitivity problem in the joint rather than structural damage. Imaging is often normal, and the knee responds well to strength training and load management.
- Should I stop running with patellofemoral pain?
- Many people can keep running with changes, such as shorter runs, flatter routes, or a slightly quicker cadence. We aim for pain that stays mild during the run and settles by the next day, and we build back up from there.
- Will a knee brace or tape fix patellofemoral pain?
- Taping or a brace can reduce pain in the short term for some people and may make exercise easier. They work best as a support to a strength program rather than as the main treatment.