What It Is

Patellofemoral Pain Syndrome (PFPS), also known as “runner’s knee,” is a common knee condition characterized by pain around the front of the knee and the patella (kneecap). It is often caused by overuse, misalignment, or abnormal tracking of the kneecap over the femur during movement. PFPS is frequently seen in athletes, runners, and individuals who perform repetitive knee-bending activities.

Signs & Symptoms

• Pain around or behind the kneecap, especially when bending the knee
• Discomfort during activities such as running, squatting, climbing stairs, or sitting for extended periods (often called “theater sign”)
• A grinding or clicking sensation in the knee during movement
• Swelling around the kneecap
• Knee pain that worsens with activity or prolonged sitting

Diagnosis

Dr. Romanelli will perform a thorough physical examination to assess knee movement, stability, and alignment. During the exam, specific tests may be done to evaluate the tracking of the kneecap. X-rays or an MRI may be recommended to rule out other causes of knee pain and to assess the condition of the cartilage beneath the kneecap.

Treatment

Treatment for PFPS focuses on relieving pain, correcting any underlying biomechanical issues, and restoring normal function. The majority of cases can be treated conservatively with non-surgical methods.

Non-Surgical Treatment

• Rest and Ice: Reducing activities that aggravate the knee and applying ice can help manage pain and swelling.
• Anti-inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to reduce pain and inflammation.
• Bracing or Taping: Braces or taping techniques can help improve kneecap alignment and reduce discomfort during movement.
• Physical Therapy: Targeted exercises to strengthen the quadriceps, hamstrings, and hip muscles can improve the alignment and movement of the kneecap, relieving symptoms and preventing future issues.

Surgical Procedure

In rare cases where conservative treatments fail, surgery may be considered to correct structural issues or realign the kneecap. Surgical options include:

• Lateral Release: A minimally invasive procedure that loosens tight ligaments on the outer side of the kneecap to improve its tracking.
• Realignment Surgery: For severe misalignment, a more extensive procedure may be required to reposition the kneecap and improve its movement over the femur.

Physical Therapy

Physical therapy plays a crucial role in both the treatment and prevention of Patellofemoral Pain Syndrome. A personalized rehabilitation program focuses on strengthening the muscles that support the knee, particularly the quadriceps and hip muscles, improving flexibility, and ensuring proper kneecap alignment during movement. Dr. Romanelli collaborates with physical therapists to ensure a comprehensive and effective recovery plan.