The Runner's Knee: Patellofemoral Pain Syndrome

If you have been an active runner or athlete over the years, you have surely felt all sorts of pain in your hamstrings, quads, calves and feet. Many times it is just the soreness or tightness that comes with running multiple miles per day, a mild pain that you can still perform through.

However, if you begin to feel consistent pain around your kneecap, you may be experiencing something a little more serious than just the typical soreness that can come from running. You could be feeling symptoms of Patellofemoral pain syndrome, or PFPS, a common knee disorder which typically affects senior athletes or those who frequently take part in running and jumping sports.

Patellofemoral pain is also known as retropatellar pain, peripatellar pain and anterior knee pain. More commonly, it is called runner's knee.

What Is PFPS?

When your knee bends and straightens, as it does when you run, your kneecap - the patella - slides along a slot on your femur. This slot is called the trochlear groove. If your knee is performing properly, the patella will move in many directions within the trochlear groove, providing you with the ability to jump, move side to side, rotate and perform a full range of motions without friction.

However, PFPS occurs when the surfaces of your patella and femur repeatedly rub and stress the tissues along the patellofemoral joint. This leads to pain, weakening of the joint, and sometimes a bone bruise. In some cases, PFPS may also be caused by the weakening of the articular cartilage or swelling within the joint.

What Leads to PFPS?

There is no universal cause for PFPS. It may depend on genetic factors or the amount of stress on your knee over time. Below are a few of the main factors that can lead to PFPS.

• Overuse. Repeated bending and straightening over time will cause PFPS, especially among runners or older athletes who still remain active. When the knee is constantly bent, it increases the pressure points between your kneecap and the femur, irritating the patella.


• Alignment. The angle between your hip and your knee, the Q angle, can be a factor in PFPS. Research has shown that those with a larger than normal Q angle are more susceptible to PFPS because your patella then tracks more to the outside. As female athletes mature and their pelvis widens, so does the Q angle, increasing the risk of developing PFPS.


• Muscular Weakness or Tightness. An imbalance in the strength of your quadriceps will affect the tracking of the patella, as will tight muscles and tendons. Flexibility is essential in the movement of the knee and hip.


• Flat feet. If your feet have little to no arch, you may be more likely to suffer from PFPS. Your tibia compensates for your feet when you run, placing atypical pressure on the patellofemoral joint.

There are operative and non-operative treatments for PFPS, though both could require a long-term adjustment of your physical activity. Your orthopedist will guide you through treatment and recovery so you can still enjoy the things you love.