Women's Sports Health Program
Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (Runner’s Kneee) is the most common cause of knee pain. It’s most prevalent in individuals who participate in sports, especially women and young adults.

The most common symptom is knee pain that increases with stair climbing or squatting movements with pain increasing after sitting for a time and then transitioning to standing and walking.

Contributing Factors

The causes of patellofemoral pain syndrome may include: 

  • Overuse: running or jumping sports with repetitive stress on the knee joint
  • Muscle imbalances or weaknesses: muscles around the hip and knee change the way you move such as allowing for too much knee collapse inward.
  • Injury: dislocation or subluxation of the kneecap which can lead to a sprain of a ligament known as the Medial Patellofemoral Ligament (MPFL)
  • Surgery: a previous knee surgery such as ACL sometimes increases the risk of knee pain.

Risk Factors

Risk Factors include:

  • Age: typically affects adolescents and young adults
  • Sex: Women are twice as likely as men to develop Patellofemoral pain
  • Certain Sports: running and jumping sports

Injury Reduction & Prevention

  • Maintain strength: Strong muscles such as your quadriceps and hamstrings, hip abductors, and the muscles in your foot that support your arch strength can help to balance out the knee and the movement at the knee joint.
  • Biomechanics: How you squat, land from jumping, decelerate or slow down and change direction are also important: Think alignment and technique.
  • Warm Up: get yourself visibly sweating before you perform any kind of higher level activity such as lifting weights, playing in a game or even practicing
  • Footwear: make sure you wear something comfortable and with the right amount of cushion.  If you are told to wear orthotics consider that most research only supports a temporary use of orthotics for no more than 6 weeks.  If you need something for longer than that consider doing some strengthening and seeing an orthopedic or physical therapist to help
  • Weight Management: While a lot of newer research debunks the risk factors of Height, weight and Body Mass Index, we do know that losing weight can help to preserve the joints of your body by reducing the amount of stress and load on those joints; consider managing your weight.  See a registered dietitian for tips. Sometimes weight management can be due to not eating enough calories for how much you are working out and a specialist can help you identify the cause and your goals.


Often a medical professional can diagnose you with patellofemoral pain syndrome purely on your history of the injury; they may ask questions like how you would rate your pain on a scale of 0 to 10, when during your daily activities you experience the pain, whether you have had any trauma or previous injuries anywhere in your body, and whether there is any activities that provide you with relief even if it’s just temporary. 

Sometimes further specialty examinations are needed such as:

  • Xray
  • CT Scans
  • MRI
  • Musculoskeletal Ultrasound
  • Motion Analysis


  • Medications: Often times an over the counter pain reliever may be recommended such as acetaminophen (Tylenol), ibuprofen (Advil), or naproxen sodium (Aleve).

  • Physical Therapy: Rehabilitation exercise: exercises that focus on strengthening areas that are weak, improving movement of areas that might not move as well and correction of specific movement patterns such as squatting.

  • Braces/Taping/Ice: Sometimes a physical therapist or physical therapist assistant might recommend knee braces, taping or ice; however these are just temporary and not often prescribed for long term use.

  • Surgery: If non-conservative management does not work then your medical team might elect for surgical intervention.

    • Arthroscopy: is a surgery with a small scope entering the knee through small incisions in order to remove or repair any structure that might not be working well.

    • Realignment: In more severe cases a surgeon may need to perform a surgery known as a Tibia Tubercle Transfer or Osteotomy to help the alignment of the knee so that the knee cap sits better in the groove where it is supposed to be.  This is often times performed with a ligament repair as well since the structure, the medial patellofemoral ligament can get damaged from trauma or repetitive dislocations of the knee cap.

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