Patellofemoral pain syndrome – Symptoms and causes

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KNEE PAIN is the most common problem faced by millions of people across the world. The reasons for this are attributed to JOINT HEALTH, OBESITY, INJURY and many a times AGE too. KNEE PAIN is a common ailment that people who are regularly exercising and gymming, also complain of. But the reason for that is Injury or the result of an incorrect posture/movement while lifting.

Knee pain is all the more common in the community that is not into exercising. It begins with a minor pain but slowly increases with time, if appropriate measures are not taken for it. OBESITY and being OVERWEIGHT is also a strong reason, and this is something that needs to be addressed by the ones suffering from it. It is commonly seen that the people who have this pain, are already leading a sedentary lifestyle, and once they fall prey to this pain, they further stop their walking and physical activity, as it increases the pain, and then they attribute it to the KNEE PAIN, while it is the other way round, vice versa. And the reason for the initiation for this was the sedentary lifestyle.


The knee is composed of two joints, the TIBIOFEMORAL AND THE PATELLOFEMORAL.

The patellofemoral joint is made up of the patella (knee cap) and the groove of cartilage on the femur in which it sits. The purpose of the patella and the patellofemoral joint is to allow for greater force development through the quadriceps muscle by creating a fulcrum mechanism as the knee is extended. This joint is subject to tremendous forces when the knee is repetitively loaded in flexion and extension during sports and physical activity.

Normally the knee cap slides up and down following the natural track of the groove in the middle of the femur. When the knee cap fails to slide up and down evenly in the groove this can create irritation of the cartilage on the underside of the knee cap. There are many potential reasons as to why the patella would not accurately track within its groove.

One reason is the alignment of the bones of the leg and foot. Subtle abnormalities in alignment and a bony structure can cause the patella to sit in a position in which it will create uneven pressure and wear within the groove. Another potential cause of increased load on the joint is improper pull and tension from the connective tissue that surrounds the joint and the muscles that control the movement of the patella. Tight structures surrounding the patella can cause it to slide toward the outside of its groove when the quadriceps is contracted.

These tight structures also cause the patella to be compressed into the groove as it slides up and down. Imbalance in strength between the four heads of the quadriceps and weakness throughout the muscles of the hip can also cause the patella to be improperly positioned during weight bearing activities.

knee pain


When the cartilage on the under surface of the knee cap has been continually irritated for a long period of time it can begin to wear down and degenerate. This condition is known as chondromalacia of the patella. This degeneration may be responsible for the crunching and grinding noise heard in some patients when the knee is bent and straightened. When significant chondromalacia is present this may undermine the knee’s ability to respond well to conservative treatments.


This condition can be caused by muscle weakness or imbalance, tight tendons, or abnormal movement of the kneecap over the thighbone. Patellofemoral pain syndrome can also be caused and aggravated by repetitive movements of the knee.


You will feel a general ache or pain at the front of your knee, behind or around your kneecap. The pain may be triggered when you place pressure on your knee, when walking up or down stairs, or running (especially downhill), for example. Strenuous exercise, squats, and weight-bearing movements that involve bending your knee may also cause you pain. You may have swelling around your kneecap and a grating sensation (known as crepitus) within the knee joint. Symptoms can be difficult to pinpoint, so your physician may need to perform a variety of tests to make a diagnosis and exclude any other possible causes.


If this condition is left untreated, your patellar tendon and the cartilage underneath your kneecap may become inflamed. This inflammation can get progressively worse, leading to permanent damage in the joint. It is important to rest your knee and follow any physical therapy program that is recommended, or it may take longer for the condition to improve. This syndrome can also lead to patellofemoral cartilage damage.

doctor consulting about knee pain


In most cases, if you follow a rehabilitation program, you should see a substantial improvement in a few weeks to a month, and will have made a full recovery within 4–6 months. However, if you have had surgery, your recovery period is likely to be 3 month. In every case one must be extra cautious as to pay attention to the recovery.