{"id":15372,"date":"2023-03-14T11:50:53","date_gmt":"2023-03-14T10:50:53","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=condition&p=15372"},"modified":"2026-08-13T13:21:20","modified_gmt":"2026-08-13T11:21:20","slug":"patellofemoral-pain-syndrome","status":"publish","type":"condition","link":"https:\/\/www.physiotutors.com\/conditions\/patellofemoral-pain-syndrome\/","title":{"rendered":"Patellofemoral Pain Syndrome"},"featured_media":15373,"template":"","tracking_tag":[2197,2313],"class_list":["post-15372","condition","type-condition","status-publish","has-post-thumbnail","hentry","tracking_tag-knee","tracking_tag-lower-extremity"],"acf":{"sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":15373,"background_image_alt_text":"Patellofemoral Pain Syndrome"},"heading":"Patellofemoral Pain Syndrome | Diagnosis & Treatment for Physios","subheading":"Knee Joint","content_editor":"","button_type":"url","button_label":"","button_style":"button-five","button_internal_link":4646,"button_anchor":"","button_url":"https:\/\/study.physiotutors.com\/course\/patellofemoral-pain-fat-pad-syndrome\/","button_file":"","label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Introduction & Epidemiology","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Clinical Picture & Examination","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Treatment","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null},{"button_type":"anchor","button_label":"PFPS Online Course","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Reviews","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"Become a member","button_style":"button-three","button_internal_link":22104,"button_anchor":"","button_url":"","button_file":""},"button_description":""},{"acf_fc_layout":"content-with-sidebar","content_editor":"

Patellofemoral Pain Syndrome | Diagnosis & Treatment for Physios<\/h2>\r\nPatellofemoral Pain Syndrome (PFPS) typically refers to anterior knee pain usually occurring during activities such as running, squatting, or walking up and downstairs. It should be seen as a diagnosis of exclusion though, meaning that the diagnosis is formed once all other possible conditions have been excluded such as meniscus, ligamentous or intra-articular pathologies (Crossley et al. 2016<\/a>).\r\n\r\nOne hypothesis is abnormal patellofemoral joint alignment and morphology of the trochlear groove. Consequently, the patella can\u2019t track smoothly up and down, which over time can cause irritation of the joint surfaces and triggers nociception (Crossley et al. 2016<\/a>).\r\n\r\nSecondly, muscle weakness of the quadriceps (Lankhorst et al. 2012<\/a>) and glutes (Rathleff et al. 2014<\/a>) have been considered potential risk factors associated with PFPS. Patients with PFPS showed 6-12 % less strength than their healthy controls. It is assumed that poor strength and function in the quadriceps will influence how the patella tracks in the trochlea and how the load is distributed across the patellofemoral joint (Willy et al. 2016<\/a>).\r\n\r\nWeak glutes on the other hand can alter the leg axis if the femur adopts a more internally rotated position with regards to the tibia again impairing smooth movement of the patella within the femoral trochlea (Willson et al. 2008<\/a>, Powers 2010<\/a>).\r\n\r\nThe biomechanics of PFPS have been challenged though. A systematic review of prospective predictors by Pappas et al (2012)<\/a>\u00a0found no significant link in many of the proposed anthropometric variables. Furthermore, Noehren (2007)<\/a>\u00a0found no difference in femoral internal rotation in a prospective cohort of runners who went on to develop PFPS compared to those who did not.\r\n\r\nSo while the biomechanical link may not be so clear, the above coupled with a drastic increase in load (intensity, frequency, duration) may eventually lead to symptoms.\r\n\r\n \r\n\r\nEpidemiology <\/strong><\/em>\r\n\r\nAnterior knee pain is one of the most commonly encountered problems in the primary care setting. However, no reports on the true incidence of PFPS amongst this population exist to this day (Rothermich et al. 2015<\/a>). In young adolescents, studies have shown a prevalence ranging between 7-28% and an incidence of 9.2% (Rathleff et al. 2015<\/a>, Hall et al. 2015<\/a>). Studies on PFPS in military personnel reported an annual incidence of 3,8% in men and 6,5% in female recruits, with a prevalence of 12% in men and 15% in women (Boling et al. 2010<\/a>). Typically seen in practice is a young female patient who engages in running (Glaviano et al. 2015<\/a>, Smith et al. 2018<\/a>)."},{"acf_fc_layout":"content-with-sidebar","content_editor":"

Clinical Picture & Examination<\/strong><\/h3>\r\n
\r\n\r\n[embed]https:\/\/www.youtube.com\/watch?v=9cuF4fMAfQY[\/embed]\r\n\r\n<\/div>\r\nAs stated in the introduction, patients with PFPS will usually describe dull\/achy pain around or behind the patella, which is aggravated by at least one weight-bearing activity such as squatting, stair ambulation, jogging\/running, hopping, or jumping.\r\n\r\nAdditional, but not necessarily required are:\r\n
    \r\n \t
  1. Crepitus or grinding sensation from the patellofemoral joint during knee flexion movements<\/li>\r\n \t
  2. Tenderness on patellar facet palpation<\/li>\r\n \t
  3. Small effusion<\/li>\r\n \t
  4. Pain on sitting, rising on sitting, or straightening the knee following sitting<\/li>\r\n<\/ol>\r\n \r\n\r\nPhysical Examination<\/strong><\/em>\r\nWhile Cook et al. (2010)<\/a> describe three test clusters for PFPS, they have little diagnostic value.\r\nThese are:\r\n