Patellofemoral Pain Syndrome

Understanding Patellofemoral Pain Syndrome

Also known as: PFPS, Runner's Knee, Anterior Knee Pain, Chondromalacia Patella Patellofemoral pain syndrome is pain from the joint between the kneecap (patella) and the groove in the thighbone it slides through. When the patella doesn't track smoothly — because of hip weakness, quad imbalance, foot mechanics, or training errors — the undersurface cartilage becomes irritated. PFPS is the most common cause of knee pain in active adults, and it consistently responds better to addressing the whole kinetic chain than to treating the knee alone. Dull aching around or behind the kneecap, sharper with descending stairs, squatting, or kneeling, and the "theater sign" — pain after sitting with the knee bent for a prolonged period — are characteristic.

Crepitus (grinding or crackling) is common but usually harmless. Female athletes, adolescents during growth spurts, and runners who increase mileage quickly are most at risk. We address every contributor. Patellar and tibiofemoral joint mobilization restores smooth tracking.

Hip and SI adjustments optimize the chain above. The real driver of lasting relief is targeted strengthening of the VMO, gluteus medius, and hip extensors. We release the IT band and lateral retinaculum, apply McConnell or kinesio taping, and prescribe orthotics when overpronation is significant. Running gait retraining and graded return-to-run plans prevent recurrence.

Most patients improve within six to ten weeks. We may recommend: extremity adjustments, mobilization, Graston/IASTM, kinesio taping, corrective exercise, orthotics, ergonomic coaching Seek immediate care if: The knee suddenly gives way with locking, you can't bear weight, or there is significant swelling after trauma.