Please note: This information was current at the time of publication but now may be out of date. This handout provides a general overview and may not apply to everyone. 

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Am Fam Physician. 2019;99(2):online

See related article on patellofemoral pain syndrome

What is patellofemoral pain syndrome?

Patellofemoral (puh-TELL-oh-FEM-er-al) pain syndrome (or PFPS for short) is pain at the front of your knee. It may happen when the kneecap (or patella) moves differently than usual.

What are the symptoms of PFPS?

If you have PFPS, you may feel pain behind or underneath your kneecap. The pain may be in one knee or in both. It may get worse if you run, go up or down stairs, or sit with your knee bent for a long time (like in a movie theater or when driving a car).

Who gets PFPS?

PFPS usually happens in young active adults. Long-distance running or increasing your activity level too fast can lead to PFPS. Women are twice as likely to have PFPS than men. You are more likely to get it if you are overweight.

How is it treated?

For most people, putting ice on the knee, changing activities, and following a physical therapy program work best.

Ice your knees for 10 to 20 minutes after activity. This can ease the pain and speed up healing. To keep your hands free, use an elastic wrap to hold the ice pack in place. A medicine like ibuprofen (brand names: Advil, Motrin) may also help, but talk to your doctor before you take this medicine.

Physical therapy may include exercises to make your hip, trunk, and knee muscles stronger and more flexible. Squats, quadriceps exercises, leg raises, climbing, and leg presses can be good since they target these specific areas. Taping the knee or using shoe insoles can be helpful for some people.

Take a break from activities that cause a lot of pounding on your legs, like running, volleyball, or basketball. Instead, try swimming or another low-impact activity. As your knees feel better, you can slowly go back to your normal sports. But take it slow and increase the amount of time you do the activity by only about 20% a week.

Talk to your doctor about shoes. Bring your shoes in for the doctor to see. Proper walking or running shoes can help knee pain.

Will I need surgery?

Most people with PFPS do not need surgery. Be patient, and keep exercising to get better. PFPS can be hard to treat. Some people are lucky and get better quickly. But, it might take six weeks or even longer for your knee to feel better.

Will the pain come back?

PFPS can come back. Talk to your doctor about what might have caused the pain so that you can stop it from happening again.

You'll be less likely to get this pain again if you stay in good shape, but don't make sudden changes in your workouts. Keep your knee strong and flexible.

Replace your running shoes regularly (about every 250 to 500 miles of use) so they don't get worn out.

Where can I find more information? Your doctor

AAFP's Patient Information Resource

American Academy of Orthopaedic Surgeons

The American Physical Therapy Association

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