Patellofemoral pain syndrome (runner’s knee)

Exercising man with knee pain

​​​​​​​Patellofemoral pain syndrome is commonly called runner’s knee, but it can occur in non-athletes, as well. It causes pain and irritation if your knee is bent for an extended period of time like when you’re walking or running, kneeling or sitting with crossed legs.

Your kneecap, called the patella, sits over your knee joint and connects with the lower end of your thighbone (femur). If your knee is moving the way it should, it rests in a groove on your thighbone, called the femoral groove, and slides up and down easily as you bend your knee. 

Patellofemoral pain syndrome occurs when your kneecap is out of place and not lined up correctly on the femoral groove. It moves incorrectly and wears down the cartilage beneath it, causing dull, throbbing pain at the front and center of your knee. 

Patellofemoral syndrome can be caused by a structural defect in your knee, direct trauma to the area or weak or tight knee muscles. The most common cause of this condition is overuse and activities that stress your kneecap—like when you run, jump, twist or participate in certain sports. 

Patellofemoral pain syndrome symptoms

Symptoms may include:

  • Pain behind or around your kneecap

  • Pain that is more severe after sitting for an extended period of time

  • Pain that worsens with activities that require bending your knees (going down stairs or running uphill) 

  • Rubbing, grinding or clicking sound when you bend or straighten your knee

  • Swelling on and/or around your kneecap

Patellofemoral pain syndrome diagnosis

After reviewing your medical history and symptoms, your doctor may have you squat, jump or lie down to determine your knee’s flexibility and strength. 

Diagnostic tests may include:

  • Magnetic Resonance Imaging (MRI)—a painless, noninvasive exam that uses a magnet, radiofrequencies and a computer to obtain detailed still and moving images.

  • X-ray—uses is a machine that uses a controlled beam of radiation to create an image of the knee a

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Patellofemoral pain syndrome treatment

Treatment for this condition depends on your age, general health history, the severity of your pain and your goals for recovery.

In many cases the RICE method is the only treatment needed:

  • Rest the joint

  • Ice the affected area

  • Compress the area with an elastic bandage

  • Elevate the joint

If additional treatment is needed, it may include:

  • Activity modification—discontinuing, at least temporarily, the activity that is causing the runner’s knee or making it worse.

  • Exercise - to stretch and strengthen your knee and its surrounding muscles.

  • Over-the-counter pain medication—like ibuprofen, naproxen or aspirin.

  • Physical therapy - improves your quality of movement using exercises and stretches.

  • Shoe inserts—the use of special shoes or support devices.

You don't have to continue living with knee pain. Our orthopedic specialists can provide effective treatment so you can get back to the activities you enjoy. 

Find a knee specialist near you.