What is Runner’s Knee (Patellofemoral Pain Syndrome)?
Runner’s knee, which is also known as patellofemoral pain syndrome (PFPS), is a broad term used to describe pain at the front of the knee that develops gradually. It is sometimes referred to as anterior knee pain.
Runner’s knee occurs when the kneecap (patella) does not move properly whenever the knee is bent or straightened. Improper movement can be the result of an imbalance in the strength or tightness of the muscles and tendons around and near the knee. The result is the kneecap moves too far to the outside, and this abnormal movement can lead to damage of the cartilage on the underside of the kneecap and other surrounding tissues.
Several factors can contribute to the development of runner’s knee, including overloading (e.g., long-distance or hill running), pronating or flat feet, and an abnormal Q angle, which results in a “knock-kneed” appearance. Women are more likely to have a larger Q angle because their pelvis is wider than a man’s. Individuals who have either of the latter two conditions and who run are at increased risk for runner’s knee. Patellofemoral knee pain can also develop in people who have had a knee injury if their quadriceps are weak.
Although runner’s knee is often confused with chondromalacia patellae, the latter involves damage to the cartilage on the underside of the kneecap while runner’s knee is more extensive. Chondromalacia patellae can be a result of runner’s knee, but it can occur independently.
Symptoms of Runner’s Knee
Symptoms of runner’s knee can include aching pain in the knee joint, especially in the front, under and around the entire kneecap; pain that worsens when walking up or down stairs; tenderness along the inside border of the kneecap; tight quadriceps, calf muscles, hamstrings, and iliotibial band; cracking or clicking sound when bending the knee; and swelling of the knee in some cases.
Treatment of Runner’s Knee
The first action individuals with runner’s knee should take is RICE: Rest, Ice, Compression, and Elevation, all of which help reduce pain and swelling. Consult a doctor or sports medicine specialist who can coach you on a tailored rehabilitation plan that can include use of nonsteroidal anti-inflammatory medication, use of a knee support, massage, and exercises to strengthen the quadriceps and stretches for the iliotibial band and other tight muscles. He or she may perform a gait analysis to identify overpronation, determine if you have a synovial plica, and prescribe orthotics if necessary. Surgery is generally not necessary.