patellofemoral pain syndrome

Patellofemoral syndrome (patellofemoral pain syndrome, runner's knee) is the most common sports overuse injury of young adults. It involves chronic pain in one or both kneecaps. Pain is felt behind or below the kneecap (patella) with running, going up and down stairs, cycling, or sitting for long periods with the knees bent (the "movie theater sign"). A peculiar crunching sensation under the kneecap (crepitus) is typical. The condition is caused by abnormal movement of the kneecap during exercise, caused by various causes of malalignment of the knee, and the resultant uneven forces on the knee under stress. Adolescent girls seem especially vulnerable to this condition, presumably because the wider female pelvis creates more angulation of the knee joint where femur (thigh bone) meets the tibia (shin bone).

Treatment involves reducing unnecessary stress on the knees from running or jumping by relative, not complete activity restriction. Icing the knees after exercise, leg muscle strengthening exercises to correct muscle imbalance about the knee, and compressive knee braces or taping are helpful. Competitive (or compulsive) cyclists can try changing the seat height, their cycling position, or the pedal/cleat system. Surgical treatment is only rarely necessary.

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