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Patellofemoral Pain Syndrome

Patello-femoral Pain Syndrome is the term used to describe pain at the front of the knee, around the knee cap (or patella).patello-femoral-pain-syndrome
This condition is common in children and adolescents active in sports and experiencing a rapid growth phase. The painful symptoms occur when the kneecap becomes irritated and inflamed, due to increased pressure on the joint between the knee-cap (patella) and the thigh (femur).

What causes Patello-femoral Pain Syndrome?

The knee-cap normally glides smoothly along a groove at the front of your thigh bone (femur), whenever your knee is bent and straightened. If the knee-cap does not glide normally through this groove, but travels more to one side of the groove, the knee-cap will rub against the thigh bone, causing pressure, pain and swelling at the patello-femoral joint.
Several factors may contribute to the development of patello-femoral pain in children, including:

  • Abnormal foot posture – this can cause excessive motion across the knee, placing more strain across the knee joint
  • Joint hypermobility – may cause increased motion across the knee joint
  • Weak hip muscles – may allow the thigh to rotate excessively when walking
  • Weak or unbalanced quadriceps muscles
  • Tightness in the outer thigh muscles and soft tissues can cause the kneecap to be pulled toward the outside of the knee
  • Overuse – especially if your child is active in sports involving running or jumping

What are the symptoms of Patello-femoral Pain Syndrome?

The common symptoms of Patello-femoral Pain Syndrome include:

  • Pain at the front of the knee, around or behind the kneecap
  • Pain with activities that include squatting, kneeling, hopping, jumping, running and using stairs
  • The pain is often noticeable after sitting still for long periods with a bent knee, eg getting up after watching a movie or after any prolonged sitting
  • A feeling of fullness or swelling around the kneecap

Patello-femoral pain syndrome is typically seen in children’s sports that involve running, jumping and landing. These sports commonly include netball, basketball, running, tennis, ballet, gymnastics, football and volleyball.

How is Patello-femoral Pain Syndrome diagnosed?

Your Podiatrist will take a comprehensive medical history and complete a physical examination and visual gait analysis. The assessment is likely to include:

  • Pain provocation tests – to reproduce your knee pain
  • Foot posture assessment
  • Joint flexibility tests (or range of motion)
  • Foot and leg muscle strength testing – looking for muscle imbalances and weakness
  • Footwear assessment – looking for abnormal shoe wear patterns
  • Gait analysis and biomechanical assessment – to look for any abnormalities in the way the feet and legs move during gait

How is Patello-femoral Pain Syndrome treated?

Depending on the child’s individual contributing factors your Podiatrist may recommend these treatments options:

  • Custom foot orthotics – to address abnormal foot posture problems and reduce excessive motion across the knee joint
  • Footwear changes – more supportive, stable footwear may be recommended
  • Ice massage – to reduce local inflammation after sport or exercise
  • Rest from aggravating activities until the inflammation is reduced
  • Strengthening exercises – to address any foot or leg muscle imbalance or weakness. If you require a hip stabilisation program a physiotherapy referral will be recommended
  • Stretching exercises – to improve joint and muscle flexibility

What should I do if my child has Patello-femoral Pain Syndrome?

If your child is experiencing knee pain, or you are concerned about their gait or foot posture, don’t hesitate to consult with our experienced paediatric podiatrists for a comprehensive walking assessment and professional advice.

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