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Patellofemoral Pain

The Kneecap (patella) forms part of the patellofemoral compartment of the knee.

The patella is a relatively small, mobile bone which is subject to large forces in everyday activity such as arising from a chair and climbing or descending steps/ stairs.

SIGNS AND SYMPTOMS

Kneecap (patellofemoral) pain is the commonest knee problem.

Typical symptoms include:

  • Pain with bending, kneeling and climbing
  • Stiffness and pain after prolonged sitting/ driving
  • A sensation of catching/ locking/ grating
  • Vague aching with weather change
  • A feeling of instability

The pain is often poorly localised but is usually felt around the front of the knee or under the kneecap but also commonly in the back of the knee.

Patellofemoral pain affects a wide age range from early adolescence to older age. Unfortunately, the cause of the pain is often uncertain and therefore it is difficult to treat or ‘cure’.

Investigations including x-rays and MRI scans are often normal.

CAUSES OF PATELLOFEMORAL PAIN

The most common contributing factors are:

1. Abnormal or increased load

  • Repetitive bending, squatting, climbing, kneeling or heavy lifting
  • Gaining weight

2. Abnormal tracking/ alignment of the kneecap

  • In most cases this is subtle but in extreme cases the kneecap may come out of its groove (dislocate)
  • If significant this may be amenable to surgical treatment

TREATMENT

The majority of cases are associated with abnormal or increased load or subtle maltracking of the kneecap.

Surgery has very little role in these patients and treatment is directed at decreasing the loads on the kneecap by:

  • Weight loss
  • Avoiding/ minimising bending, squatting etc.
  • Improving kneecap tracking by :
    • Stretches
    • Taping
    • Kneecap brace/ strap
    • Orthotics

Surgery (arthroscopy) has a role in:

  • Later stages where there is significant pain, swelling, grating, catching or locking
  • Significant kneecap mal tracking

REMEMBER:

Kneecap pain is very common and although there is no ‘cure’ the symptoms are often more of a nuisance than severe and can be eased by simple measures such as weight loss, avoiding bending, climbing etc and doing simple exercises and stretches.

If your surgeon recommends surgery, be sure you understand what is planned and be realistic about the outcome.

The aim is improvement not cure, there is no guarantee and there is a small risk that you could be worse.

 

This material has been produced as a reference guide only and should not be used in place of a consultation with a qualified medical practitioner.