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Runner’s Knee

Patellofemoral Pain Syndrome (Runner’s Knee)

What is patellofemoral pain syndrome?

The knee is the largest joint in the body and it is composed of the femur (thigh bone), tibia (leg bone), and patella (knee cap).  The knee cap rests on the sulcus of the thigh bone and articulate smoothly with it.  Patellofemoral pain syndrome, commonly known as runner’s knee, is the misalignment of the knee cap against the thigh bone which causes tracking disorder during knee movement.


What are the signs and symptoms?

The main symptom of patellofemoral pain syndrome is a diffuse pain or stiffness at the knee cap and its surrounding soft tissue.  Pain is worse when the knee undergoes flexion and extension motions such as kneeling, climbing stairs, running, jumping and cycling.  Grinding or clicking sensations can also be felt at times.  Sitting in a bent knee position for too long may also trigger pain, such as in the cinema or on a plane.


What causes patellofemoral pain syndrome?

The most common cause of patellofemoral pain syndrome is poor biomechanical function of the lower limb (i.e. the way your leg functions whist walking and exercising).  This can be due to a poor control around the hip and/or poor foot function (such as flat feet).


Some factors which can contribute to worsening of the syndrome are:


  • Muscular weakness/imbalances at the front of the thigh (quadriceps)
  • Malalignment between the position of the knee cap and the thigh bone
  • Increased level of physical activities
  • Improper training techniques or equipment

How is it diagnosed?

Diagnosing patellofemoral pain syndrome requires physical examination and gait analysis.  Imaging such as X-rays can be helpful in ruling out chondromalacia patella (knee cap arthritis), which is often associated with patellofemoral pain syndrome.

What can a podiatrist do for you?

Treatment often involve:

Conservative treatments are mostly sufficient to heal this syndrome; surgery is only required if non-invasive treatment fails. If you suspect that you have patellofemoral pain syndrome, it is advisable to visit your podiatrist for a proper diagnosis and treatment before the condition worsens and impairs your sports and daily activities.



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Author: Podiatrist Louis LOY

Editor: Principal Podiatrist Michael LAI