Patello-Femoral Pain

Patello-femoral pain is an irritation or inflammation of the tissues under or surrounding the kneecap. Overuse, a blow, or a structural defect causes the kneecap to be squeezed excessively against the lateral femoral condyle. Weak or inflexible quadricep muscles can also contribute to the problem. This condition is often inaccurately referred to as "chondromalacia". Chondromalacia is a diagnosis that should be reserved for cases where there is actual damage to the articular cartilage on the underside of the patella. This is not always the case in patello-femoral pain. But chondromalacia may arise from chronic patello-femoral pain.

Signs and Symptoms

• Pain (in and around the kneecap, usually on the lateral side) with running, jumping or stair climbing.
• "Achiness" while sitting for extended periods.
• A grinding sensation can sometimes be felt.

On-Site Management

P.R.I.C.E. PROTECT the area from further injury (i.e. wrap). REST the area to promote healing. ICE the area to reduce inflammation. Some COMPRESSION will help move inflammation away from the area. ELEVATE the area to promote circulation to the heart. 

Referral. A physician should be seen to rule out any other problems. They may also prescribe anti-inflammatory medication.

Rehabilitation. Work on range of motion and strengthening exercises for the hip and knee. With all squating and lunging activities be sure that the knee is in line with the toe and NOT past it. If pain persists, seek the advice and treatment of a physiotherapist.

Return to Activity. Exercises to strengthen the quadriceps muscles and to stretch the hamstring muscles are essential prior to returning to activity. Commercially available neoprene knee sleeves often offer support to assist the patella to properly "track" in the femoral condyle groove.

Prevention. To avoid developing this condition, athletes should ensure good strength of the quadricep muscles. This will help pull the patella into the proper tracking alignment.

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