Clinical Reference Systems: Pediatric Advisor 10.0
Patellofemoral Pain Syndrome (Runner's Knee) for Teenagers
What is patellofemoral pain syndrome?
Patellofemoral pain syndrome is pain behind the kneecap. It
has been given many names, including patellofemoral
disorder, patellar malalignment, runner's knee, and
How does it occur?
Patellofemoral pain syndrome can occur from overuse of the
knee in sports and activities such as running, walking,
jumping, or bicycling.
The kneecap (patella) is attached to the large group of
muscles in the thigh called the quadriceps. It is also
attached to the shin bone by the patellar tendon. The
kneecap fits into grooves in the end of the thigh bone
(femur) called the femoral condyle. With repeated bending
and straightening of the knee, you can irritate the inside
surface of the kneecap and cause pain.
Patellofemoral pain syndrome also may result from the way
your hips, legs, knees, or feet are aligned. This alignment
problem can be caused by your having wide hips or
underdeveloped thigh muscles, being knock-kneed, or having
feet with arches that collapse when walking or running (a
condition called over-pronation).
What are the symptoms?
The main symptom is pain behind the kneecap. You may have
pain when you walk, run, or sit for a long time. The pain
is generally worse when walking downhill or down stairs.
Your knee may swell at times. You may feel or hear
snapping, popping, or grinding in the knee.
How is it treated?
Treatment includes the following:
- Place an ice pack on your knee for 20 to 30 minutes every
3 to 4 hours for the first 2 to 3 days or until the pain
- Elevate your knee by placing a pillow underneath your leg
when your knee hurts.
- Take anti-inflammatory medication, such as ibuprofen.
- Do the exercises recommended by your doctor or physical
Your doctor may recommend that you:
- Wear custom-made arch supports (orthotics) for over-
- Use an infrapatellar strap, a strap placed beneath the
kneecap over the patellar tendon.
- Wear a neoprene knee sleeve, which will give support to
your knee and patella.
While you are recovering from your injury, you will need to
change your sport or activity to one that does not make
your condition worse. For example, you may need to bicycle
or swim instead of run. In cases of severe patellofemoral
pain syndrome, surgery may be recommended. Your doctor will
show you exercises to help decrease the pain behind your
How can I prevent patellofemoral pain syndrome?
Patellofemoral pain syndrome can best be prevented by
strengthening your thigh muscles, particularly the inside
part of this muscle group. It is also important to wear
shoes that fit well and that have good arch supports.