With the nice weather upon us, it is not surprising to see an increasing number of people running outdoors. While there are many benefits associated with outdoor running, the repetitive loading involved can exaggerate underlying non-optimal movement patterns and lead to various conditions including patellofemoral pain syndrome.
What is patellofemoral pain syndrome?
Patellofemoral pain syndrome is one of the most common knee conditions encountered by young female runners.1 It most often presents as retropatellar (behind the kneecap) or peripatellar (around the kneecap) pain that comes on with ascending and descending stairs, squatting, running, kneeling, cycling or sitting with knees bent for prolonged periods of time.2 Fortunately individuals with patellofemoral pain syndrome respond well to physiotherapy and rarely require surgical intervention.1
Am I at risk for developing patellofemoral pain syndrome?
Female adolescents and young adults have the highest risk of developing patellofemoral pain syndrome.2 In fact females are affected twice as often as males.3 Other factors that may predispose you to developing patellofemoral pain syndrome include:
Pes planus (flat feet)3,4
Poor kneecap alignment3,4
Poor kneecap tracking while walking/running3,4
Leg length discrepancy3
Knee laxity allowing for excess movement3
Hamstring and/or IT band tightness3
Decreased hip and/or knee strength3,5
Muscle imbalances across the knee3,4,5
Increased load (ie. high intensity or prolonged training)3
What can physiotherapy do?
Physiotherapy can help relieve symptoms associated with patellofemoral pain syndrome and help you return to the activities you love. Your therapist will work with you to manage pain, improve alignment and restore optimal muscle balance in order to improve function and prevent reoccurrence.1,2,3 Strategies commonly used include but are not limited to:
Stretching and strengthening exercises1,2,3
Balance and proprioceptive training1,3
Manual therapy to optimize joint mechanics
Soft tissue release technique to restore normal muscle balance
After performing a detailed assessment, your physiotherapist will be able to determine which options are best for you and work with you to develop an individualized treatment plan.
By Melissa Richardson, UWO PT Student
 Rixe JA, Glick JE, Brady J, Olympia RP. 2013. A review of the management of
patellofemoral pain syndrome. Phys Sportsmed. 41(3):19-28.
 Van der Heijden RA, Lankhorst NE, Van Linschoten R, Bierma-Zeinstra SM, Van
Middelkoop M. 2015. Exercise for treating patellofemoral pain syndrome.
Cochrane Database Syst Rev. doi: 10.1002/14651858.CD010387.pub2.
 Petersen W, Ellermann A, Gosele-Koppenburg A, et al. 2014. Patellofemoral pain
syndrome.Knee Surg Sports Traumatol Arthrosc. 22:2264-74.
 Lankhorst NE, Bierma-Zeinstra SMA, Van Middelkoop M. 2013. Factors associated
with patellofemoral pain syndrome: a systematic review. Br J Sports Med.
 Peters JS, Tyson NL. 2013. Proximal exercises are effective in treating
patellofemoral pain syndrome: a systematic review. Int J Sports Phys Ther.