Knee Pain

Patient Information: Knee Pain (Patellofemoral Syndrome)

What are the common causes of knee pain?

  • Knee pain can be caused by injuries to the tendons, ligaments, and cartilage, or by overuse
  • One of the most common types of non-traumatic knee pain is patellofemoral syndrome
  • Patellofemoral syndrome can be caused by overuse, abnormal kneecap motion, weak/imbalanced leg muscles, or changes in intensity or type of exercise

What are the symptoms of patellofemoral syndrome?

  • Pain in the front of the knee, around or under the patella (kneecap)
  • Knee stiffness, difficulty with kneeling, climbing stairs, squatting

How is patellofemoral syndrome diagnosed?

  • Your physician will perform an exam to evaluate the structures inside your knee- the tendons, ligaments, and cartilage
    • They will also evaluate the tracking of your patella (how it moves when you bend and straighten your leg)
  • Musculoskeletal ultrasound can be done to evaluate the soft tissue around your patella for inflammation
  • X-rays may be obtained to review your patellar alignment
  • If injury to an internal knee structure is suspected, an MRI may be obtained

How is patellofemoral syndrome treated?

  • Initial treatment focuses on improving pain and stiffness with decreased activities, ice, compression wraps, and anti-inflammatory medication
  • An anti-inflammatory injection under or around the patella may also be utilized
  • The second phase of treatment addresses the cause of the pain, by strengthening weak muscle groups, taping/bracing to improve patella alignment, and slowly increasing activity levels
  • In rare cases where patella alignment does not improve with rehabilitation, surgery may be indicated

How can I prevent patellofemoral syndrome?

  • Include strength training activities for all of the muscles that support the knee and patella- for example, resistance band walks, abductor/adductor machines, and single leg squats
  • Warm up and stretch prior to exercising, and include a cool down stretch at the end
  • Wear activity-appropriate, supportive footwear
  • Increase activity intensity slowly, and incorporate rest days and low-impact exercise days (swimming, yoga, tai chi)
  • Proactively address new-onset patellar pain by reducing activity intensity, and taping or bracing the patella if needed

Where can I learn more about patellofemoral syndrome?

To schedule an appointment, visit the Steward St. Elizabeth’s Sports Medicine website at:



736 Cambridge St, CCP9, Brighton, MA 02135

Phone 617-779-6500 Fax 617-779-6555


Adapted from: American Academy of Orthopaedic Surgeons (, Hospital for Special Surgery (, Mayo Clinic ( This information is for patient reference only. It is not intended to diagnose or guide treatment without evaluation by a physician.