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Home > Services > Rehabilitation > Conditions We Rehabilitate > Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome refers to pain felt under the kneecap (patella), caused when the kneecap rubs against the thigh bone (femur) when you move.


The Kneecap

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Several factors can cause this to occur, including:

  • Misalignment of the knee joint, often caused by dysfunction in the feet 
  • Weak anterior thigh muscles — the ones that help hold the kneecap in place 
  • Overuse, especially from high-impact sports 
  • Trauma
  • Flat feet
  • High arches
  • Hip dysfunction
  • Pronation when walking—rolling feet outward
  • External rotation of the lower leg
  • Knock knees
You can reduce your risk by adequately warming up before exercise, varying your activities to avoid overuse and managing injuries in a timely manner.

Symptoms of Patellofemoral Pain Syndrome

Pain around or under the kneecap may be the first sign that you have this syndrome. At first, you may feel the pain during high-impact activities. As the condition gets worse, long periods of sitting can trigger the pain. Other symptoms include:

  • Swelling of the knee
  • Popping or grinding sounds in the knee joint during activity
  • A snapping sensation in the knee

Your doctor can confirm diagnosis using X-rays, MRI or CT scans and then refer you to a specialist. Orthopedic surgeons focus on bone and joint disorders.

Treatment for Kneecap Pain

The first step: Rest. This means: Choose low-impact, not high-impact, exercise.

Exercise and Physical Therapy

Most people will benefit from strengthening the muscles around the knee. This includes the quadriceps muscles in the thigh as well as other muscles near the hip. Physical therapists can recommend specific exercises. This treatment can take 6 to 12 weeks to see an improvement.

External Devices

Many people find relief from knee braces or knee sleeves. These devices typically have a cutout in the kneecap area. Some hold the kneecap in place during activity; others hold the patella from going too far laterally.

Certain methods of taping the patella in position have also been helpful to many patients.

Special shoe inserts, called orthotics, may also be helpful. They work best when the condition is due to dysfunction in the foot, such as flat feet or excessive pronation.


In rare cases, a specialist will recommend surgery to correctly align the patella.

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Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

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