Knee

Patellofemoral Pain

Anterior knee pain from poor tracking of the kneecap in its groove — 'runner's knee.'

Cared for across all 6 OSI locations

Overview

what it is and why it matters
Front view of the knee showing the femur, tibia, patella, cruciate and collateral ligaments, and the medial and lateral menisci.
Knee anatomy. The knee is the meeting point of the thigh bone (femur), shin bone (tibia), and kneecap (patella). Four ligaments hold it together — the ACL and PCL inside the joint and the MCL and LCL on the sides — and two C-shaped menisci cushion the joint surfaces.
Blausen Medical · Wikimedia Commons · CC BY-SA 4.0

Patellofemoral pain syndrome (PFPS) — "runner's knee" — is diffuse anterior knee pain originating from the interface between the patella (kneecap) and the trochlear groove of the femur. It is among the most common knee conditions seen in active adolescents and young adults. When the patella tracks abnormally in the groove — due to muscle imbalances, hip weakness, or structural anatomy — excessive pressure on the cartilage causes pain.

Pain is characteristically worse with stairs, prolonged sitting (the "movie sign"), squatting, and running. It is not a single diagnosis but a symptom complex with multiple contributing factors.

Diagnosis

exam first, imaging second

Peripatellar or retropatellar pain, positive Clarke's sign (pain with patellar compression against the trochlear groove), and pain during a single-leg squat. Assessment of hip abductor strength and foot pronation is important for identifying contributing factors. MRI is obtained when cartilage damage (chondromalacia patella) or structural pathology is suspected.

Treatment Path

how care progresses at OSI
1

Hip and quadriceps strengthening

Strengthening the hip abductors, external rotators, and VMO (inner quadriceps) is the most effective treatment — corrects the biomechanical drivers of poor patellar tracking.

2

Activity modification

Reducing hill running, stair climbing, and deep squatting during the acute phase.

3

Foot orthotics

Controlling overpronation reduces medial knee collapse and patellar maltracking.

  1. Patellar taping / bracing

    McConnell taping or a patellar tracking brace provides symptom relief and biofeedback during rehabilitation.

  2. NSAIDs

    Acute symptom control.

Surgical Options at OSI

if non-operative care isn't enough

Surgery is rarely indicated for PFPS. When significant chondromalacia or structural malalignment (trochlear dysplasia, high TT-TG distance) is identified and symptoms persist after comprehensive conservative care, procedures to address the underlying anatomy are considered.

Providers Who Treat Patellofemoral Pain

sports-medicine team

Michael S. Vrana, M.D.

David B. Templin, M.D.

Trent Twitero, M.D.

Further Reading

authoritative sources

External patient-education references and related OSI pages for additional background:

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