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Patello-Femoral Syndrome (PFS)

What is Patellar Femoral Syndrome? - An imbalance in the knee area that causes the kneecap (patella) to shift or tilt out of place as the leg bends or straightens. It is usually noticeable by achy pain surrounding kneecap.

What causes Patellar Femoral Syndrome?

Quadriceps weakness. Strong quadriceps muscles anchor the kneecap (patella) in place; weak quadriceps allow the patella to move off track.

Tendon and muscle tightness in the leg, foot, or hip areas. For example, runners who don't cross-train are likely to have weak quadriceps combined with tight hamstrings and iliotibial bands (ITB). A tight iliotibial band can pull the patella toward the outside of the knee.

Activities that repeatedly stress the knee at a 30- to 90-degree angle (cycling with a low seat, gardening, jumping, playing baseball catcher position, hill running, descending stairs).

Improper athletic technique or training. Trying a new sport can also lead to a patellar disorder.

A blow to the kneecap, causing it to shift (sublux) or dislocate. After an initial dislocation, the patella is at increased risk of dislocating more easily.

Excessive body weight, which overstresses the knee joint.

A growth spurt. Patellar tracking problems are common among teens.

A previous injury that has healed improperly, causing an imbalance in how the leg functions.


What can be done? To relieve PFS pain, the athlete needs to decrease or cease activities that cause knee pain. The inflammation and pain can be controlled with ice before and after activity, and with anti-inflammatories. Wearing an open patella neoprene brace may help to correct patellar tracking. Supportive shoe inserts may provide some relief. Once pain has decreased, stretching must be done on quadriceps, hamstrings, iliotibial band, and Achilles tendon. Strengthening of the quadriceps is essential to prevention of recurrence of injury.