Runner's Knee / Patellofemoral Pain Syndrome (Pediatric)

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What is runner's knee?

Patellofemoral pain syndrome, commonly known as runner's knee, is one of the most common knee conditions. The patellofemoral joint is made of the kneecap (patella), thigh bone (femur), and soft tissues that provide support. The pain of runner’s knee usually comes from these supporting structures.

Who is affected by runner's knee?

Among adolescents, 20 to 45 percent experience runner’s knee. It is more than twice as likely to affect females as males.

What causes runner's knee?

Runner’s knee is usually caused by a combination of direct trauma, overuse, and abnormal kneecap movement (patellar tracking). The most frequent causes of abnormal patellar tracking are weakness in the thigh and hip muscles, too much movement of the kneecap, inadequate flexibility, and abnormalities of alignment between the hip, knee, and foot. Training errors, poor shoes, and running surface abnormalities can also aggravate runner’s knee.

What are the symptoms of runner's knee?

The most common symptoms are pain during and/or after activity, and pain or stiffness after prolonged sitting or standing. Some people may also notice a grinding or popping feeling under the kneecap and experience mild swelling. Pain is usually dull and achy and shifts from one side of the kneecap to the other. Athletes may have pain in both knees or only in one knee. The pain is usually worse when kneeling, walking downhill, or going up and down stairs.

How is runner's knee diagnosed?

Our doctors review the patient's history and do a physical examination. X-rays, MRIs, and other imaging tests are usually not needed, unless we need to rule out another cause of the symptoms.

What is the treatment for runner's knee?

Treatment includes modifying activities and taking a break from those that cause symptoms. The mainstay of treatment is a customized physical therapy program to strengthen and stretch the hip and thigh muscles, so they can help the kneecap move smoothly through its groove. Ice and anti-inflammatory medication can also reduce pain and inflammation.

Our doctors may recommend shoe inserts (orthotics) to redistribute pressures during activity. Some patients benefit from a brace or taping to support the kneecap and reduce pain during activity. Though rarely needed, surgery is sometimes necessary to help improve kneecap mobility if rest and physical therapy fail to relieve symptoms.