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Patellofemoral Stress Syndrome

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Patellofemoral Pain Syndrome

UW Health's Sports Medicine doctors in Madison, Wisconsin, treat a wide range of common athletic injuries, including patellofemoral stress syndrome, or anterior knee pain.


Patellofemoral Stress Syndrome


Patellofemoral stress syndrome is a term used to describe pain in the front part of the knee (medically termed as anterior knee pain) that occurs due to abnormal motion or pressure between the kneecap (patella) and thighbone (femur).




Patellofemoral stress syndrome has many symptoms, including:

  • Dull, achy pain in the front and/or sides of the kneecap
  • Increased knee pain during and/or after activities such as running, walking, aerobics, stair climbing and bicycling
  • Knee stiffness or soreness after prolonged sitting with activities such as driving long distances and/or watching a movie
  • Knee pain that causes the thigh muscle to feel weak or the knee to give out



Patellofemoral stress syndrome may be caused by several factors, including:

  • Activities requiring repetitive use of the knee, especially activities with higher impact such as running
  • Quadriceps muscle weakness, specifically the vastus medialis (inner quad), and/or gluteus muscle weakness, specifically the gluteus medius
  • Poor alignment with the three bones that are found at the knee, including the femur (thigh bone), tibia (shin bone) and the patella (kneecap)
  • Excessive mid-foot pronation (flat feet)
  • Improper training, including rapid increases in activity, intensity and/or duration
  • Athletic shoes that are worn out or do not provide enough support
  • Muscle tightness, specifically the hamstrings, calf muscles and iliotibial band.



Several treatment options exist for patellofemoral stress syndrome, including:

  • Eliminate or modify daily and physical activities that cause knee pain, especially stair climbing, kneeling, squatting and running
  • Begin a supervised rehabilitation program that targets improved biomechanics, strength and flexibility throughout the lower part of your body
  • Ice your knee(s) after activity for 15-20 minutes
  • Take anti-inflammatory medications as prescribed by a physician
  • See a physician or rehabilitation provider to consider the use of arch supports to correct excessive foot pronation

Completely eliminating knee pain due to patellofemoral stress syndrome is difficult. Treatment will usually reduce the amount of pain and allow an athlete to continue activity, although activities may need to be modified.




Patellofemoral stress syndrome is challenging to prevent since the onset is often gradual and may be due to numerous factors. However, the following tips can help prevent the onset and/or progressive symptoms of patellofemoral stress syndrome:

  • Avoid sudden changes in training and gradually progress into new programs
  • Maintain good lower extremity flexibility and strength
  • Begin treatment early when symptoms first arise
  • Maintain a healthy body weight