Sports Medicine

Patellofemoral Stress Syndrome (PFSS)

Our Pediatric Sports Medicine team put together these videos to provide information for you.

Carlos R. Rodriguez, MD

Patellofemoral stress syndrome is the most common cause of anterior knee pain in athletes.

This is a condition that we see and treat quite often in the Johns Hopkins All Children's Sports Medicine clinic. It is very common in athletes, whose sports demand a lot of running, jumping, walking, or cycling.

The pain is located in the front of the knee and you may feel it behind or underneath the kneecap. The pain can affect one knee or both. It usually gets worse if you run, walk, or sit with your knee bent for a long time (this is called the "theater sign"). The pain is also worsened by walking down stairs or downhill. Your knee may swell at times and you may feel or hear a popping, snapping, or grinding in the knee.

The condition is generally caused by an abnormal movement of the kneecap as it glides up and down on the end of the thigh bone called the patellar groove. With repeated bending and straightening of the knee, this abnormal movement of the kneecap causes irritation and inflammation of the inside surface of the kneecap causing pain.

Patellofemoral syndrome may result from the way your hips, legs, knees or feet are aligned. Wide hips, weak thigh muscles, being knock-kneed, tight hamstrings, or having flat feet or arches that collapse when walking or running can all contribute to the development of this condition.

Our physicians at the Johns Hopkins All Children's Sports Medicine clinic will review your symptoms, examine the knee and may order some x-rays.

The treatment for patellofemoral stress syndrome usually involves icing the knee for 20-30 minutes 3-4 times a day, resting and changing your activities, anti-inflammatory medications and a physical therapy program to make your muscles stronger and more flexible. In some patients taping the knee, using knee braces or sleeves or using shoe insoles can be helpful in relieving and preventing the condition.

It may take several weeks or months of treatment for the pain to go away.

Our goal is to get you back to your sport as safely and quickly as possible. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.


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