Patellofemoral Stress Syndrome

Running Injuries #6: Patellofemoral Stress Syndrome
Ryan Whitford

Knee Pain is one of the most frequent problems among runners.  Although there can be a wide variety of knee pain diagnoses, I'll focus on a very common one that we see in physical therapy:  Patellofemoral Stress Syndrome (commonly called "Runner's Knee")More simply, this is pain right on or under the knee cap or patella. This problem occurs when either the Vastus medialis oblique (VMO) is weak or the lateral (outside) retinaculum that holds the patella firmly to the femoral condyle is excessively tight.  In either case, the end result is lateral excursion of the patella.  An excessive inward angle of the leg (called the Q angle), an internal rotation of the femor, and an external rotation of the tibia can all play a roll in the lateral excursion.

The individual may report a dull, aching pain in the center of the knee.  Point tenderness can be located over the lateral side of the patella with intense pain and crepitus (a peculiar crackling, crinkly, or grating feeling or sound) when the patella is moved medially.

Treatment involves NSAIDs (apirin, ibuprofen, etc.).  A specialized taping technique may help track the patella in the proper groove.  This will help train certain muscles to correct themselves.  Also, a specialized strengthening and stretching program that focuses on the hip, quadriceps, and hamsrtings should help.

Also, shoe wear may be an important factor to consider. If you have flat feet, the general rule is to be in Stability or Motion Control shoes.  If you have a high arch, again the general rule is to be in a Cushion shoe. Rogan's has them all and their staff is very knowledgeable - I've tested the sales staff out once or twice.  Each time the sales associate gave me the correct information, and did not push me to be a certain name brand shoe.

I hope this information is helpful and if you do get injured, ask your physican for a referral to a sports clinic or a physical therapy dept.  Many happy days running.


Additional information on this injury can be found on line at web site of the University of Virginia Health System.