Category: Patellofemoral Pain Syndrome

Dr. Manu Mengi – Best Orthopedic Doctor in Mohali

Patellofemoral Pain Syndrome Treatment in Mohali | Expert Physiotherapy Guide by Dr. Aayushi

The Truth About Patellofemoral Pain Syndrome: A Physiotherapist’s Guide to Recovery.

Patellofemoral Pain Syndrome Treatment in Mohali | Expert Physiotherapy Guide

Patellofemoral Pain Syndrome affects 25-40% of all knee disorders, making it one of the most common conditions we treat in physiotherapy. As a physiotherapist, Dr. Aayushi, recognised as the Best Physiotherapist in Mohali, has helped countless patients overcome this condition, particularly runners, cyclists, and office workers who sit for extended periods. At the Best Physiotherapist Clinic in Mohali, we specialise in evidence-based approaches to ensure lasting recovery.

Women are twice as likely to develop this condition compared to men due to anatomical differences in leg structure. The symptoms can be particularly frustrating, with pain worsening during everyday activities like climbing stairs, squatting, or simply sitting for long periods. However, there’s hope—research involving 420 subjects has shown that targeted physical exercise and physiotherapy can significantly improve both pain and function. At our Physiotherapy Clinic in Mohali, we combine cutting-edge techniques with personalised care to deliver results.

I’ve created this comprehensive guide to help you understand Patellofemoral Pain Syndrome and walk you through the most effective physiotherapy approaches for recovery. Whether you’re dealing with recent-onset symptoms or looking for long-term management strategies, this guide will provide you with practical, evidence-based solutions.

Understanding Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome (PFPS) represents one of the most frequent knee complaints I encounter in my physiotherapy practice. Often misunderstood and frequently misdiagnosed, this condition deserves careful attention as we explore its intricacies.

What is PFPS, and who does it affect?

PFPS is a broad term describing pain around or behind the kneecap (patella) where it articulates with the thigh bone (femur). You might have heard it called by various names, including runner’s knee, jumper’s knee, anterior knee pain, or retropatellar pain syndrome. Essentially, it’s a chronic condition affecting the patellofemoral joint that tends to worsen with specific movements and activities.

This condition is remarkably common. Among active individuals, it accounts for 25% to 40% of all knee problems seen in sports medicine clinics. Looking at the general population, the annual prevalence rate is approximately 22.7%, while in adolescents it reaches 28.9%. Furthermore, PFPS affects about 7.3% of all orthopaedic visits.

Women experience PFPS at roughly twice the rate of men, with some studies suggesting females are affected two to ten times more frequently than males. Although PFPS is often associated with younger populations, especially those in their second and third decades of life, it affects people across all age groups, with interesting peaks among those aged 50-59.

Risk factors include:

  • Overuse of the knees through repetitive motions
  • Weak or tight muscles around the knee, especially the quadriceps
  • Sudden increases in activity level or training intensity
  • Natural anatomical variations in knee structure

Common symptoms and how they present

The primary symptom of PFPS is a dull, aching pain in the front of the knee that typically develops gradually. This pain generally worsens with activities that increase compression on the patellofemoral joint.

Most patients describe their symptoms being triggered or exacerbated by:

  • Climbing up or down stairs
  • Squatting or kneeling movements
  • Running, jumping, or other high-impact activities
  • Sitting with knees bent for extended periods (sometimes called “theatre sign”)

The pain is usually poorly localised, described as being “behind” or “around” the patella. While typically presenting as an ache, it can occasionally feel sharp, especially during aggravating activities. Notably, you might also experience cracking or popping sensations (crepitus) when bending or extending your knee.

Symptoms can affect one knee (unilateral) or both knees (bilateral) simultaneously. Unlike traumatic knee injuries, PFPS symptoms typically emerge gradually over time, though some cases can present acutely following changes in activity patterns or footwear.

Why early diagnosis matters

PFPS is considered a diagnosis of exclusion, meaning other potential knee conditions must be ruled out first. This highlights why proper assessment by a qualified physiotherapist or healthcare provider is crucial.

Early diagnosis matters tremendously because untreated PFPS tends to worsen over time. Studies show that approximately 74% of individuals experiencing this condition will limit or completely stop sport participation due to their symptoms. Additionally, 40% of cases recur after two years if not properly addressed.

Perhaps most concerning, emerging evidence suggests that PFPS may contribute to the development of patellofemoral osteoarthritis later in life. This creates both long-term health implications and increased healthcare costs.

Prompt evaluation allows for identifying the underlying causes of your specific case. Since PFPS has a multifactorial etiology, understanding whether it stems from muscle imbalances, overtraining, biomechanical issues, or anatomical factors is essential for effective treatment.

When PFPS is properly diagnosed early, conservative treatment approaches—including therapeutic exercise programs—have excellent success rates in relieving symptoms and preventing recurrence.

Step 1: Identifying the Root Cause

Finding the true origin of Patellofemoral Pain Syndrome requires detective work, as the actual source isn’t always where the pain presents itself. As a physiotherapist, I’ve found that identifying the root cause is the critical first step toward effective treatment.

Assessing movement patterns and posture

When examining patients with knee pain, I look beyond the knee itself. The way you move and hold your body can significantly contribute to PFPS. Typically, I assess:

  • Walking and running mechanics: People with PFPS often display altered biomechanics during functional movements. I watch for early heel rise, scissoring of the legs, excess trunk flexion, and stride length issues that might indicate compensatory patterns.
  • Stair navigation: This reveals eccentric control problems and whether you’re using your pelvis or ankle excessively to avoid knee flexion.
  • Single-leg stance stability: Research indicates that individuals with PFPS have shorter reach distances in anterior, posteromedial, and posterolateral directions during balance tests. They also demonstrate worse stability indexes during single-leg and double-leg stance.

Poor postural control is often an overlooked factor in PFPS treatment. Research suggests that the condition may involve impaired neuromuscular reflexes affecting balance. Consequently, excessive hip and ankle movements observed in people with PFPS might be compensations for underlying postural control deficiencies.

The role of muscle imbalances and joint alignment

Muscle imbalances undeniably play a central role in developing PFPS. Common patterns I observe include:

Weakness in the gluteus medius and minimus muscles causes pelvic instability, making it impossible to support the pelvis while standing on the affected leg. This weakness leads to internal rotation of the femur, placing excessive stress on the patellofemoral joint.

Quadriceps imbalances are particularly problematic. When the vastus medialis obliquus (VMO) isn’t strong enough, the vastus lateralis exerts greater force, causing lateral displacement of the patella. This creates uneven loading on the knee joint.

Hip weakness is increasingly recognised as a key factor. Research shows that poor hip abductor strength is a risk factor for future PFP pain in novice runners. This weakness allows excessive inward motion of the knee during activities.

Regarding alignment, I check for knee malalignment patterns like functional varus (knees bow outward) or functional valgus (knees collapse inward). These often stem from issues elsewhere – posterior pelvic tilt causes constant abduction and external rotation of the femur, placing continuous misloading onto the medial meniscus.

Foot mechanics likewise influence knee function. Flat feet or overpronation cause the lower leg to rotate inward, placing additional stress on the knee joint. Even subtle differences in leg length (more than 1.5 cm) can significantly alter gait symmetry and joint mechanics.

When to seek a physiotherapy evaluation

Primarily, you should consult a physiotherapist if your knee pain doesn’t improve within a few weeks. Seeking early evaluation is crucial as untreated PFPS tends to worsen over time.

A thorough physiotherapy assessment includes:

  • Comprehensive movement analysis, including gait evaluation and functional activities assessment
  • Muscular strength and flexibility testing, particularly of the hip, knee, and ankle
  • Patellar tracking assessment
  • Measurement of Q-angle and leg length differences
  • Foot posture and pronation evaluation

During your initial consultation, I’ll examine your alignment, muscle function, and movement patterns while collecting detailed information about your symptoms and activities. This systematic approach helps identify all contributing factors, leading to a personalised treatment plan.

Remember that PFPS rarely has a single cause. Instead, several dysfunctional biomechanical patterns likely contribute to overloading tissues in this area. A qualified physiotherapist can pinpoint your specific combination of factors and design an individualised treatment approach accordingly.

Step 2: Starting Physiotherapy Treatment

Once the underlying causes of your Patellofemoral Pain Syndrome have been identified, it’s time to begin the treatment process. As a physiotherapist specialising in knee rehabilitation, I’ve found that a structured approach yields the best results for managing PFPS.

Initial pain management strategies

The priority is to reduce pain and inflammation. Most patients benefit from implementing the RICE protocol:

  1. Rest: Modify activities that trigger pain – this doesn’t mean complete inactivity, but rather avoiding movements that worsen symptoms
  2. Ice: Apply cold packs to your knee for 20 minutes every 3-4 hours (always wrap ice in a towel to protect your skin)
  3. Compression: Consider using a compression bandage to reduce swelling
  4. Elevation: Keep your knee elevated above heart level when possible

Over-the-counter pain relievers typically provide sufficient relief. Research shows that naproxen is more effective than aspirin for PFPS pain management. However, medications should be limited to 2-3 weeks unless otherwise directed by your healthcare provider.

Safe workouts for knee pain patients

Maintaining fitness while recovering from PFPS is both possible and beneficial. Primarily, focus on low-impact activities that don’t aggravate your symptoms:

  • Recommended activities: Elliptical machine, swimming or water aerobics, stationary cycling without hill climbs, rowing machine, and upper body exercises

Conversely, temporarily avoid high-impact movements that place excessive force on your knees:

  • Activities to avoid: Basketball, volleyball, jumping rope, high-impact aerobics, deep squats (90° or more), running (especially on inclines), and lunges

Most patients see improvement within 3-5 weeks when following these modifications, though complete recovery may take 8-12 weeks, depending on severity.

Home physiotherapy for Patellofemoral Pain Syndrome

For effective home management, I typically prescribe specific exercises targeting flexibility and strength. Begin each session with a 5-7 minute warm-up like gentle cycling or walking.

Key stretches to incorporate:

  • Calf wall stretch (30 seconds, 2-4 repetitions)
  • Quadriceps stretch (30 seconds, 2-4 repetitions)
  • Hamstring wall stretch (1-6 minutes, 2-4 repetitions)

Essential strengthening exercises:

  • Quad sets (6-second holds, 8-12 repetitions)
  • Straight-leg raises to front and back (6-second holds, 8-12 repetitions)
  • Wall slides with ball squeeze (10-second holds, 8-12 repetitions)

Supportive devices can supplement your exercise program. Patellar taping has been proven to decrease pain when used alongside physical therapy. Similarly, knee braces or orthotic shoe inserts may help stabilise your knee and improve alignment. These supportive devices are particularly helpful during early recovery when symptoms are most pronounced.

After each exercise session, apply ice to your knee for 20 minutes to manage any post-exercise inflammation.

Step 3: Building Strength and Stability

After managing initial pain and inflammation, targeted strength building becomes the cornerstone of effective Patellofemoral Pain Syndrome rehabilitation. Research consistently demonstrates that specific strengthening protocols lead to substantial improvements in both pain reduction and functional recovery.

Glute & hip strengthening for Patellofemoral Pain Syndrome

Hip muscle weakness plays a crucial role in PFPS development. Studies reveal that weakness in hip abductors and external rotators fundamentally alters how forces are distributed through your knee. This weakness allows excessive femoral internal rotation and adduction during weight-bearing activities.

Key hip exercises include:

  • Side-lying clam exercises: Position yourself on your side with knees bent at 45°, keeping feet together while opening your top knee like a clamshell. Adding resistance bands above the knees intensifies the workout.
  • Side leg raises: Lying on your side with both legs straight, lift your top leg toward the ceiling without rotating your hips. Hold briefly before lowering.
  • Unilateral bridging: This targets your gluteus maximus while providing core stability benefits.

Vastus medialis obliquus strengthening for knee alignment

The VMO muscle sits on the inside of your thigh and plays a critical role in proper patella tracking. When VMO weakens, particularly after knee swelling, it creates an imbalanced quadriceps action that pulls your kneecap laterally.

Effective VMO exercises include:

  • Straight leg raises: Lying flat, tighten your quadriceps and lift your straightened leg off the floor. This simultaneously strengthens core muscles and quadriceps.
  • Quadriceps isometrics: Perform these at various knee angles (0°, 45°, 90°) to comprehensively strengthen all quadriceps components.

Wall sits & step downs for Patellofemoral Pain Syndrome

Wall sits provide controlled quadriceps activation without excessive patellofemoral stress. Start at 45° knee flexion before progressing to 60°, then 90°. The single-leg wall sit represents an advanced progression that markedly enhances joint resilience.

Step downs require excellent control and build functional strength. Standing on a step, maintain proper alignment while lowering your non-affected leg toward the floor. Proper form includes keeping your pelvis level and maintaining an arch in your foot.

A comprehensive strengthening program typically requires 8-12 weeks for optimal results. Research suggests that combining hip and knee strengthening produces superior outcomes compared to knee strengthening alone.

Step 4: Returning to Activity Safely

The journey back to normal activity after PFPS requires systematic progression and patience. Rehabilitation should focus not just on recovery, but on building resilience to prevent future episodes.

Gait retraining in Patellofemoral Pain Syndrome

Gait retraining represents an effective approach for correcting faulty movement patterns that contribute to PFPS. Research demonstrates this technique produces significant improvements in pain reduction and function, with benefits persisting long-term. The most effective programs incorporate a faded feedback design with 8-18 sessions over 2-6 weeks, typically scheduling 3-4 sessions weekly.

Several retraining strategies have proven successful:

  • Step rate modification – Increasing cadence by 7.5-10% reduces peak hip adduction while decreasing patellofemoral joint stress by 10-22%
  • Visual feedback – Real-time mirror feedback helps correct hip mechanics and improves knee function during running
  • Foot strike pattern – Transitioning from rearfoot to forefoot strike can decrease knee pain and improve biomechanics

Functional strengthening in knee rehabilitation

Functional strengthening bridges the gap between isolated exercises and real-world activities. Indeed, proper recovery of function matters more than time-based criteria for returning to sports.

Before attempting impact activities, you need:

  • Minimal to no knee swelling
  • Full, symmetrical knee range of motion
  • Quadriceps strength is at least 80% compared to your unaffected side
  • Appropriate mechanics during single-leg squats without knee valgus

Gradually incorporate exercises that mimic daily movements or sport-specific demands. Subsequently, include balance challenges and unpredictable environments to develop responsive control.

Preventing recurrence through load management

Managing activity levels properly prevents PFPS recurrence. Moreover, a successful return requires consistent adherence to your rehabilitation plan.

For runners, reduce mileage to pain-free levels while maintaining fitness through low-impact alternatives like swimming or cycling. Gradually reintroduce activities following soreness rules – mild discomfort during exercise is acceptable, but pain shouldn’t increase after activity or persist into the next day.

Finally, addressing flexibility deficits in the iliotibial band and quadriceps is essential, as tightness in these areas significantly increases PFPS risk.

Conclusion

Patellofemoral Pain Syndrome recovery demands patience, dedication, and proper guidance. Throughout my years treating PFPS patients, successful rehabilitation consistently follows a structured approach – starting with accurate diagnosis, progressing through targeted strengthening, and finally returning to normal activities.

Research clearly shows that conservative treatment yields excellent results when patients follow their rehabilitation program diligently. Most people achieve significant improvement within 8-12 weeks, though individual recovery times vary based on severity and commitment to prescribed exercises.

Remember that prevention matters as much as treatment. Maintaining proper form during exercises, gradually increasing activity levels, and addressing muscle imbalances early help avoid future episodes. Regular check-ins with your physiotherapist ensure you stay on track and adjust your program as needed.

My experience confirms that PFPS doesn’t have to be a permanent limitation. Armed with proper knowledge and targeted exercises, you can overcome knee pain and return to your favourite activities stronger than before.

FAQs

Q1. How long does it typically take to recover from Patellofemoral Pain Syndrome?

A1. Recovery time varies, but most people see significant improvement within 8-12 weeks of following a structured rehabilitation program. Some may experience relief in as little as 4-6 weeks, while others might require longer, depending on the severity of their condition and adherence to treatment.

Q2. What are the key components of physiotherapy treatment for PFPS?

A2. Physiotherapy treatment for PFPS typically includes pain management strategies, targeted exercises to strengthen hip and knee muscles, gait retraining, and a gradual return to activities. The approach often starts with non-weight-bearing exercises and progresses to weight-bearing exercises, along with patient education on proper form and load management.

Q3. Can I continue exercising while recovering from PFPS?

A3. Yes, but it’s important to modify your activities. Focus on low-impact exercises like swimming, stationary cycling, or using an elliptical machine. Avoid high-impact activities that aggravate your symptoms, such as running or jumping, until your physiotherapist clears you to return to these activities gradually.

Q4. What exercises are most effective for strengthening the knee in PFPS?

A4. Effective exercises for PFPS include quad sets, straight-leg raises, wall slides with ball squeezes, and step-downs. Additionally, exercises targeting the hip muscles, such as side-lying clam exercises and side leg raises, are crucial for overall knee stability and alignment.

Q5. How can I prevent PFPS from recurring after recovery?

A5. To prevent recurrence, maintain a consistent strength training routine focusing on hip and knee muscles, practice proper form during exercises, and gradually increase activity levels. Regular stretching, particularly of the iliotibial band and quadriceps, is also important. Pay attention to your body and modify activities if you start experiencing symptoms again.

About the Doctor

Dr. Aayushi is widely regarded as Mohali’s Top Physiotherapist, with years of expertise in treating musculoskeletal conditions, including Patellofemoral Pain Syndrome. At her Best Physio Clinic in Mohali, she combines advanced physiotherapy techniques with a patient-centred approach to ensure optimal recovery. Whether you’re an athlete or someone dealing with chronic knee pain, Dr. Aayushi and her team at the Physiotherapy Clinic in Mohali are dedicated to helping you regain mobility and live pain-free.

May 24, 2025 / by Manu
Patellofemoral Pain Syndrome - The Hidden Reason Your Knees Hurt While Running - Dr. Manu Mengi

Patellofemoral Pain Syndrome: The Hidden Reason Your Knees Hurt While Running

Runner’s Knee Treatment in Mohali – Causes & Prevention Tips by Dr. Manu Mengi

One-third of people visiting healthcare providers with knee pain are diagnosed with patellofemoral syndrome—runner’s Knee, making it one of the most common knee conditions we treat at our Sports Injury Clinic in Mohali. This prevalent condition particularly affects athletes and physically active individuals who regularly run and jump.

As an athlete or regular runner, you might be familiar with that nagging, dull ache at the front of your knee that worsens when climbing stairs or during squats. This pain can affect one or both knees and typically appears during or after intense physical activities. Young female patients and adults aged 20 to 40 are particularly vulnerable to this condition, especially those who suddenly increase their activity levels.

In this comprehensive guide, we’ll explore the causes, symptoms, and effective treatments for patellofemoral pain syndrome, including the RICE method and targeted physical therapy exercises. We’ll also share practical strategies to prevent this condition from affecting your running routine.

What is Patellofemoral Pain Syndrome (Runner’s Knee)?

Patellofemoral Pain Syndrome (PFPS) refers to pain around or behind the kneecap (patella) where it meets the thigh bone (femur). This condition got its nickname “Runner’s Knee” because it frequently affects people who run or participate in activities that put repeated stress on the knee joint. However, unlike what the name suggests, this condition isn’t limited to runners—it can affect anyone who engages in activities that stress the knee joint.

Understanding the patellofemoral joint

The patellofemoral joint consists of your kneecap (patella) and the groove in your thigh bone (femur) where the patella slides. This joint plays a crucial role in your daily movements. The patella acts as a pulley, increasing the leverage of the quadriceps muscles and providing protection to the knee joint.

The kneecap is normally held in place by various structures:

  • Quadriceps muscles (front thigh)
  • Hamstring muscles (back thigh)
  • Medial and lateral retinaculum (tissue along the sides)
  • Patellar tendon (connecting to the shin bone)

In a healthy knee, the patella glides smoothly up and down in this femoral groove as you bend and straighten your leg. This movement should be pain-free and efficient. Nevertheless, if any element of this mechanical system is off, whether it’s muscle imbalance, abnormal anatomy, or poor movement patterns, problems begin to develop.

What happens in PFPS is that the patella doesn’t track properly in its groove. Instead, it may shift laterally (outward) or tilt, creating excessive pressure on certain areas of the cartilage. This improper tracking leads to irritation of the soft tissues and inflammation, consequently causing pain and discomfort.

Why runners are more prone to PFPS

Runners face a higher risk of developing patellofemoral pain syndrome, which is why many seek Runner’s Knee Treatment in Mohali for relief. First and foremost, running creates repetitive stress on the knee joint. With each stride, your knee absorbs a force equivalent to several times your body weight. Over thousands of strides during a typical run, this adds up to significant cumulative stress on the patellofemoral joint.

Furthermore, biomechanical factors make runners particularly vulnerable:

  1. Muscle imbalances – Tight quadriceps combined with weak hip abductors (particularly the gluteus medius) can pull the patella out of alignment during running.
  2. Running form issues – Overpronation (excessive inward rolling of the foot), crossover gait (feet crossing over the midline), or overstriding can all contribute to abnormal knee mechanics.
  3. Training errors – Sudden increases in mileage, intensity, or hill work without proper adaptation time put excessive stress on the knee structures.

The repetitive nature of running means that even minor misalignments or muscle imbalances get magnified over time. As a runner logs more miles, these small issues compound until they reach a threshold where pain develops.

Moreover, running on hard surfaces or uneven terrain increases impact forces and can exacerbate existing biomechanical issues. Similarly, worn-out running shoes that no longer provide proper support can alter your gait and contribute to patellofemoral issues.

Unlike traumatic knee injuries, PFPS typically develops gradually. Many runners ignore early warning signs—such as mild discomfort that disappears after warming up—until the pain becomes persistent enough to interfere with training. This is why understanding the underlying mechanics and recognising early symptoms is vital for preventing long-term problems.

Common Causes of Knee Pain While Running

Running places significant demands on your knees, which is why Knee Pain When Running Treatment in Mohali is a common request among athletes. Understanding what causes knee pain while running can help you prevent patellofemoral pain syndrome or address it before it worsens.

Overuse and repetitive stress

Approximately 80% of running-related injuries are associated with overload. Unlike acute injuries, overuse problems develop gradually through repeated microtrauma that exceeds your body’s natural repair capacity.

When you run, various tissues including muscles, tendons, bones, and ligaments experience physiological stress. These structures adapt differently to training loads—tendons and ligaments adapt more slowly than muscles, making them particularly vulnerable to injury.

The problem arises when the cumulative damage surpasses your tissue’s repair threshold. This typically happens when you don’t allow adequate recovery time between training sessions. For overzealous runners who push too hard too often, the damage accumulates until pain and dysfunction appear.

What makes overuse injuries challenging is their gradual onset. There’s rarely a single, identifiable traumatic cause. Instead, the damage builds up silently until symptoms become noticeable, at which point significant tissue stress has already occurred.

Muscle imbalances and poor biomechanics

Your running form directly impacts how effectively your body absorbs and distributes forces. Poor biomechanics significantly increase your risk of developing patellofemoral pain syndrome.

Muscle imbalances are among the most common culprits. About 25% of adults experience knee pain, representing a 65% increase over the last 20 years. Often, this pain stems from muscle imbalances around the joint:

  • Weak gluteal muscles (particularly gluteus medius and maximus) fail to properly control hip and knee alignment during running
  • Quadriceps weakness reduces support across the knee joint and strongly correlates with the advancement of knee problems
  • Tight hamstrings or calves alter how your knee moves through its normal range
  • An imbalance between inner and outer thigh muscles can pull the kneecap out of alignment

These imbalances change how your patella tracks in its groove, creating excessive pressure on certain areas of the cartilage. Notably, runners with anterior knee pain have weaker knee extensors and flexors than those without pain.

Inefficient running biomechanics, such as excessive knee valgus (“knocked knee”) or knee varus (“knee out”), create abnormal stress patterns that your knee structures weren’t designed to handle.

Sudden changes in training or surface

Making abrupt modifications to your running routine often triggers knee pain. Runners who suddenly increase their mileage, intensity, or hill work without proper adaptation time put excessive stress on their knees.

Contrary to popular belief, changing to a softer running surface doesn’t necessarily reduce injury risk. Different surfaces simply alter the biomechanical demands on your body. While softer surfaces may reduce impact loading rates, they increase demands on muscles and tendons. A sudden change in running surface may decrease stress in one area but increase injury risk in others.

Training errors account for many cases of runner’s knee. Adding too much distance too quickly or not allowing sufficient recovery between runs prevents proper adaptation. This explains why many patients develop patellofemoral pain syndrome after they start running at an incline or increase their miles or speed.

Recognising the Symptoms Before It Gets Worse

Early detection of Patellofemoral Pain Syndrome can prevent progression to more severe conditions, which is why visiting a Knee Pain Doctor in Mohali at the first sign of discomfort is crucial. Recognising the warning signs promptly allows for faster intervention and better outcomes. When detected early, most cases resolve with conservative treatment rather than requiring invasive procedures.

Pain patterns and when they appear

The hallmark of Patellofemoral Pain Syndrome is a dull, aching pain around or behind the kneecap, particularly where it meets the lower part of the thighbone. Unlike acute injuries, this pain typically develops gradually over time.

You’ll likely notice pain intensifying when:

  • Walking up or down stairs
  • Squatting or kneeling
  • Running, especially downhill
  • Sitting with knees bent for extended periods (sometimes called “theatre sign”)
  • Standing up after prolonged sitting

Pain is usually diffuse rather than pinpointed to a specific location. Many runners report that symptoms peak when the knee is bent at 60° to 90°, such as during deep squats, and subside when straightening the leg. Initially, discomfort might only appear during or after intense activities, but as the condition progresses, even daily movements can trigger pain.

Clicking or popping sounds in the knee

That strange clicking or popping sound in your knee has a medical name: crepitus. While often alarming, knee crepitus by itself isn’t necessarily a cause for concern. Scientists have studied this phenomenon since 1947, with real-time medical imaging finally revealing in 2015 that these sounds typically occur when tiny nitrogen bubbles in joint fluid collapse due to pressure changes.

Nevertheless, when clicking or popping accompanies pain, attention is warranted. In Patellofemoral Pain Syndrome, you might experience:

  • Rubbing, grinding, or clicking sensations when bending and straightening the knee
  • Popping sounds that worsen after periods of rest
  • Crunching sensations when climbing stairs or kneeling

Clicking at the front of the knee can result from an anatomical structure called a plica. While usually painless, when inflamed it causes “Plica syndrome,” another condition that frequently affects runners.

Swelling around the kneecap after activity

Swelling indicates inflammation in the knee joint and serves as an important diagnostic clue. Following intense activities, you might notice mild swelling around the front of your knee or kneecap, representing fluid buildup in or around the joint.

This swelling typically develops gradually rather than suddenly. Sudden swelling (within four hours of activity) is more concerning, as it may indicate bleeding within the knee (hemarthrosis) and possible structural damage. In contrast, the swelling associated with Patellofemoral Pain Syndrome usually appears more gradually and is milder in nature.

Persistent swelling that doesn’t improve with rest should prompt medical evaluation. Although mild swelling might resolve with home treatment, recurrent episodes indicate that the underlying issues causing your runner’s knee remain unaddressed. In essence, your body is signalling that something isn’t right with your knee mechanics.

PFPS typically worsens over time if left untreated, potentially increasing your risk of injuries beyond just pain and discomfort. Hence, promptly recognising these symptoms can help prevent progression to more serious conditions.

Effective Treatments for Patellofemoral Pain Syndrome

Treating Patellofemoral Pain Syndrome effectively requires a multi-faceted approach, which is why many patients opt for a Knee Pain Doctor in Mohali as part of their recovery. Most patients recover completely with conservative treatments, though recovery timeframes vary depending on severity and adherence to treatment protocols.

RICE method and pain relief options

First and foremost, the RICE method provides immediate relief for acute flare-ups:

  • Rest: Temporarily avoid activities that trigger pain
  • Ice: Apply cold packs for 15-20 minutes every 2-3 hours
  • Compression: Use an elastic bandage around the knee to reduce swelling
  • Elevation: Keep your knee above heart level when possible

Over-the-counter pain relievers can complement this approach. NSAIDs like ibuprofen and naproxen reduce both pain and inflammation, while acetaminophen (Tylenol) addresses pain without anti-inflammatory effects. Generally, these medications should not be taken for more than 10 days without medical supervision.

Physiotherapy and strengthening exercises

Physiotherapy forms the cornerstone of effective treatment. Studies show that performing knee- and hip-strengthening exercises three times weekly for six weeks significantly decreases knee pain and improves physical activity.

Key exercises often include:

  • Straight leg raises for quadriceps strengthening
  • Side-lying clam exercises for hip abductors
  • Wall sits for thigh muscle development
  • Step-ups for gluteal and quadriceps activation

Primarily, these exercises aim to correct muscle imbalances and faulty movement patterns that contribute to improper tracking of the kneecap.

Knee braces and orthotics for support

Supportive devices provide additional stability during recovery. Patellofemoral braces help track the kneecap properly, reducing pressure on affected areas. Unloader braces, the most commonly recommended type, redistribute weight-bearing forces away from painful areas.

Orthotic inserts, either over-the-counter or custom-made, can correct foot mechanics that contribute to knee misalignment. These interventions work best when combined with appropriate exercises.

When to consider surgery

Surgery represents a last resort, typically considered only after 6-12 months of consistent conservative treatment failure. Arthroscopic procedures allow surgeons to examine the knee joint and address specific issues like removing damaged cartilage or releasing tight lateral structures.

For severe cases with significant misalignment, realignment surgery may be necessary to adjust the position of the kneecap. Fortunately, most patients respond well to non-surgical approaches, making surgery rarely necessary for this condition.

Preventing PFPS and Staying Pain-Free

Preventing Patellofemoral Pain Syndrome demands a proactive approach, including Proper Running Form and Knee Pain Treatment in Mohali if symptoms arise.  As the saying goes, an ounce of prevention is worth a pound of cure—nowhere is this more applicable than with runner’s knee.

Stretching and warm-up routines

Before hitting the pavement, engage in dynamic stretching that mimics running movements to increase your heart rate and warm up muscles. Subsequently, save static stretching for after your run when muscles are warm. Many experts recommend a 5-10 minute walking warm-up to get blood flowing properly through your body. For optimal results, focus on stretching your quadriceps, hamstrings, calves, and hip flexors—all crucial muscle groups that impact knee alignment.

Choosing the right footwear

Your running shoes play a vital role in preventing knee pain. According to podiatrists, proper footwear should provide appropriate cushioning without raised heels, which can shift your center of gravity and place additional pressure on the knee joint. Typically, shoes with lower heel drops (under 8mm) help reduce forward knee push and alleviate IT band issues.

Gradual training progression

Abrupt changes in training volume often trigger knee pain. Accordingly, structure your progression carefully—increase your weekly mileage by no more than 10% and allow approximately six weeks for your body to adapt to new training loads. Likewise, alternate running days with low-impact activities like swimming or yoga to give your knees recovery time.

Maintaining healthy body mechanics

Proper running form dramatically reduces stress on your knees. Land with slightly bent knees rather than straight legs, and avoid overstriding. Additionally, aim for a cadence around 180 steps per minute (170 for taller runners), and ensure your feet point in your direction of travel rather than splaying outward. Above all, focus on a circular leg motion versus a pendulum-like straight leg action that increases impact forces.

Conclusion

Understanding and addressing Patellofemoral Pain Syndrome makes the difference between a short-lived running career and years of enjoyable miles. If you’re experiencing persistent discomfort, consult a Patellofemoral Pain Syndrome Specialist in Mohali for personalised care. While this condition affects many runners, proper knowledge empowers us to prevent and manage it effectively.

Most cases respond well to conservative treatment approaches, especially when caught early. Regular stretching, appropriate footwear, and smart training progression serve as our first line of defence against runner’s knee. Strengthening exercises targeting key muscle groups help maintain proper knee alignment during runs.

Smart runners pay attention to their bodies and address minor discomfort before it develops into chronic pain. Rather than pushing through knee pain, taking appropriate rest periods and following proper rehabilitation protocols leads to better long-term outcomes. Remember, protecting your knees today ensures many more miles of pain-free running tomorrow.

FAQs

Q1. What are the main symptoms of Patellofemoral Pain Syndrome, and when should I see a Knee Pain Doctor in Mohali?

A1. The primary symptoms include a dull, aching pain around or behind the kneecap, especially when walking up or down stairs, squatting, or sitting with bent knees for extended periods. You may also experience clicking or popping sounds in the knee and mild swelling around the kneecap after activity.

Q2. Why are runners more susceptible to developing Patellofemoral Pain Syndrome?

A2. Runners are more prone to this condition due to the repetitive stress placed on the knee joint during running. Factors such as muscle imbalances, poor running form, and sudden increases in training intensity or mileage can contribute to the development of PFPS in runners.

Q3. How can I prevent Patellofemoral Pain Syndrome while running?

A3. Prevention strategies include proper warm-up and stretching routines, choosing appropriate footwear, gradually increasing training intensity, and maintaining good running form. It’s also important to strengthen key muscle groups, particularly the quadriceps, hip abductors, and gluteal muscles.

Q4. What are some effective treatments for Patellofemoral Pain Syndrome?

A4. Effective treatments include the RICE method (Rest, Ice, Compression, Elevation), physiotherapy exercises to strengthen muscles around the knee, and the use of knee braces or orthotics for support. Over-the-counter pain relievers can also help manage pain and inflammation.

Q5. When should I seek medical attention for knee pain while running?

A5. You should consult a healthcare professional if you experience persistent knee pain that doesn’t improve with rest, sudden swelling within hours of activity, or if the pain interferes with your daily activities. Early intervention can prevent the condition from worsening and improve treatment outcomes.

About Patellofemoral pain syndrome specialist Mohali

If you’re experiencing persistent knee pain while running, don’t ignore the warning signs. Early intervention from a Patellofemoral Pain Syndrome Specialist in Mohali can prevent long-term damage and get you back to pain-free movement. Dr. Manu Mengi, an experienced sports medicine expert, provides personalised treatment plans combining physiotherapy, bio-mechanical analysis, and targeted exercises for runners and athletes. Whether you’re training for a marathon or simply want to stay active without knee discomfort, seeking professional guidance ensures proper recovery. Book a consultation today to address your knee concerns with evidence-based care.

May 12, 2025 / by Manu