Patellofemoral Syndrome

The incidence of injury among distance runners is estimated to be between 37-56%.  Of these, pain in the area of the patellofemoral joint (near the “knee-cap”) is one of the most common complaints.  Thankfully, some recent research has uncovered some of the risk factors for this condition.

Patellofemoral Syndrome Risk Factors


Patellofemoral Syndrome

Patellofemoral Syndrome

Traditionally, it has been understood that the risk factors for patellofemoral pain have been related to different aspects of the knee.  Some of these include malalignment of the patellofemoral joint, imbalance in the muscles around the joint, weakness in the quadriceps or abnormalities in the bone.  Interestingly, the scientific research has not been able to agree on whether fallen arches have any bearing on this condition.

Patellofemoral Pain and Running Impact

A 2008 study published in the British Journal of Sports Medicine has helped to identify that patellofemoral pain can be related to impact.  Specifically, they found that those who developed patellofemoral pain ran with a higher impact (at footstrike) in the outside of the heel and in the second and third toes (during push-off).  So what does this mean?

Run Lighter for Patellofemoral Pain?

Traditionally, patellofemoral pain has been attributed to alignment factors.  Given the new literature, we now know that it can also be related to impact.  Although we don’t recommend that you change your running technique without the help of a qualified professional, you may want to lighten your step if you’re known to be heavy on your feet!

Physiotherapy for Patellofemoral Syndrome

Treatment for patellofemoral syndrome can vary.  Frequently (but not always) the goal of treatment is to manually treat and “release” the lateral structures of the quadricep, hamstring and the iliotibial band combined with strengthening aimed at the gluteals and the inside of the quadricep.  Quite often, this involves the use of active release technique and graston technique.  For more information, please contact us at 905.220.7858


Powers CM, Chen PY, Reischl SF et al. Comparison of foot pronation and lower extremity rotation in persons with and without patellofemoral pain. Foot and Ankle International 2002; 23: 634-640.

Thijs Y, Clercq D, Roosen P, Witvrouw E. Gait-related intrinsic risk factors for patellofemoral pain in novice recreational runners. British Journal of Sports Medicine 2008; 42: 466-471.

Wen D, Puffer JC et al. Lower extremity alignment and risj of overuse injuries in runners. Med Sci Sports Exerc 1997; 29: 1291-1298.