As your knee bends or straightens, your kneecap, or patella, should glide smoothly up and down in the groove at the end of your thigh bone. Pain felt ‘behind the kneecap’ is often caused by the kneecap rubbing on n the thigh bone. In extreme cases, the smooth cartilage surface on the back of the kneecap begins to crack and breakdown, a condition known as chondromalacia patella.
Patella femoral syndrome is defined as retropatellar or peripatellar pain resulting from the physical and biochemical changes in the patella femoral joint. It is actually a group of different diagnosis put together that are sometimes difficult to separate out. Pain is worse when the knee is loaded in a bent position, such as during squatting actions or walking up or down hills or steps. Prolonged sitting in a cramped space, such as on a plane or in a theater, may cause aching in the knee. The problem is often caused by an imbalance in the quadriceps muscles on the front of the thigh, which means the kneecap is pulled more toward the outside. Other causes include falls into the knee and poor foot mechanics, sometimes due to faulty sports shoes. Treatment requires reducing the impact from running or jumping, along with strengthening and stretching exercises for the quadriceps. A variety of straps or supports are available to improve the ‘tracking’ of the kneecap, which can reduce symptoms until you find and treat the underlying cause. Most of the time athletes who have patella femoral syndrome have some issues with respect to strength of their quadriceps & core muscles. On occasion, individuals will have problems with the alignment of their limb or the position of their kneecap. It should be distinguished from chondromalacia, which is actual fraying & damage to the patellar cartilage. Treatments for patella femoral syndrome are mainly strengthening of the quadriceps and the core muscles. It can be supplemented by orthotics or bracing to help alignment issues. Sometimes anti-inflammatory medications or steroid injections can helpful to manage symptoms. Athletes with patella femoral syndrome can typically play given their symptoms are reasonably well controlled.