Patellofemoral Pain Syndrome: How to Care for Your Child

Someone with patellofemoral pain syndrome (also called runner's knee) has pain or a grinding feeling under or around the kneecap (patella). The pain may come on suddenly or gradually and is often felt during squatting, running, kneeling, getting up after sitting, and going up/down stairs.

Treatment usually includes cutting back on or stopping activities and sports until the pain is better and doing exercises that strengthen the hips and legs. It can take several months and sometimes even longer for patellofemoral (peh-tel-oh-FEM-er-el) pain syndrome to get better. Very rarely, surgery is needed.

Help your child adjust their activity level:

• If your child's symptoms are mild, they just need to shorten or change their sports routine. But if they have severe pain or limping, they need to stop any sports that put stress on the knee and rest it until the pain is better. 

• They can gradually add activities and increase workout intensity if the pain doesn't get worse. If the pain gets worse, they should stop the activity and try it again after the pain is better.

Follow your health care provider's advice for:

• Any movement exercises or stretches your child should do and any activities or sports to avoid.

• Using a brace, knee taping, or shoe arches. 

• Helping your child keep a healthy weight to put less stress on the knee.

• Whether your child should go to a bone doctor (orthopedist), sports medicine doctor, or physical therapist to help them build strength and flexibility and create a plan for returning to full activities and sports.

• When your child should follow up.

For pain, your child can:

• Place ice wrapped in a towel on the knee for about 20 minutes several times a day. Do not put ice directly on the skin.

• Take ibuprofen (Advil^®, Motrin^®, or a store brand) or naproxen (Aleve^®, Naprosyn^®, or a store brand). Follow the directions on the label for how much they should take and how often. Your child should not take this medicine for longer than about 2–3 weeks.

Your child:

• has pain that gets worse

• can't bend or fully straighten the knee

• can't put weight on the knee

• has times when the knee "gives way" (suddenly feels unstable, weak, or unable to bear weight)

• limps

What causes patellofemoral pain syndrome? It often happens from bending and straightening the knee over and over (for example, in running, biking, or skiing). It's most common in athletes. It can also happen in people whose kneecap is slightly out of line with their leg (for example, from trauma or weak muscles) or who have flat feet.

When can someone with patellofemoral pain syndrome return to sports? This usually is when:

• Their hip, leg, and core strength is near normal.

• Their flexibility, especially in the hamstring muscle, has improved.

• There's no pain with everyday activities, such as walking and going up/down stairs.

• Any pain with activity is very mild and goes away within a few minutes of starting the activity.