What Is Patellofemoral Pain Syndrome – Symptoms & Diagnosis

Do you have pain in your kneecap? Is it almost bringing you to tears when you have to bend your knee? And that knee just hurts? Is it killing you that this isn’t getting better and every time you have to kneel or bend your knee for some reason, it just hurts or worse and worse?

Well, in this video today, I’m going to tell you how kneecap pain happens. It’s also known as patellofemoral pain syndrome. I’ll be talking about the symptoms of it, how to find it on yourself and what treatment options are for you if you’ve got that kneecap pain.

My name is Dr. David Middaugh. And I’m a specialist physical therapist here at El Paso manual physical therapy. And this channel is dedicated to helping people stay healthy, active and mobile, while avoiding unnecessary surgeries, injections and having to rely on pain medications, please subscribe to our channel so that you don’t miss out on any of the helpful videos that we upload every single week.

Now let’s get straight to it. How does kneecap pain happened?

The number one thing that causes pain behind the kneecap is too much pressure in your knee joint. Usually from too strong quad muscles have drawn you a picture to show you what I mean.

Here we’ve got the thigh bone, and then the shin bone and the kneecap right here. The quad muscles are the thigh muscles in the front of the thigh these in red right here, they connect to the top of the kneecap and the bottom of the kneecap connects to the shin bone through a ligament or some people call it a tendon. But there’s a it isn’t muscle, it’s just a piece of connective tissue down here. When these quad muscles appear get too strong.

That leads to too much pressure of the kneecap against the thigh bone, the end of the thigh bone right here. Here in blue, I’ve drawn the cartilage. And so cartilage is designed to take pressures. But if it’s taking too much pressure over a long period of time, then that cartilage begins to get irritated, eventually damaged, worn down, sometimes torn. And it’s just a matter of time before that knee starts to hurt, especially behind the kneecap right there.

So if you’ve got very strong quad muscles, or maybe you don’t have strongest quad muscles ever, but you’ve had gotten imbalance where your quad muscles are much stronger than the other muscles in your leg, then you’ve got the setup to get this kneecap pain also known as patellofemoral pain syndrome.

This is often a mystery to healthcare providers out there and people can’t really explain it, they just know this term called patellofemoral Pain Syndrome, where the kneecap hurts, there’s usually some weak muscles around the hip areas that we do know that and what doctors might tell you is it just gets better over time, you might need to go to physical therapy and even physical therapists will tell you it just gets better over time your cartilage is worn down or irritate is what they’ll say.

And in some cases, some other healthcare providers might even tell you extreme situations like you can’t ever run again, you can’t ever do this exercise or that exercise again, or you can’t stay on your feet for more than an hour or two. And that’s just not true. In most cases, this can heal very well. And let me just tell you some of the signs of this problem in case you’re wondering if you really have it.

Whereas you’ve got something else that looks similar like knee arthritis, which this does an end up setting you up for. So if you’ve got pain, the classic is you’ve got pain right behind the kneecap not on top by the skin is there’s actually another condition that causes that it’s a super patellar bursitis. But behind the kneecap kind of deep. That is the number one sign that you’ve got this behind the kneecap pain, kneecap paver patellofemoral Pain Syndrome, the other common sign that you’ll see is crepiness are crunching and popping whenever you bend and straighten out your knee.

I’ve got it right now actually, and I don’t have this issue anymore. I fixed it thankfully, but I’ve got some long term damage from it thankfully doesn’t cause me any problems right now. But I have less margin for error, my knees will ache and hurt a little bit if I let my muscles get too out of balance or if I overdo it somehow.

But if you’re at home trying to test this for yourself, that pain behind the kneecap, and then the crunchiness the third test that you can do and definitively nail this down that this is the problem for you. And this is going to be potentially painful, you got to be careful, you’re going to have to sit somewhere with your leg extended just like this. And then you got to push down on your kneecap do this generally because you are compressing the cartilage behind the kneecap against your thigh bone.

And this is the reason why this happens. Right? That’s what I was just saying. So if this test is positive or it causes the problem, then you can pretty definitively say that you’ve got this patellofemoral Pain Syndrome, and you know what’s going on.

So you just press down like that gently with One hand, kind of test it, give it some good force. And if that doesn’t set it off, and that’s good, you either don’t have patellofemoral Pain Syndrome, or you’ve got very mild patellofemoral Pain Syndrome, if it’s severe, this is going to already be hurting you. And if you need to take it a little harder, put two hands on there and press pretty hard.

I mean, you can see my leg moving here. That’s how hard you got to press in order to really tension that cartilage. And remember, cartilage is designed to take pressures. So just resting like this, I should be able to press on my kneecap, and it should not hurt. If yours is hurting when you press on it, you’ve got irritated cartilage, or damaged cartilage, there’s something wrong with your cartilage back there.

And it’s a level of concern for you got to be concerned about this, because this is the setup for knee arthritis, if you don’t treat it early, like when it’s just simple patellofemoral Pain Syndrome right now, if you’ve got patellofemoral Pain Syndrome, all three of these things were happening to you, you’ve got the crunchy knee, you’ve got the pain right behind the knee, and then you can reproduce the pain by pressing on your kneecap.

Then let’s talk about the treatment options that are out there for this. Number one, resting it and I’m a big fan of this, especially if it’s really irritated. If it’s just hurting you to bend your knee just sitting around, then you need to take some time off, you got to stop walking more than you normally need to. In other words, you know, walk for your everyday things, you got to walk to the bathroom, walk to the kitchen, get to work and do simple things.

But keep it to a minimum, don’t go on a long walk if you can order your groceries and have them delivered to you do so instead of shopping at the grocery store. Or if you just got to go to the grocery store, be efficient with the walking you’re doing around, don’t don’t hang out too much. Don’t go shopping them going a long walk, you’ve got to decrease the amount of use, you’re putting through that leg to rest it.

And if you’re at home, kick your feet up, get comfortable for a bit, watch a Netflix series or hang out on YouTube, watch all our channel videos and learn about your knee problems so that you can give your knee a chance to just calm down and rest. Once you’ve rested it, then you have a chance at doing more active stuff.

But most people don’t take the time, enough time needed to rest they don’t realize it sometimes it can be because it’s cartilage. Sometimes it can be a while it can be weeks, it can take a while because cartilage is one of the slowest healing tissues in the body.

Health care professionals don’t always say this. Usually they’ll just say, Well, did you take a week off? Like I told you is it better. And if you say no, they’ll move on to the next thing which doctors we usually recommend oral medications you take by mouth, but want to inject it as well to put cortisone in there.

And in some cases, they’ll refer you to a surgeon. And the surgeon can do a debrief mint surgery, which is where they go in and they clean out the knee joint, they clip loose ends of cartilage and re smooth the surfaces of the cartilage so that there isn’t as much grinding and crepiness there’s more to it than that I’m not a surgeon, I can’t tell you all the specifics on what’s done in a debrief meant.

But it’s surgery and you might be able to get away without it. If you do things right. over the counter pain medications are often used as well. And all of these things that I’ve mentioned so far are just short-term solutions. They’re going to take the pain away for a period of time, but they’re not addressing the deeper-rooted problem, which can be addressed with a specialist physical therapist, like what we do here, the deeper rooted problem is usually in a muscle imbalance.

And being able to analyze a muscle imbalance and treated properly does take some specialist skill. But typically, the imbalance that I see in people with patellofemoral pain syndrome or kneecap pain is their quads are way too strong in their glutes for their button muscles are quite weak. There is situations where it’s a hamstring weakness or a calf muscle weakness. It could even be coming from the core. And sometimes there isn’t even a weak muscle.

It’s just the way that the person is moving. In other words, we might need to address a running form their walking form or their weightlifting form, something like that might need to be addressed and not so much a strength issue. But I’d say by and large seven to eight out of 10 people that we see with patellofemoral Pain Syndrome have a glute weakness and quad dominance or too strong in their quadricep muscles.

So because this is the root problem and we see here in the clinic all the time, this can usually be treated 100% and naturally without having to rely on surgery injections or pain medications and people get back to doing all the active stuff they love to do running, jumping, lifting weights in ama walking living testament of it I don’t have a testimonial from a client for you right now.

But just for me myself, I started having knee pain when I was 17-18 years old just doing high school sports and sports on my own. I got really into running I was running long distances I did cross country and longer distances and is that are done in cross country. I also did a A lot of sports, football, soccer, I did frisbee, I did all kinds of other sports. And I ended up having knee pain quite a bit and a lot of crunchiness. I had patellofemoral Pain Syndrome had meniscus issues as well, ligament issues have had all kinds of troubles.

But I have been able to fix them simply by addressing the root problem like I’ve talked about. If you’re looking for these exercises, we’ve linked a video that talks about exactly what exercises to do for patellofemoral Pain Syndrome right here in the description below.

Go check that out. And if you’re interested in a more comprehensive program for your knee health, we’ve got something called the 28 day knee health and wellness boost program. You can also learn more about it in the description below. I hope this video was helpful for you. And please give us a like if you thought it was helpful. And don’t forget to subscribe so you don’t miss out on any of the helpful videos that we upload every week. Bye guys. Have a wonderful day.