2025 UPDATED Patellofemoral Pain Syndrome(PFPS) Evaluation & Treatment

Are you tired of dealing with Patellofemoral Pain Syndrome (PFPS), also known as anterior knee pain? Pain while squatting, running, or even walking can feel debilitating, but new 2025 research brings hope! This groundbreaking study sheds light on effective ways to manage PFPS and introduces exercises that can help reduce pain and improve function. In this video, we’ll break down the latest findings, show you the 3 best exercises for Patellofemoral Pain Syndrome, and explain how an expert examination can lead to a proper diagnosis and faster recovery. 714-502-4243 | Costa Mesa, CA | http://www.p2sportscare.com Book a Discovery Session/ Consultation to see if we can help (virtually or in-person) #Patellofemoralpain #kneepain #trailrunners Transcript: Are you dealing with side-of-the-knee pain known as patellofemoral pain syndrome? Today, we’re going to go over the relevant anatomy, some potential causes, and I’ll walk you through a full exam for patellofemoral pain syndrome (PFPS). Then, I’ll show you some of my favorite exercises for it. I have a handy knee model here, which is actually a right knee. In patellofemoral pain syndrome, we’re talking about the patella, which is the kneecap, and the patellofemoral joint, which involves the femur (your main thigh bone). If we turn this around, you can see the main thigh bone here. The third bone that’s relevant is the tibia, your main shin bone, which you can feel when you run your fingers down your shin. Once we get past the layers of quadriceps tendons, we reach the kneecap, which sits right on top of the femur. If you can see in here, there’s actually a little groove in the middle, followed by two walls on the sides. Your patella ideally sits in that groove and tracks right in the middle as you flex and extend your knee. In people with patellofemoral pain syndrome, the patella often moves to one side or the other, rubbing against the walls of the groove when you bend and straighten your knee. If this rubbing occurs enough, it can lead to inflammation and pain in the area. What causes this to happen? According to a study from 2016, increased peak hip adduction is a risk factor for developing patellofemoral pain in female runners. Hip adduction refers to the leg moving toward the midline of the body. This means areas around the knee, such as the hip, core, ankle, and foot, play a significant role in PFPS. It’s not all about your quads. In fact, the quads aren’t very involved with hip adduction. It’s more about your hip and core function, and when you’re standing, your ankle and foot mechanics also matter. Another study focused on runners specifically showed that in the stance phase, female runners with patellofemoral pain have increased hip adduction, and the same is true for male runners. The hip adduction is often coupled with internal rotation of the femur. This combination can lead to a reduction in the space in the knee joint, causing friction, and ultimately, pain in the patellofemoral joint. Let’s go over the exam for PFPS. First, take a visual look at the knee. There shouldn’t be significant swelling. If there’s enough swelling that you can’t see your kneecap anymore, this might not be PFPS—it could be something else. Roll up the leg to see the bottom of the quad, and perform a quick swipe test to see if any jelly-like fluid comes up towards the bottom of the quad. If you don’t notice that, we can move on. Next, we’ll poke around the outside of the kneecap. Press fairly hard around the circumference. If you experience pain, it could suggest a different condition, such as jumper's knee. Pressing on the bottom of the patella and the patellar tendon, down to where it attaches to the tibia (the tibial tubercle), will help assess for any tenderness. If you feel pain here, it’s likely patellar tendinopathy. In teenagers, pain in this area could also indicate Osgood-Schlatter disease. Now, let’s move on to the grind test. In people with PFPS, this is usually painful. Start with the leg in a neutral position, place your hand on top of the patella, and push down and grind around. You should feel the groove and the walls of the groove. Usually, pain occurs when you push on the outside of the kneecap. We’ll then perform some stress tests for the ligaments. First, we’ll let the knee fall. Any problems here? No? Good. If you can’t get terminal knee extension (knee all the way straight), we might be talking about a meniscal injury instead of PFPS. If you can’t get the knee all the way bent, we might also be talking about a meniscus injury in a different area.