Patellofemoral Pain Syndrome (PFPS)

Patellofemoral Pain Syndrome (PFPS) is a topic covered in the 5-Minute Clinical Consult.

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  • Pain in or around the patella that increases after prolonged sitting, squatting, kneeling, or ascending/descending stairs
  • Synonyms: anterior knee or retropatellar pain syndrome, chondromalacia patella, runner’s knee
  • System(s) affected: musculoskeletal


  • Annual prevalence of 29% in adolescents and 23% in adults (1)
  • In a military population, prevalence of 12% in males and 15% in females (2)

Etiology and Pathophysiology

Multifactorial etiology, including:

  • Weakness and incorrect firing of knee extensors (3)
  • Impaired gluteal muscle function resulting in increased hip joint adduction and internal rotation (3)
  • Decreased strength and altered recruitment patterns of core muscles during movement (3)
  • Decreased muscle length, particularly of the quadriceps, may also contribute (3).


Risk Factors

  • Recent research has found that age, height, weight, body mass index, body fat, Q angle, and hip weakness are no longer considered risk factors for patellofemoral pain syndrome (PFPS) (4).
  • In a military population: quadriceps weakness (4)
  • In adolescents: increased hip adduction strength, although this may represent increased activity level (4)

General Prevention

Strengthening and stretching exercises, particularly hip abductors and terminal extension of the quadriceps

Commonly Associated Conditions

  • Overuse
  • Knee ligament injury/surgery
  • Patellar tendinopathy
  • Prolonged synovitis
  • IT band friction syndrome

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