The patella is the formal name for the knee cap. This bone lies on the front of the knee joint and is encased in the quadriceps muscle. It serves as a fulcrum and improves the efficiency and power of the quadriceps muscle to extend the knee. With knee flexion and extension, the patella is compressed against the groove on the top of the knee. It is designed to track straight up and down and is covered on its undersurface with cartilage that serves as a cushion. It is estimated that patellar cartilage can feel 4-5 times body weight with walking and up to 8 times body weight with stairs and squatting.
Pain in the Patellofemoral joint is typically seen in women more frequently than men and results from poor tracking of the patella relative to the groove on the top of the knee. This improper tracking can overload the cartilage and create pain in the front of the knee. It typically will get worse with an increase in training or exercise and then can become painful with normal activity such as squatting and stairs.
Treatment for this condition usually involves anti-inflammatory medications and occasional knee injections to help control flares. Chronic management focuses on physical therapy to strengthen the vastus medialis muscle to help improve tracking of the joint, activity modification, bracing, and controlling body weight. Rarely surgery may be indicated.