Patellofemoral Syndrome

Patellofemoral Syndrome (PFS), also known as “runner’s knee,” is a common condition characterized by pain around or behind the kneecap (patella). It often affects athletes, particularly runners, but can occur in anyone. This article provides a comprehensive overview of Patellofemoral Syndrome, including the symptoms patients might experience, potential causes, available medical treatments, and alternative therapies such as massage. Additionally, we will explore the benefits of chiropractic care in managing PFS and introduce the Zone Technique, a specialized chiropractic approach that offers the best solution for addressing the root causes and healing the structures of the knee to eliminate all symptoms of Patellofemoral Syndrome.


The primary symptom of Patellofemoral Syndrome is pain around the front of the knee, especially in the area where the patella meets the femur. Other common symptoms include:

  • Pain During Activity: Pain is often exacerbated by activities that put stress on the knee joint, such as running, squatting, climbing stairs, and jumping.
  • Pain After Prolonged Sitting: Pain can also occur after sitting for long periods with the knees bent, known as “theater sign” or “moviegoer’s knee.”
  • Grinding or Clicking Sensation: Some individuals may feel a grinding or clicking sensation when bending or straightening the knee.
  • Swelling: Mild swelling around the knee joint.
  • Tenderness: Tenderness around the patella, especially when pressing on it.

These symptoms can vary in severity and may impact daily activities and athletic performance.


Patellofemoral Syndrome results from a combination of factors that increase pressure on the patellofemoral joint. Common causes include:

1. Overuse and Repetitive Stress

  • Running and Jumping: Activities that involve repetitive knee bending and straightening can stress the patellofemoral joint, leading to inflammation and pain.

2. Biomechanical Issues

  • Misalignment: Poor alignment of the patella, femur, or tibia can cause uneven distribution of forces across the knee joint.
  • Muscle Imbalances: Weakness or tightness in the muscles surrounding the knee, particularly the quadriceps and hamstrings, can contribute to PFS.

3. Structural Abnormalities

  • Patellar Maltracking: The patella may not move smoothly within the femoral groove, causing increased friction and pain.
  • Flat Feet: Overpronation or flat feet can alter the alignment and movement patterns of the lower extremities, affecting the knee joint.

4. Trauma

  • Knee Injury: Direct trauma to the knee, such as a fall or impact, can lead to PFS.

5. Inadequate Footwear

  • Improper Shoes: Wearing shoes that do not provide adequate support or cushioning can contribute to knee pain and PFS.

Medical Treatments

The treatment for Patellofemoral Syndrome aims to reduce pain, improve function, and address the underlying causes. Here are some common medical interventions:

1. Medications

  • Pain Relievers: Over-the-counter medications like acetaminophen can help manage mild to moderate pain.
  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen and naproxen can reduce inflammation and pain.

2. Physical Therapy

Physical therapy is a cornerstone of PFS treatment and focuses on:

  • Strengthening Exercises: Targeting the quadriceps, hamstrings, and hip muscles to improve knee stability and alignment.
  • Stretching: Stretching the quadriceps, hamstrings, and iliotibial (IT) band to reduce muscle tightness and improve flexibility.
  • Patellar Taping: Applying tape to the patella to improve its alignment and reduce pain during activity.
  • Gait Analysis: Assessing and correcting abnormal walking or running patterns.

3. Orthotics

  • Shoe Inserts: Custom orthotics or over-the-counter shoe inserts can provide additional support and correct biomechanical issues, such as overpronation.

4. Bracing

  • Knee Braces: Wearing a knee brace or patellar strap can help stabilize the patella and reduce pain during activity.

5. Rest and Activity Modification

  • Rest: Reducing or modifying activities that exacerbate pain can allow the knee to heal.
  • Gradual Return to Activity: Gradually increasing activity levels under the guidance of a healthcare professional can prevent recurrence of symptoms.

6. Surgery

In severe cases where conservative treatments fail, surgical interventions may be considered. Surgical options include:

  • Lateral Release: Releasing tight structures on the outer side of the patella to improve its alignment.
  • Realignment Procedures: Surgical realignment of the patella to correct tracking issues.

Alternative Treatments

In addition to conventional medical treatments, several alternative therapies can help manage Patellofemoral Syndrome symptoms and improve quality of life.

1. Massage Therapy

Massage therapy can help alleviate symptoms by:

  • Improving Circulation: Enhanced blood flow can promote healing and reduce muscle tension.
  • Reducing Muscle Tension: Relaxing muscles around the knee can decrease pressure on the patella and reduce pain.
  • Promoting Relaxation: Reducing stress and anxiety can help manage chronic pain.

2. Acupuncture

Acupuncture involves inserting thin needles into specific points on the body to stimulate nerves and muscles, potentially reducing pain and improving function.

3. Chiropractic Care

Chiropractic care focuses on diagnosing and treating musculoskeletal disorders, particularly those involving the spine and joints. Chiropractors use various techniques to adjust the spine and other joints to improve alignment, reduce nerve compression, and enhance overall health.

Benefits of Chiropractic Care

  • Non-Invasive: Chiropractic adjustments are a non-surgical treatment option.
  • Pain Relief: Many patients experience significant pain relief after chiropractic treatments.
  • Improved Function: Chiropractic care can improve mobility and function, reducing the impact of Patellofemoral Syndrome.
  • Holistic Approach: Chiropractors often address overall health, including nutrition and lifestyle factors, which can contribute to better outcomes.

The Zone Technique: A Specialized Chiropractic Approach

While typical chiropractic care offers numerous benefits for managing Patellofemoral Syndrome, there is a specialized technique known as the Zone Technique that may provide the best results for eliminating symptoms and addressing the root cause.

What is the Zone Technique?

The Zone Technique is a chiropractic method developed by Dr. Peter Goldman. It focuses on balancing six systems within the body, which Dr. Goldman refers to as “zones”: the glandular, eliminative, nervous, digestive, muscular, and circulatory systems. The theory is that imbalances in these zones can lead to various health issues, including Patellofemoral Syndrome.

How Does the Zone Technique Work?

  1. Assessment: The chiropractor assesses the patient’s zones by palpating specific points on the head.
  2. Zone Balancing: Based on the assessment, the chiropractor performs adjustments to specific areas of the spine and body to restore balance to the affected zones.
  3. Follow-Up: Regular follow-up sessions help maintain balance and address any recurring issues.

Why the Zone Technique is Effective

  • Holistic Approach: By addressing multiple systems in the body, the Zone Technique aims to treat the root cause of symptoms rather than just the symptoms themselves.
  • Personalized Care: Each treatment is tailored to the individual’s specific imbalances, providing a customized approach to healing.
  • Comprehensive Healing: By restoring balance to the body’s systems, the Zone Technique can promote overall health and prevent future issues.


Patellofemoral Syndrome is a common condition that can significantly impact a person’s mobility and quality of life. Understanding the potential causes and available treatments is crucial for managing this condition effectively. While medical treatments and alternative therapies such as massage can provide relief, chiropractic care offers a non-invasive and holistic approach that can significantly improve outcomes.

Among the various chiropractic techniques, the Zone Technique stands out as a comprehensive method that addresses the root causes of Patellofemoral Syndrome by balancing the body’s systems. By considering this specialized approach, patients may find the most effective and lasting relief from their symptoms, ultimately leading to better health and quality of life.

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