Have you ever had that pesky pain in the front of your knee? Some days, it keeps you from hitting the gym. Other days, you think you're cured. Until you jump back on the mats to roll with an 18-year-old wrestler and it smacks you right on your ass. Or maybe that was the 18-year-old. Either way, if the pain flares up during training or running and it’s right in front of the knee, it might be Patellofemoral Syndrome.

What the Heck Is Patellofemoral Syndrome?

Gotta love that doctor lingo, right? The patella is your kneecap, and the femur is your thigh bone. Patellofemoral Syndrome happens when the kneecap doesn’t glide smoothly in its groove. This poor tracking leads to irritation behind the kneecap, especially where the cartilage ends meet between the 2 bones. Over time, it causes inflammation and pain.

This usually results from a combination of:

Poor movement mechanics
Weak glutes and quads
Overuse or sudden increases in training

How Do You Know If You Have It?

Athletes with patellofemoral syndrome often describe:

Pain in the front of the knee (anterior knee pain)
Pain after sitting for long periods
Pain with stairs, squatting, or kneeling
Clicking or grinding behind the kneecap

It usually builds up over time without one specific injury. So if you had a sudden pop, major swelling, or instability, it’s probably something else.

The Good News: It’s Very Treatable

No, you probably don’t need an MRI. Yes, you do need physical therapy.

If your knee pain is consistent with patellofemoral syndrome, I don’t tell my patients to stop jiu jitsu altogether. I simply ask them to avoid positions that aggravate the pain and stick more to drilling until it improves.

Seeing a sports-specific physical therapist is key. Depending on your insurance, you may need a referral from your doctor. If insurance is an issue, many cash-based online PTs specialize in treating jiu jitsu athletes. This can make a huge difference. If your PT doesn’t understand our sport, it can be frustrating.

Where to Begin…

Start with these adjustments:

Switch to low-impact cardio, like the stationary bike
Focus on upper body strength training in the gym for now
Begin glute and quad strengthening, especially targeting the VMO
Incorporate single-leg balance work (think BOSU ball or stability drills)
Get feedback on your squat or running mechanics from a movement specialist
This is the time for a short course (2-4 weeks) of anti-inflammatory medication

Final Thoughts

Don’t ignore early signs of knee pain. Patellofemoral syndrome is one of the most common causes of knee discomfort in athletes, and it’s very treatable especially when caught early. If left unchecked, it can lead to poor movement patterns and other injuries.

Strengthen your hips, train smart, and listen to your body.

Next week, I’ll be breaking down the most common causes of shoulder pain in athletes. Stay tuned!

—

Dr. Megan Lisset Jimenez

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It’s Not Just Soreness: The Truth About Anterior Knee Pain