Stop Patellofemoral Pain Syndrome Naturally: Symptoms, Causes, Healing Cycle & Treatment
What is patellofemoral pain syndrome?
Patellofemoral syndrome, patellofemoral pain syndrome, or runner’s knee constitutes a common cause of anterior knee pain. Patients suffering from patellofemoral syndrome commonly present with generalized anterior knee pain, which is aggravated upon loading of a flexed knee, for instance, during squatting, running, and climbing stairs.  The following sections discuss the causes, risk factors, symptoms, normal healing cycle, ineffective treatments, and effective treatment measures for patellofemoral pain syndrome.
Symptoms of Patellofemoral Pain Syndrome
The symptoms of patellofemoral pain syndrome are enlisted as follows.
- Pain at the anterior aspect of the knee joint
- Stiffness and swelling at the knee
- Instability or weakness
- Inability to straighten the knee
Causes and Risk Factors of Patellofemoral Pain Syndrome
The causes and risk factors of patellofemoral pain syndrome are enlisted as follows. The etiology of this syndrome is multifactorial and occurs secondary to training practices. The anatomic areas involved in the patellofemoral pain syndrome include the synovium, muscle, skin, nerve, subchondral bone, and retinaculum. Compared to multisport athletes, early sport specialization practices tend to increase patellofemoral syndrome relative risk by 1.5. This pathology is more common among females, with a women-to-men ratio of 2:1. Patellofemoral syndrome accounts for approximately 25%-40% of the total knee problems that are encountered by a sports medicine specialist. 
- Wearing bad shoes
- Iliotibial band syndrome
- Injury to the knee
- Overuse such as in running or jumping sports
- Muscle imbalance
- Female gender due to wider pelvis angle
Normal Wound Healing Cycle and Chronic Conditions
The normal wound healing cycle is comprised of three major phases, including the inflammation stage, proliferation stage, and maturation stage. In order to understand effective treatment mechanisms for patellofemoral pain syndrome, one must understand the mechanisms underlying the three stages of the normal healing cycle, which are discussed in the table below. The given table also discusses the wound healing cycle in chronic conditions. 
Inflammation stage of the healing cycle
|The initial phase of the healing cycle is the inflammation phase, during which the inflammatory cells arrive at the site of injury and release inflammatory cells and cytokines as a response to injurious stimuli. These substances recruit immune cells, which eliminate the injurious stimuli. The cardinal signs of inflammation are swelling, warmth, redness, loss of function, and pain.|
Proliferation stage of the healing cycle
|The next phase of the healing cycle is the proliferation phase. The mechanisms involved in this phase include re-epithelization, synthesis of extracellular matrix, collagen deposition by the proliferating fibroblasts, and the formation of new blood vessels by a process termed angiogenesis. It is during this stage of the healing cycle that excessive scar tissue, muscle trigger points, fascia restrictions, and muscle spasm occur. These events usually occur in chronic conditions and depend on the proliferation of fibroblasts.|
Maturation stage of the healing cycle
|The maturation phase is the last phase of the wound healing cycle. During this phase, wound contraction, scar formation, and deposition of collagen type I take place. The resolution of the maturation stage of the healing marks the completion of the healing. During chronic conditions, the healing cycle moves back and forth between the inflammation and proliferation phases and fails to attain resolution.|
Ineffective Treatments of Patellofemoral Pain Syndrome
The following treatment measures are commonly used at homes and at clinics for promoting recovery from patellofemoral pain syndrome, however, these treatment measures are not effective, and only provide short-term pain relief or may even aggravate pain in some cases. These treatment measures are enlisted as follows.
- Application of ice and heat therapy
- Electrical stimulation on the knee
- Massage therapy
- Massage therapy with a foam roller
- Stretching of the knee
- Strength exercises during the inflammation stage of healing
- Mobilization of the knee
Effective Treatments for Patellofemoral Pain Syndrome
The following therapeutic approaches target the inflammation and proliferation stages of the healing cycle, accelerating their resolution and promoting the progression of the healing cycle to the maturation phase.
|Resolution of the inflammatory stage||
|Resolution of the proliferation stage||
|Other therapeutic measures||
Patellofemoral pain syndrome or runner’s knee is a common etiology of anterior knee pain, particularly among athletes who engage in early sports specialization practices. This not only hinders the functioning of an individual but also influences the optimal performance of daily activities. While conventional approaches may provide short-term pain relief, these are not effective in stimulating a normal healing cycle. ASTR-based tools and protocols including anti-inflammatory supplements, MagnaHeal device, and A1, A3, and A5 tools are useful in resolving the inflammation and proliferation stages of the healing cycle and alleviating patellofemoral pain syndrome.
- Bump JM, Lewis L. Patellofemoral Syndrome. [Updated 2022 Feb 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557657/
- Grubbs H, Manna B. Wound Physiology. [Updated 2022 May 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518964/