Patellofemoral Pain Syndrome — Pediatric — Non-Operative

Massachusetts General Hospital · MGH Brigham Pediatric Sports Medicine

Weight-Bearing

WBAT; activity modification; avoid painful PF compression positions

Key Restrictions

Minimize aggravating factors (stairs, prolonged sitting, running, jumping); pre-fabricated foot orthoses for >normal pronation (up to 6 weeks); discharge Phase III: quad index >80% HHD; discharge Phase IV: quad >=95%, H:Q ratio >=66%, hop testing >=90%

Timeline & Phases

Phase I (0-2 wks): patellar taping/mobilization, quad isometrics (0/45/90 deg), SLR, hip abductor/core strengthening, stationary bike; Phase II (2-4 wks): terminal knee extension, closed chain without knee flexion, balance/proprioception; Phase III (4-6 wks): partial squats, step-ups/step-downs, lateral step-downs, leg press; Phase IV (6-12 wks): return to run with running mechanics retraining, plyometrics, sport-specific program

Notes

Pediatric/adolescent PFPS protocol; explicit note: 'Children are not small adults'; includes VMO coordination test, patellar apprehension, Clarke's, eccentric step test; extensive differential diagnosis; running mechanics retraining (cadence, hip adduction cueing).

Surgeon / Author

MGH Brigham Pediatric Sports Medicine