Patellofemoral pain syndrome is most commonly managed with which initial plan for adolescent girls?

• A. Complete immobilization
• B. Reducing running distance and physical therapy
• C. Surgical realignment
• D. Corticosteroid injection

Answer: (B)

Patellofemoral pain in adolescents is usually an overuse issue related to how the patella tracks and how the muscles around the knee behave during activity. The most effective first step is to ease the knee’s load while correcting mechanics through targeted strengthening. Reducing running distance lowers repetitive patellofemoral stress, giving irritated tissues a chance to settle. Pair that with a structured physical therapy program that focuses on strengthening the quadriceps (especially the vastus medialis obliquus) and the hip abductors and external rotators, plus neuromuscular and gait training. This combination improves patellar tracking, stabilizes the knee during bending activities, and restores function, all without resorting to surgery or injections.

Immobilization isn’t ideal here because movement is needed to recover muscle strength and coordination, and long immobilization can cause stiffness. Surgical realignment is reserved for cases that don’t improve with conservative therapy, and corticosteroid injections don’t address the underlying mechanics and carry risks.