American Board of Internal Medicine (ABIM) Certification Practice Exam

What physical activity is likely to worsen patellofemoral pain syndrome?

1. Swimming

2. Walking on a flat surface

3. Running

4. Cycling

The correct answer is: Running

Patellofemoral pain syndrome (PFPS), often characterized by pain around the kneecap, is commonly associated with activities that put stress on the knee joint, particularly during weight-bearing exercises. Running is likely to exacerbate this condition due to the repetitive impact and stress it places on the patellofemoral joint and surrounding structures. When running, there is significant knee flexion and extension with each stride, which can cause increased compression of the patella within the femoral groove. This repetitive motion can irritate the surrounding soft tissues and lead to increased pain for those already suffering from PFPS. Additionally, running often involves abrupt changes in speed or direction, which can further strain the knee. In contrast, swimming involves a buoyant environment that reduces stress on the joints, and walking on a flat surface and cycling typically exert less direct loading on the knee compared to running, making them less likely to worsen symptoms associated with patellofemoral pain syndrome.