Patellofemoral Pain Syndrome (PFPS) is a common cause of pain to the front of the knee but may be felt in all aspects of the knee joint. The front of the thigh consists of four muscles (quadriceps) which aid in the correct tracking/movement of the kneecap (patella). Problems occur when the patella does not move correctly over the knee joint. When muscle imbalances occur around the knee joint, the result is “maltracking” of the patella.

The onset of PFPS can be due to a combination of several factors such as overload of the patellofemoral joint, anatomical/biomechanical abnormalities, muscular weakness and/or muscular dysfunction. PFPS usually has a gradual onset but in some cases it may also present secondary to a traumatic injury or following knee surgery.


Patellofemoral pain can be due to:

  • Muscle imbalance about the knee joint
  • Overtraining or overload
  • Muscle weakness
  • Muscle dysfunction (reduced muscle control/activation)
  • Muscle tightness
  • Altered biomechanics of the hip, knee, foot

What do I feel?

  • Sharp pain/diffuse aching in the front of the knee (may be felt vaguely throughout the whole knee in some cases)
  • Pain is increased by loaded activities (e.g., running, jumping, using stairs, squatting, or prolonged sitting)
  • Tenderness on under the surface of the kneecap
  • Swelling may be present
  • Creaky knees
  • Feelings of giving way in the knee may occur

What can I do?

  • Reduction and/or modification of activity
  • RICE (Rest, Ice, Compression and Elevation)
  • Support the kneecap with bracing or strapping tape
  • See a physiotherapist for effective rehabilitation and exercises
  • A podiatrist may assist if poor foot mechanics contribute to the problem

The management of a patient with patellofemoral syndrome requires a holistic approach. Physiotherapy looks to address the underlying cause for your patellofemoral pain and uses modalities such as manual therapy, taping, targeted exercise, orthotics, and advice around activity modification. Recovery may take 6-8 weeks depending on a variety of lifestyle factors and the underlying cause for your specific pain. Your physiotherapist will collaborate with you to design a personalised rehabilitation plan catered towards your goals.