Patellofemoral Pain Syndrome

What is patellofemoral pain syndrome?

Patellofemoral pain syndrome (PFPS) is a diffused, anterior knee pain which occurs particularly during running, stair climbing, or squatting activities. When the knee is bent, the forces within the knee joint increase. With repeated stress and/or trauma, the joint may develop inflammation which causes irritation and pain.


PFPS commonly occurs in young, active people who place repetitive stress through the patellofemoral joint. For example, runners, netballer players, soccer players, and basketball players, among others.

Common Signs & Symptoms:

  • Gradual onset of diffuse, anterior knee pain.

  • Pain on running, squatting, lunges, stair climbing, or any activities that involve bending the knee.

Common Causes:

PFPS is said to be a multifactorial condition which means that a variety of factors which could cause the above symptoms. The key is to develop rehabilitation interventions addressing any underlying contributing factors for the knee pain, and prevent any future occurrences. The following are common findings in patients with PFPS:

  • Malalignment

    • Abnormal lower limb biomechanics
      E.g. femoral anteversion, genu valgum, increased Q angle, tibial torsion, subtalar pronation

    • Patella Mistracking

  • Growth spurt in children

  • Long bones grow faster than the muscles, ligaments, and tendons causing abnormal stresses on joint.

  • Muscular imbalance

    • Uncoordinated co-contraction

    • Delayed or mistimed activation of VMO

    • Tight lateral structures (ITB, VL, and lateral retinaculum) causing lateral pull force on patella

    • Weak gluteals or poor gluteal control leads to dynamic lower extremity valgus, reducing proximal lower limb stability

  • Poor running, jumping, squatting, or landing technique.

  • Excess load caused by an increase in training volume, load, or intesntiy

What will your physios do?

Physiotherapists are able to reduce the immediate pain and inflammation, identify the factors contributing to your pain, and develop an appropriate rehabilitation specifically for you.

  • Identify whether your symptoms match the stereotypical clinical presentation of PFPS.

  • Ask questions to determine how the injury happened, your current symptoms, the type of pain you are having, and what activities bring on that pain.

  • Perform a physical examination of your knee.

  • Perform a range of special tests to rule out any serious pathologies.

  • Ask you to perform some functional tasks. E.g. jogging, or squatting.

  • Assess the range of motion and strength of your muscles.

  • Determine the cause of your knee pain and develop strategies to address these issues.

  • Develop an individualised treatment and rehabilitation plan.

  • Provide you with education regarding your injury, the treatment and rehab process, and strategies to manage your condition.

  • Answer any questions you have regarding your knee pain.

At-home Exercise Recommendations

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