Patellofemoral Pain Syndrome: Physiotherapy For Your Knee Pain

What is Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS) is a condition involving pain at the front of the knee, around or behind the kneecap (patella).

This pain is generally due to contact between the patella and thigh bone (femur), which over time can affect the joint surface.  

PFPS is often referred to as “runner’s knee”  and is common in active people who participate in sports – but can occur in non-athletes too.

The pain and stiffness caused by PFPS can make it difficult to go up and down stairs, kneel, squat and run.


Symptoms of Patellofemoral Pain Syndrome

Patellofemoral pain syndrome commonly involves a dull, aching pain in or around the kneecap.

The onset of pain is usually gradual, not sudden/traumatic.

The pain symptoms are generally noticed during exercise and weight bearing activities that involve bending of the knee.

Climbing up and down stairs, running, jumping, hopping, squatting and kneeling are commonly painful with PFPS. 

Pain can also be experienced after sitting for long periods with knees bent.

The 3 Most Common Causes of Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is generally the result of the patella not tracking properly on the femur when the knee is being bent and straightened.

3 common causes of patellofemoral pain syndrome we see are

1. Overuse – sudden changes in activity level or intensity


2. Muscle imbalances – weakness in thigh or buttock muscles, tightness hamstrings or ITB


3. Biomechanics – excessive pronation of the feet/ankles, angle of the hip and knee joint

How Physios Treat Patellofemoral Pain Syndrome

The aim of treatment in the short term is to reduce pain and inflammation; and in the long term to correct the cause and prevent returning.

Short term treatment will involve rest, ice, protection and anti-inflammatories in the early stages to help reduce pain, inflammation and avoid activities that exacerbate pain. 

Physiotherapy treatment will involve a range of techniques for pain relief and taping of the knee to help relieve pain and begin to encourage better alignment at the knee joint.

Long term treatment will involve:

  • Regaining full passive range of motion in the knee and kneecap
  • Restoring muscle length to avoid tightness and tension around your kneecap
  • Strengthening of weak muscles around the hip and knee to help prevent future occurrences
  • Correction of poor technique or movement patterns.

Physiotherapy Treatment May Include

  • Massage
  • Joint mobilisations
  • Ultrasound
  • Dry needling/acupuncture
  • Taping techniques
  • Orthotics
  • Stretching program to reduce tightness and increase flexibility
  • Rehab program focusing on strengthening muscles around the knee

3 Exercises You Can Do at Home

1. Straight Leg Raise 

Lie on your back with one leg bent up and one leg fully straightened.  

Tighten your quadriceps (thigh muscles) in your straight leg and raise leg to a 45degree angle.

Slowly lower leg back down.

Complete 10 on each leg. Complete 2-3 times a day.

2. Clams

Lie on your side with hips and knees bent and knees together.

Raise your top knee toward the ceiling, keeping your feet together.

Slowly lower your knee back down.

Complete 10 on each leg. Complete 2-3 times a day.


3. Hamstring Stretch

Sit on the floor with one leg out straight.

Bend the other leg so your foot rests against your opposite thigh.

Reach forward over the straight leg as far as possible to feel a stretch in your hamstring.

Hold 20-30 seconds. Repeat on each leg.


Remember, there are other potential causes of pain in the knee, so we recommend you consult your physiotherapist or healthcare professional for assessment, advice and treatment specific to you.

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