Patellofemoral Syndrome (kneecap pain)

Patellofemoral Pain Syndrome

  • Patellofemoral pain syndrome refers pain arising from under and around the kneecap.
  • The patella slides up and down within a groove at the end of the thigh bone (femur). The knee cap may start to track to the outside of the groove and because of this misalignment pain
  • develops.
  • With repeated bending and straightening of the knee, which occurs with activity, the cartilage behind the knee cap can become irritated.


The main symptom that is experienced is pain behind and around the knee cap. This pain is generally worsened with running, going downstairs and extending periods of time sitting with the knee bent.

There may be a clicking or grinding sensation with bending and straightening of the knee and a sensation of weakness at the knee.


  • Poor foot biomechanics
  • Weakness in the inner quadriceps muscle (VMO)
  • Tightness through the outside thigh musculature (especially the ITB, vastus lateralis and lateral retinaculum).
  • Femoral anteversion (internal hip position).
  • Decreased external hip rotation

Treatment may include:

  • Orthotic therapy to improve foot biomechanics – research has shown that orthotics are effective in treating Patellofemoral Syndrome ( Mills K, Blanch P, Dev P, Martin M, Vicenzino B. (Br J Sports Med. 2012 Mar;46(4): 247-52)
  • Rest
  • Anti-inflammatory Medications
  • Footwear Advice
  • Ice
  • Avoid activities that exacerbate the condition
  • Soft tissue Strengthening and Stretching
  • Taping and bracing of the patella for stability