Could You Have Knee Patellofemoral Syndrome? How to Find Out

Knee pain that lingers around the front of the knee is one primary symptom of Patellofemoral Pain Syndrome (PFPS), also known as knee patellofemoral syndrome or anterior knee pain syndrome. It can easily disrupt simple, everyday movements, such as walking up stairs or getting out of a chair.

If you’ve been feeling discomfort at the front of your knee, especially during or after activity, this guide will help you understand what might be going on, what causes it, and how to manage it.

What Is Patellofemoral Pain Syndrome (PFPS)?

Patellofemoral pain syndrome refers to pain around or behind the kneecap (patella), particularly where it meets the thigh bone (femur). This occurs when the kneecap moves out of alignment within the groove of the thighbone, resulting in pain or discomfort.

Sometimes referred to as "runner's" or "jumper's" knee, PFPS is one of the most common culprits of anterior knee pain. While often associated with athletic activities, PFPS is not caused by a specific injury. Rather, it's a result of irritation or stress on the soft tissues of the knee joint. Unlike structural conditions such as chondromalacia patellae, which involves cartilage damage, PFPS is usually linked to problems in the surrounding soft tissues, like muscles or tendons.

This pain syndrome is considered an overuse condition, often triggered by activities that load the patella, such as squatting, climbing stairs, or running.

Why Is It Also Called “Runner’s Knee”?

The name “runner’s knee” comes from the fact that many runners and endurance athletes develop symptoms due to the repetitive bending and straightening of the knee. However, it doesn't just happen to runners. The term has stuck because of how often it appears in people with higher activity levels.

What Exactly Is Happening in the Knee Joint?

In individuals with PFPS, the patella doesn’t track smoothly over the femur. This can create friction and strain on the front of the knee, especially when the thigh muscles are weak or imbalanced. Misalignment of the patella can lead to irritation in surrounding tissues, such as the patellar tendon or cartilage under the kneecap.

Who Typically Gets Patellofemoral Pain Syndrome?

Patellofemoral pain syndrome is most commonly seen in active adults, particularly those involved in sports or physical jobs that involve repetitive knee bending.

Is It Just Athletes or Runners Who Experience This?

No. Although runners, dancers, and cyclists often experience symptoms, so do people who spend long hours sitting, kneeling, or walking. Inactivity, oddly enough, can also worsen the condition, especially if the hip muscles or the thigh muscles become weak from disuse.

Are Women More Likely To Get PFPS?

Yes. Women are more likely to experience knee patellofemoral syndrome due to anatomical differences. Their wider hips can alter how the patella tracks. Hormonal and structural differences may also contribute to muscle imbalances and joint stress.

What Are the Most Common Symptoms of PFPS?

PFPS often shows up as vague, activity-related knee pain without a clear injury. Here are the typical signs to watch for:

• Dull pain around or behind the kneecap
• Discomfort when bending the knee (walking downstairs, squatting, or kneeling)
• Stiffness or pain after sitting or standing for long periods
• Popping, clicking, or grinding sounds in the knee
• Occasional swelling or puffiness around the kneecap

Is the Pain Always Right Behind the Kneecap?

The pain is usually described as a dull ache at the front of the knee or around the kneecap. The discomfort may not always be directly behind the kneecap, but it typically centres on the front of the knee.

How Can I Find Out If I Have Patellofemoral Syndrome?

You can either watch for early signs at home or directly consult a qualified healthcare provider.

What Tests Will a Physiotherapist or Doctor Use?

A healthcare provider will begin with a detailed diagnosis based on your symptoms, activity level, and physical exam. They may check for tenderness on the front of the knee, assess how the patella tracks, and look for muscle weakness or alignment issues. X-rays might be used to rule out other causes of knee pain, but they typically don’t show PFPS directly unless serious cartilage damage is present.

Are There Simple Checks I Can Try at Home?

Yes, but these are not substitutes for a professional assessment. Try squatting or climbing stairs. If the pain increases at the front of the knee, it may suggest PFPS. You can also contract your thigh muscles and observe if the kneecap moves off to the side, which might indicate tracking issues.

What Causes Patellofemoral Pain Syndrome?

PFPS doesn’t usually come from a single injury. It’s often the result of repeated stress combined with how your body moves.

• Overuse from running, jumping, or standing for too long
• Weak or tight thigh, hip, or core muscles
• Misaligned kneecap that tracks unevenly
• Flat feet that throw off knee alignment
• Poor exercise form or training habits

These factors can lead to irritation in the joint and discomfort during everyday movements.

Can Muscle Imbalance or Weakness Lead to PFPS?

Absolutely. Weakness in the hip muscles, glutes, or inner thigh muscles can change how the patella moves. Muscle imbalances can pull the kneecap off track, increasing stress on the knee joint during motion.

Do Footwear and Flat Feet Make It Worse?

Yes. Poorly fitting shoes or flat feet (overpronation) can affect alignment all the way up the leg, putting extra pressure on the patella. Custom insoles or proper support may help alleviate some of this stress.

What Are My Treatment Options for PFPS?

Many people with PFPS improve with conservative care. Here’s a breakdown of commonly recommended treatments:

1. Rest – Temporarily stop or reduce activities that cause pain; This gives the knee joint time to recover and calm down.
2. Ice – Apply ice packs for 15–20 minutes several times a day; helps reduce inflammation and manage flare-ups.
3. Strengthening exercises – Focus on quads, hamstrings, hips, and core; improves stability and reduces stress on the kneecap.
4. Stretching – Loosen tight hamstrings, quads, and calves; supports movement and knee alignment.
5. Bracing or taping – Used to support or realign the kneecap; can reduce pain during activity and improve tracking
6. Orthotics – Use shoe inserts to improve foot and ankle position; useful if flat feet or poor mechanics are contributing factors.
7. Medications – NSAIDs like ibuprofen reduce pain and swelling; recommended for short-term use to help manage symptoms during recovery.
8. Surgery – Rarely needed; considered as a last resort only if symptoms persist after months of treatment.

Can Physiotherapy Really Help PFPS?

Yes, physiotherapy is an effective treatment for patellofemoral pain. It focuses on strengthening weak areas, improving mobility, and correcting movement patterns that may contribute to the condition. A physical therapist can assess what’s contributing to your PFPS and create a targeted plan of exercises and treatments to address it.

What Can I Expect During Physiotherapy for PFPS?

A physiotherapist will assess your movement, strength, and flexibility. They’ll guide you through specific exercises to target hip muscles, thigh strength, and overall knee stability. Treatments may also include manual therapy and education about movement habits and footwear.

Are Taping or Knee Braces Useful?

They can be. Taping techniques or knee braces designed to guide the patella can reduce symptoms temporarily. However, these are typically used in conjunction with exercise and not as standalone solutions.

Do I Need Surgery for Patellofemoral Syndrome?

Surgery is rarely needed. Only when conservative treatment fails and symptoms persist for months, a surgeon may consider options like knee surgery to realign the patella. But for many people, non-surgical treatments are effective.

What Are the Long-Term Effects If PFPS Is Left Untreated?

If you ignore the symptoms, patellofemoral pain syndrome can worsen and affect your ability to carry out daily activities. Over time, chronic stress on the knee joint may contribute to cartilage wear, resulting in persistent knee pain or even early osteoarthritis.

Are There Home Exercises That Can Help With PFPS?

Yes. Low-impact exercises focused on hip and thigh muscle strength are key. Examples include:

• Straight leg raises
• Side-lying leg lifts
• Glute bridges
• Clamshells
• Wall sits (with proper form)

Consistency is crucial. Always start gently and increase difficulty as tolerated. If needed, apply the RICE method (rest, ice, compression, elevation) after activity to reduce flare-ups.

When to See a Doctor

If your knee pain doesn’t improve, keeps you from daily tasks, or becomes intense, it’s recommended to see a doctor for a clear diagnosis and tailored care.

Conclusion

Patellofemoral pain syndrome isn’t something you have to live with. Early recognition and the right treatment—whether it’s focused exercises, support gear, or professional guidance—can help you recover faster and prevent chronic pain. With a consistent approach, many people get back to moving comfortably and doing what they love.