Patellofemoral syndrome (PFS) is a common cause of pain to the front aspect of the knee. Problems associated with the patellofemoral complex are common in athletes in a wide variety of sports. Problems occur when the patella (knee cap) does not move correctly over the knee joint.

The front of the leg (quadriceps)) consists of four muscles which aid in the correct tracking/movement of the knee cap. When muscle imbalances occur around these muscles, the result is mal-tracking of the knee cap.


Pain to the front of the knee region due to poor alignment can be due to:

  • muscle imbalance about the knee joint
  • muscle fatigue from overtraining
  • muscle weakness
  • altered biomechanics of the hip, knee, foot

What do I feel?

  • Sharp pain/ aching in the front of the knee, usually of gradual onset
  • Pain increased by running, jumping, using stairs, or by prolonged sitting
  • Tenderness on undersurface of knee cap
  • Swelling, creaky knees

What can I do?

  • Reduce and/or modify activity
  • RICE (Rest, Ice, Compression and Elevation)
  • Support knee cap with bracing or tape
  • See a physiotherapist for rehabilitation and exercises
  • A podiatrist may assist if poor foot mechanics contribute to the problem

The management of a patient with patellofemoral syndrome requires an integrated approach. Reduction and modification of exercise is key in the initial stages. Recovery may take up to six weeks. Your physiotherapist is the best person to help you over this period.