Patellofemoral Pain Explained 

Patellofemoral Pain Syndrome is a common cause of pain around the knee cap. When the knee bends or straightens, the knee cap normally glides smoothly in a groove on the thigh bone called the ‘Patellofemoral groove’.

However, for a number of reasons the knee cap may stray from this path, usually towards the outside of the knee. This is called ‘Patellofemoral Maltracking’ and produces abnormal stresses on the under-surface of the patella that can cause knee cap pain.

If allowed to progress, these stresses can cause damage to the cartilage between the knee cap and Femur.

Most Common Causes

  • Tightness in the lower limbs – calf, hamstring , quadriceps muscles
  • Weakness or lack of  co-ordination in muscles that should help maintain normal patella tracking.
  • Altered hip, knee or foot posture.
  • Anatomical variations in our makeup such as a shallow Patellofemoral groove.

Sign & Symptoms 

Patellofemoral maltracking is one of the most common causes of knee pain and can be caused by numerous factors.

The most common symptom of Patellofemoral mal-tracking is pain at the front of the knee that occurs when running up, or most commonly, running down hill.

Pain can also result from prolonged sitting i.e. driving long distances.

Treatmenting Patellofemoral Pain

1.Reduce Pain

The causes of Patellofemoral maltracking will be specific for each person and so it is important that a treatment plan is formulated by a clinical expert.
Ice & Pain relief prescribed by your GP can often be the first step to take.
Once the initial acute pain has reduced, treatment with your physiotherapist can commence.


2.  Stretch

General stretches to reduce tightness which may be pulling on your kneecap or causing patella mal-alignment will need to be prescribed.
Targeted muscles generally include

  • Calves
  • Hamstrings
  • Quadriceps
  • ITB – Iliotibial Band


3.  Strengthen & Improve Coordination

Greater emphasis will need to be placed on exercises to strengthen and improve the coordination of the Vastus Medialis Oblique (VMO) muscle.

The VMO forms part of the Quadriceps muscle group and is located just above the knee cap, on the inner aspect of the thigh.
It is believed to help maintain the knee cap in its correct position in the Patellofemoral groove.

Strengthening of the Quadriceps muscle group as a whole, working on the gluteal muscles as well as foot posture will also be of priority.

Methods of improving muscle function with a physiotherapist may involve:

  • Effective and functional exercises – Closed Chain Exercises (where the sole of the foot is in contact with a flat surface)
  • Sports Taping techniques
  • Advice on footwear

During the enforced rest from running activities many people find that they are able to do pool running and exercises as a means of maintaining fitness, but it is important that these exercises are pain free.