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PFPS is pain from the tissues within or surrounding the joint between the knee cap (patella) and the thigh bone (femur). Pain is typically felt under or around the patella at the front of the knee. It is usually aggravated by activities such as squatting, lunging, kneeling, going downstairs, running, and walking especially downhills.  It is also often aggravated by prolonged periods of flexion i.e. sitting.



Pain is caused by overloading the PF joint and this can happen due to a number of reasons with most often more than one cause contributing to the problem.

  • Training error – We all know it, too much, too soon, too little rest. Or doing a lot on one day…i.e. Coastrek!!
  • Muscle weakness – In the quads and/or gluts (bottom)
  • Poor movement control – poor single leg balance and control of single knee squat
  • Reduced flexibility – Quads, Hip flexors, ITB, Hamstring and Calf
  • Biomechanics – Foot pronation, angle of your leg bones, the position of the patella.



  • Rest from running and walking (especially hills) until your pain settles
  • Reduce load by modifying or reducing aggravating movements. I.e. avoiding kneeling, squatting prolonged sitting etc for at least a few days until things settle
  • Anti-inflammatories or pain relief
  • Ice – 10-15 minutes over the painful area 2-3 times per day for the next 5 days
  • Foam roller – Rolling the quads, ITB, hamstring and the calf can all help
  • Stretching – Quads, Hip flexors, ITB, hamstrings, calf
  • Taping – very useful in reducing the load and settling symptoms. Your Physio will be able to show you how to do this.


If your symptoms do not settle within a week or so or return when you begin to resume your normal exercise regime further assessment and treatment should be undertaken. PFPS can be complex and have multiple potential causes. The causes need to be identified, and after the pain settles you will require rehab to deal with the cause of the problem before gradually “reloading” the area to return to normal.

SquareOne Physiotherapists are experts in assessing, diagnosing and treating overuse injuries such as PFPS and can get you back to exercising sooner to enable you to achieve your next goal.


Give us a call 9968 3424 or book in online to see one of our physios who will be able to help you.


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