Patellofemoral Pain Syndrome (Runner’s Knee)
Patellofemoral pain syndrome (PFPS) is one of the most common knee conditions treated in physiotherapy. It produces pain at the front of the knee — behind or around the kneecap (patella) — that worsens with running, squatting, going up and down stairs, and prolonged sitting with the knee bent (the “cinema sign”).
Despite being extremely common, it’s very treatable with the right approach.
What’s Going On
The patella glides in a groove at the front of the femur. When the forces tracking the kneecap are uneven — through hip weakness, tight lateral structures, quad imbalance or excessive knee loading — it can cause pain in the cartilage and surrounding tissue.
The root cause is almost always in the hip or lower limb biomechanics, not the knee itself.
Who Gets It?
- Runners, cyclists and team sport athletes
- Young women in their teens and twenties (higher prevalence)
- People who’ve suddenly increased activity or started a new training program
- Office workers who spend long periods with the knee bent
- Those with hypermobility or flat feet
Symptoms
- Aching pain behind or around the kneecap
- Worsens with running, squatting, lunges, stairs and kneeling
- “Cinema sign” — pain with prolonged sitting that eases when you straighten the leg
- Clicking or crepitus around the kneecap (usually not a sign of serious damage)
- Occasional swelling
Treatment
Hip and Quadriceps Strengthening
Research consistently shows hip abductor and external rotator strengthening is the most effective treatment — often more than quad exercises alone. We design a progressive program tailored to your level.
Taping and Bracing
McConnell taping to correct patellar tracking can give immediate pain relief and allow better engagement with exercises. Knee braces with a patella cutout can also help during sport.
Manual Therapy
Soft tissue release of the lateral retinaculum and quadriceps, patellar mobilisation, and any contributing hip or lumbar restrictions.
Biomechanical Correction
Running analysis, footwear assessment, and correction of excessive knee valgus (knees caving inward) with movement retraining.
Load Management
A graded return to activity, avoiding symptom spikes that set recovery back. We’ll keep you active — complete rest is rarely appropriate.
