Do you experience discomfort in the front of your knee when climbing stairs, squatting, or standing up from a seated position? Does your knee feel sore after sitting for long periods, or does it make clicking, popping, or grinding noises during movement? If so, you may be suffering from patellofemoral pain syndrome (PFPS) – a common cause of anterior knee pain that can affect people of all activity levels.
In this comprehensive guide, we’ll explore the nature of patellofemoral pain, common causes, symptoms to watch for, and the most effective treatment strategies to help you regain pain-free movement.
What Is Patellofemoral Pain?
Patellofemoral pain refers to discomfort at the front of the knee, specifically where the kneecap (patella) meets the thigh bone (femur). This region forms the patellofemoral joint, and when this joint is subjected to abnormal stress, it can result in pain, inflammation, and a gradual decline in function.
This condition is sometimes referred to as:
- Anterior knee pain
- Runner’s knee
- Patellofemoral pain syndrome (PFPS)
Common Symptoms of Patellofemoral Pain:
- Pain behind or around the kneecap
- Discomfort when walking up or down stairs
- Pain when squatting, kneeling, or sitting for extended periods (also called “moviegoer’s knee”)
- Grinding, clicking, or popping sounds during knee movement
- Sensitivity during running or other high-impact activities
What Causes Patellofemoral Pain?
Patellofemoral pain can develop due to a range of factors, often involving poor movement patterns, muscular imbalances, or a sudden increase in activity levels. Understanding the root cause of your knee pain is essential for effective treatment.
1. Overuse or Sudden Increase in Activity
Many individuals develop PFPS after suddenly increasing their activity levels. Common triggers include:
- Starting a new fitness routine
- Preparing for a race or sports event
- Moving to a home with stairs
- Wearing high heels or unsupportive footwear more frequently
These activities can place extra stress on the patellofemoral joint, especially if the knee is repetitively bent or loaded under pressure.
2. Muscle Weakness or Imbalance
Weakness in the quadriceps, gluteal muscles, or hip stabilisers can contribute to poor knee alignment. When the muscles surrounding the knee fail to work in harmony, the kneecap may not track properly within its groove, leading to irritation and pain.
3. Poor Biomechanics or Movement Patterns
In some cases, patellofemoral pain results from faulty movement mechanics such as:
- Knee valgus (inward knee collapse during squatting or stair climbing)
- Foot overpronation (excessive inward rolling of the foot)
- Limited ankle mobility or hip stiffness
These issues place uneven stress on the patellofemoral joint and can lead to joint irritation over time.
4. Joint Stiffness or Hypermobility
Stiffness in the knee or surrounding joints can restrict healthy movement, while excessive mobility can lead to instability. Both extremes may increase load on the patellofemoral joint and contribute to pain.
The Importance of a Physiotherapy Assessment
Because patellofemoral pain can stem from various causes, an individualised assessment by a physiotherapist is crucial. At Logan Physio, our detailed one-hour assessment includes:
- Evaluation of local joint mobility
- Muscle strength testing (hip, quadriceps, glutes)
- Assessment of tissue flexibility and muscle tightness
- Analysis of gait, movement patterns, and exercise technique
This comprehensive approach allows us to determine the key factors contributing to your pain, so we can tailor a specific treatment plan that targets the root cause rather than just masking the symptoms.
Evidence-Based Treatment for Patellofemoral Pain
1. Exercise Therapy
Targeted exercise is the cornerstone of treatment for patellofemoral pain. These exercises are designed to:
- Strengthen weak muscle groups (especially the quadriceps, glutes, and hip stabilisers)
- Improve joint mobility and flexibility
- Correct faulty movement patterns and reduce knee load
Some examples include:
- Glute bridges and clamshells
- Step-ups and controlled lunges
- Quadriceps stretches and foam rolling
- Hip mobility drills
2. Manual Therapy
While exercise is essential, manual therapy techniques can provide short-term pain relief and improved movement. These may include:
- Joint mobilisation
- Soft tissue release
- Patellar mobilisation
Manual therapy works best when used in combination with exercise and load management.
3. Load Management
One of the most important aspects of recovery is managing your activity levels to avoid overloading the joint. A physiotherapist will help you adjust your training volume, intensity, and frequency so you can maintain fitness without aggravating your symptoms.
4. Taping or Orthotics
In certain cases, kinesiology taping or custom foot orthoses may be used to improve patella tracking or reduce stress on the joint, especially when faulty foot mechanics contribute to the issue.
What About the Noises in My Knee?
Many people with patellofemoral pain worry about the creaks, pops, or grinding sounds (called crepitus) coming from their knee. These noises can be alarming, especially if they’re accompanied by pain, but it’s important to understand that:
- Noisy knees aren’t necessarily damaged knees.
- Joint noise is common and often harmless, especially in younger people or those with tight soft tissues.
- Fear of movement can worsen the problem.
- When people become fearful of pain or joint noise, they may start avoiding movement altogether. This fear-avoidance behaviour can lead to increased stiffness, weakness, and deconditioning – ultimately worsening the pain and reducing function.
This is where physiotherapy guidance becomes essential. Your physio will reassure you about what your symptoms mean (and what they don’t mean) and help you exercise safely, without fear of causing harm.
Regain Confidence, Reduce Pain, and Get Back to Living
Patellofemoral pain is a treatable condition—but it requires a personalised, evidence-based approach. With proper physiotherapy support, most people can return to their usual activities pain-free.
A skilled physiotherapist will:
- Guide you through safe, progressive rehabilitation exercises
- Educate you about pain and movement
- Help you adjust your routine to support long-term recovery
- Rebuild your confidence and strength
Book Your Comprehensive Knee Assessment Today
If you’re ready to tackle your knee pain and get back to doing the things you love, our experienced team at Logan Physio is here to help.
📞 Call us on (07) 3200 8541 or book online to schedule your one-hour initial examination, where we’ll identify the underlying issues and design a recovery plan tailored just for you.
