Physiotherapy for Patellofemoral Pain
Patellofemoral pain, often called “runner’s knee,” is one of the most common causes of pain at the front of the knee. It can affect people of all activity levels — from athletes and gym-goers to those who spend long hours sitting or kneeling. The good news is that with the right physiotherapy treatment, most people can make a full recovery and get back to the activities they enjoy.
In this article, we’ll explore what patellofemoral pain is, how physiotherapy can help, what exercises to avoid, and which ones are most effective for recovery.
What Is Patellofemoral Pain?
Patellofemoral pain refers to discomfort felt around or behind the kneecap (patella), especially when climbing stairs, squatting, running, or sitting for long periods. It usually happens when the kneecap doesn’t move smoothly in its groove at the front of the thigh bone.
This can be due to several factors, such as muscle imbalances, poor hip and knee control, overuse, or training errors. While it can be frustrating, physiotherapy plays a key role in both reducing pain and preventing it from returning.
How Is Physiotherapy Used to Treat Patellofemoral Syndrome?
Physiotherapy focuses on identifying and addressing the specific factors that are causing your pain. Your physiotherapist will begin with a thorough assessment of how your hip, knee, and foot move and work together. From there, a personalised treatment plan is developed.
Here’s how physiotherapy can help:
Exercise Therapy – Strengthening and control exercises are the cornerstone of treatment. Physios focus on improving strength in the quadriceps (front of thigh), glutes (hip muscles), and core. These muscles help keep your kneecap tracking correctly and reduce pressure on the joint.
Movement Retraining – Many people with patellofemoral pain have subtle movement patterns that put extra stress on the knee. Physiotherapists use movement retraining to correct these patterns during activities like running, walking, or squatting.
Manual Therapy – Gentle hands-on techniques may be used to relieve stiffness in the soft tissues or joints around the knee and hip, helping to improve movement and reduce discomfort.
Taping or Bracing – In some cases, tape or a knee brace can help guide the kneecap and provide short-term pain relief while strengthening work takes effect.
Education and Activity Modification – Your physio will help you understand which activities to adjust or temporarily avoid while healing, and how to safely build back up to your usual training or daily routine.
What Exercises Should I Avoid with Patellofemoral Pain Syndrome?
When your knee is sore, some movements can make symptoms worse — especially those that load the knee heavily in deep or repetitive positions. While every case is unique, here are some general exercises to limit or avoid in the early stages:
Deep squats or lunges where the knee bends more than 90 degrees
Jumping or plyometric exercises that involve repeated impact
Running downhill or on hard surfaces
Stairs or step-up workouts if they trigger pain
The goal isn’t to stop moving altogether but to reduce the strain on your knee while it recovers. Your physiotherapist can modify your exercise program so you can stay active safely — for example, swapping deep squats for shallower ones or focusing on low-impact cardio like cycling or swimming.
What Is the Best Exercise for PFPS?
The “best” exercise for patellofemoral pain depends on what’s driving your symptoms, but strengthening the muscles around the hip and knee is key.
Hip-focused exercises are especially important because strong glutes help stabilise the leg and reduce strain on the knee. Common examples include:
Side-lying leg raises
Clamshells
Bridges
Step-ups (once pain allows)
For the knee itself, quadriceps strengthening is crucial. Exercises such as straight-leg raises, mini squats, or wall sits help build strength in the front of the thigh without overloading the joint.
Your physiotherapist may also include balance and control exercises, such as single-leg stands, to improve how your muscles coordinate and support the knee during daily activities and sport.
What Is the Best Practice for Patellofemoral Pain?
Best practice for managing patellofemoral pain is a multifaceted approach — not just focusing on one muscle or exercise but addressing all the factors contributing to your pain.
Research shows that the most effective treatment programs include:
Individualised exercise therapy for the hip and knee
Education about load management and gradual return to activity
Movement retraining to improve running or squatting technique
Ongoing self-management strategies to prevent recurrence
Consistency is key. It usually takes several weeks of regular physiotherapy-guided exercises to notice lasting improvement. Sticking with your program and gradually increasing your activity levels as your pain decreases is the best way to achieve long-term results.
How Long Does It Take to Recover?
Recovery time varies from person to person, depending on how long you’ve had symptoms and how consistent you are with your rehab. Most people start to notice improvement within 4–6 weeks, but full recovery may take 8–12 weeks or more for chronic cases.
The important thing is to avoid pushing through pain — small, steady progress is better than aggravating the knee and setting your recovery back.
When to See a Physiotherapist
If knee pain has lasted for more than a few weeks, is stopping you from exercising comfortably, or flares up with stairs, running, or squatting, it’s worth seeing a physiotherapist. They can identify what’s contributing to your pain and guide you through a tailored program that fits your lifestyle and goals.
At Novar Sports Physio, we use evidence-based treatment and one-on-one care to help you move better, reduce pain, and get back to the activities you enjoy. Whether your goal is to return to sport, gym training, or simply walk without discomfort, our physiotherapists are here to support you every step of the way.
Final Thoughts
Patellofemoral pain can be stubborn, but it’s highly treatable. With the right physiotherapy approach — combining exercise, education, and movement retraining — you can regain confidence in your knee and prevent the pain from coming back.
If you’re experiencing knee pain, don’t wait for it to worsen. Book an appointment today and take the first step toward a stronger, pain-free knee.
Disclaimer: Our articles are not designed to replace medical advice. If you have an injury or health concern, we recommend seeing a qualified health professional.
