What causes patellofemoral pain syndrome?

The kneecap glides in a groove at the end of the thigh bone as the knee bends and straightens. Running, squatting, stairs, jumping, or sitting with the knee bent for a long time can increase pressure in this area. Symptoms may arise after a change in training, hills, footwear, work demands, or body mechanics. Weakness or poor control in the hip and thigh can allow the knee to move inward; flat feet may also alter the chain of movement from the foot to the knee. See more about [Flat Feet](/conditions/flat-feet/).

This syndrome is a pain pattern, not proof that the joint is being permanently damaged. A clinician may check the kneecap, hip, ankle, strength, flexibility, and the activities that bring on pain. The condition is described in more detail in [Patellofemoral Pain Syndrome](/conditions/patellofemoral-pain-syndrome/).

Reduce or modify the activity that provokes pain while keeping comfortable movement. Ice after activity may ease symptoms for some people. Gradual exercises for the hip and thigh, guided by a physiotherapist, can improve control and load tolerance. A clinician may also suggest temporary changes to running, squatting, stairs, or footwear. Increase activity step by step rather than returning suddenly to the previous level.

Arrange an assessment if pain persists, keeps returning, limits walking or exercise, or is accompanied by swelling, locking, giving way, fever, or marked tenderness. Seek prompt care after a significant injury, especially if you cannot bear weight or straighten the knee.

Ask which movement or strength findings are contributing, whether another knee problem needs to be excluded, which exercises fit your current symptoms, and how to return safely to your usual activity.