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Knee Pain – Patello Femoral Pain Syndrome

Knee Pain – Patello Femoral Pain Syndrome

PFPS (Patello Femoral Pain Syndrome) is one of the common knee pain condition affecting active population of all age groups. It is found more in women because of wider pelvis which changes the direction of forces acting on knee joint.

Patella (knee cap) sits in a groove which is present in the lower part of thigh bone (femur). In a normal knee it glides up and down in the groove smoothly, whenever there is knee bending and straightening movement, such as going up and down stairs. However, in an affected knee the patella moves out of the groove causing friction between the two bones which eventually results in pain. Pain can vary from dull ache to sharp pain, which might be accompanied by clicking or momentary weakness in knee joint.




Knee cap is held in position with a good balance between outer and inner structures around the knee cap. Structures which are responsible for movement around the knee are the muscles. The muscle present in front of the thigh is known as quadriceps, as it has four prevailing muscles. Any imbalance between these 4 muscles can change the way the patella moves.

Contributing factors:

  • Poor lower limb mechanics due to
    • Increased foot pronation (foot  flattening)
    • Decrease lumbopelvic (lower-back and hip area) stability due to weak core (abdominal) and gluteal (hip) muscles
    • Decrease VMO (vastus medialis obliques) activity, the inner most muscle of quadriceps




  • Incorrect footwear
  • Muscle tightness; specially increase in Vastus lateralis (outer most muscle of quadriceps) and Illiotibial band (ITB) tightness/activity. ITB is a connective tissue band present on the outer thigh
  • Tight hip flexors and Tensor fascia latae muscle
  • Poor sporting technique/ergonomics
  • Heel strike running pattern increases GRF (ground reaction force)
  • Over-training
  • Sudden increase in training intensity/frequency

Treatment options – Click here