Patellofemoral pain exercises

Patellofemoral pain is pain around or behind the kneecap, where it glides in a shallow groove at the end of the thigh bone. The kneecap works as a pulley for the thigh muscles, so a lot of force passes through that small joint every time you bend the knee under load. It is one of the most common knee problems, especially in runners, cyclists and active teenagers.

It almost always builds up gradually rather than starting with an injury. The usual story is a change in training - more mileage, more hills, a new sport, a return after a break - or a spell of far more or far less activity than the knee was used to. Strength and control at the hip and thigh matter as much as anything happening at the knee itself.

The typical picture is an ache at the front of the knee that comes on with running, stairs, squatting, kneeling, or sitting with the knee bent for a long time; a long car journey or the cinema is the classic. Grinding or clicking is common and, on its own, harmless. There may be a little puffiness after a hard session, but the knee does not lock or give way.

Nothing is damaged: the tissue around the kneecap has become overloaded and sensitive, and it settles as capacity is rebuilt. Most people improve over 6 to 12 weeks with consistent strengthening and a sensible return to activity, though it takes longer if the load is not managed. This programme settles the irritation, builds hip and thigh strength so the kneecap is better supported, then gradually rebuilds the activities that set it off.

Who this programme is for

Adults and older teenagers with gradual-onset pain at the front of the knee, worse with loaded knee bending such as stairs, squatting or running, and with no locking or significant swelling. A knee that locks, gives way or swelled rapidly after an injury needs assessment first.