Patellofemoral Syndrome

Patellofemoral Syndrome is a more common condition than one might think. It affects women more often than men and primarily occurs during adolescence, although it can be present at any age. Here is a description of this condition and the main physiotherapy treatments.

 

What is Patellofemoral Syndrome?

Patellofemoral Syndrome (PFS) is a knee disorder characterized by pain often described as a bruise or irritation under or around the kneecap. The pain can be located on the outer or inner side of the patella and is often difficult to pinpoint on palpation, as if it were beneath the bone. Patients commonly report knee pain when sitting for long periods without being able to extend their leg, for example in a car or a movie theater. Symptoms also appear during eccentric movements, such as going down stairs, or during repeated impact activities like running.

The causes of this syndrome are multiple and sometimes difficult for the patient to identify. Pain is often caused by poor movement mechanics that create friction between the patella and the femur—hence the name “femoro” for femur and “patellar” for patella. The physiotherapist’s role is to assess the entire syndrome, including the pain, associated symptoms, and problematic movements. After a thorough evaluation, an appropriate treatment plan can be created to address the patellofemoral syndrome and associated pain.

 

What are the possible treatments?

Following the evaluation, your physiotherapist will assess your strength, flexibility, joint range of motion, and, most importantly, your motor control—how you move. Based on this assessment, specific exercises tailored to your needs will be prescribed, as controlling knee movement is crucial in patellofemoral syndrome.

These exercises often focus on strengthening specific muscles, such as the quadriceps (vastus lateralis and vastus medialis) and the gluteal muscles (gluteus minimus, medius, or maximus). Strengthening these muscles provides greater leg stability and is key during the early phases of physiotherapy treatment. These exercises should not cause pain and should progress quickly to functional movements.

Because this area has limited blood supply and gains in strength and motor control can take several weeks to appear, pain may take some time to fully resolve. For this reason, taping is often used as part of the treatment. It provides temporary but rapid pain relief.

To improve motor control, exercises such as slow step-downs or single-leg mini-squats may be prescribed. In treating patellofemoral syndrome, it is important to gradually reintroduce stress to the knee joint while improving the problematic movement patterns.

Treatment will also include manual therapy, where the physiotherapist uses hands-on techniques to mobilize joints or release muscular tension if stiffness is identified during the assessment.

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