Patella Femoral Pain


The advanced stage of patella femoral pain is known as chondromalacia patella.

Patella femoral joint syndrome is a condition that affect mainly the knee cap and structures around it. The pain is caused by the misalignment of the knee cap relative to the femoral cartilege. During normal knee bending the knee cap glides smoothly inside the groove that exists between the two condyles of the femur. If there are biomechanical problems affecting the surrounding structures that help move and stabilise the knee cap then the kneecap can track outside it’s normal groove. This change in knee cap orientation causes pain and the condition called patella femoral joint syndrome.

The cause is nearly always multifactorial and can include:

  • Direct trauma to the knee.
  • Muscle imbalance between the medial and lateral structures either side of the knee cap. For e.g. if there is a difference in strength between the medial and lateral quadriceps muscles the knee will track towards the stronger side.
  • Tight ITB/ hamstring/ gastrocnemius/ glut med/ hamstring.
  • Weakness in the glut med.
  • Lower back pain or weakness.
  • Distance running.
  • Running up stairs and hills.
  • Pronating feet.




Common symptoms are:

  • Dull ache behind the patella (kneecap) when bending the knee.
  • Kneeling.
  • Squatting.
  • Prolonged sitting with knee bent.
  • Climbing up and down stairs.
  • As condition progresses walking will become painful.


As patella femoral joint syndrome is a complex multi cause condition the treatment is determined by the cause found on assessment.

Physiotherapy treatment can consist of:

  • Avoiding the aggravating activity.
  • Soft tissue mobilisation of the tight muscles and ligaments.
  • Stretches to the ITB and other tight muscles.
  • Strengthening of weak muscles especially the glut med muscle and quadriceps.
  • Hip stability.
  • Functional strengthening exercises e.g. squats.