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Patellofemoral joint pain

The patellofemoral joint (PFJ) refers to the joint between the underside of the kneecap and the femur (Thigh bone). The kneecap sits in a groove at the bottom of this bone and is attached by multiple soft tissue structures such as ligaments. Your patella tendon runs over the top of this with a fluid like sac, called the bursa, in-between.

Patellofemoral pain syndrome (PFPS) refers to pathology (an issue) in the aforementioned joint or it's surrounding soft tissues. It is an umbrella term and can be the result of many causes.

These factors include and aren't limited to;

  • Strength around the knee.
  • Strength around the hip.
  • Flexibility of the surrounding muscles.
  • Trauma
  • Knee/hip control in dynamic activities.
  • Foot posture/position and stability.
  • Anatomical differences.

Signs and symptoms

As many different structures can be the cause of pain, signs and symptoms can often vary. These signs/symptoms include;

  • Pain when sitting with a flexed knee for long periods
  • Pain when walking up/down hills
  • Pain when walking up/down stairs
  • Pain when wearing heels
  • Pain when squatting
  • Pain when kneeling

As expressed, pain tends to be the result of activity and can linger immediately post activity or the following day. Pain does not tend to occur with rest generally or when sitting with your leg rested out straight.


Conservative management (Non-operative management) through a suitable exercise/loading programme tends to be effective in reducing symptoms and restoring normal function. This programme can be supported by activity modification (slightly changing your daily habbits/activities), use of orthotics and occasionally the use of taping.

Due to the multifactorial nature of PFJP it is recommended to seek advise from a medical professional to rule out other diagnosis. They will also design your programme around your specific presentation, needs and goals.

For pain on the bottom of your patella; consider if your issue may be a Patella tendinopathy as these conditions often look similar.

Unsure how to return to your activity? This may help: Return to sport

Any questions? Contact us


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