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Running Injuries: Patellofemoral Pain Syndrome (PFPS)

Updated: Jun 15, 2020

What is it?

Patellofemoral Pain Syndrome (or PFPS for those not interested in a tongue twister!), is a blanket term that simply means pain of the patellofemoral joint (where your kneecap connects with your thigh bone). Pain from a PFPS injury is typically localized to the front of the knee and tends to increase with more activity or with sitting for long periods of time.

What are the symptoms of a PFPS injury?

· Pain at the front of one or both knees, around or behind the kneecap (although it is sometimes hard to pinpoint the exact location)

· Pain with prolonged sitting, knee bending, or walking up/down stairs

· Pain with activities such as: squatting, kneeling, cycling and running

How did I injure my Patellofemoral joint?

· Overuse and overloading of the patellofemoral joint

· Weakness, tightness and/or imbalance of the leg muscles

· Increasing physical activity levels too quickly

· Previously undiagnosed issue, such as ‘knock-knees’, or lack of lubrication in the joints

· You may be “knock-kneed”

· Previous injury to the kneecap

· Poor foot or hip mechanics


Can PFPS be treated?

It sure can! Registered Physiotherapists can provide you with a specialized plan of action to treat your PFPS.

1. Exercise and Strengthen:

Hamstring Stretch

In a seated position, take your affected leg and straighten it in front of you with your heel in contact with the floor. Keep your other foot planted on the ground for support. While maintaining a tall spine, hinge forward from the hips and feel a stretch at the back of your thigh. Hold for 30 seconds.

Calf Stretch

Start in a standing position with your hands on a wall for support. Bring your affected leg back and your unaffected leg forward. Make sure your toes are pointing towards the wall. Straighten your back knee and keep the front knee bent. Shift your weight to the front leg, keeping your back foot flat on the ground and feel a stretch along the back of the calf. Hold for 30 seconds.

IT Band Stretch

Start in a standing position next to a stable object that you can hold on to (such as a table, chair or wall). Cross your unaffected leg in front of your affected leg. Keep both feet flat on the ground and lean your weight towards your unaffected side while holding the stable object for balance. Hold for 30 seconds.

Straight Leg Raise (Quadricep Strengthening)

Start by lying on your back with your affected leg extended straight out. The unaffected leg should be bent with the foot flat on the ground. Contract your core and slowly lift your affected leg towards the ceiling, while keeping the knee straight. Slowly lower down and repeat 5-10 times.

Clamshell (Hip Stabilizer Strengthening)

Start by lying on your side, with your hips and knees bent. Make sure that your hips, knees and ankles are stacked on top of each other. Lift your knee towards the ceiling, while keeping your ankles connected. Make sure your hips stay stacked and do not roll backwards. You should feel this on the side of your hip/glutes. Repeat 5-10 times.

2. Ice ice baby!

General rules of thumb for icing:

· Make sure there is a barrier between the ice pack and your skin (such as a dish cloth or a rag)

· Ice the location for 5-10 minutes, remove ice until the skin returns to normal temperature, re-apply

3. Take a Break

If you’re still doing exercises that make the pain worse, think about putting them on hold until your pain improves. This is not a “no pain, no gain” situation. Once you’re starting to feel better, slowly re-integrate these exercises and see how you feel. Always listen to your body!


Although these are general guidelines to follow if you’ve been diagnosed with PFPS, we always suggest consulting a Registered Physiotherapist before beginning any regimented treatment plan. Contact Blueberry Therapy to book an appointment today.

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