Pain at the Front of the Knee (Patellofemoral Pain)

Are you experiencing pain at the front of the knee?

At New Lynn Physio, we can help you eliminate this pain to get you back performing at your best!

We will not only look at the knee, but look up and down the chain to look for all factors that may be contributing towards your symptoms. We do this through movement analysis as well as using our VALD force decks and dynamometry device to look for side to side differences and calculate strength normatives. From this, we will develop an appropriate strengthening programme tailored to you. Current best-practice evidence supports an individually tailored programme combining targeted strengthening, patellar taping and education for exactly this reason (Barton et al, 2015).

Our approach to treatment: taping and targeted strengthening

PCL Patellofemoral pain can be a frustrating, often recurring condition, because it’s rarely caused by just one thing. Correct alignment of the patella (kneecap) within the trochlear groove depends on the coordinated action of several muscles, particularly the quadriceps (including the VMO, or vastus medialis oblique), hip and gluteal muscles, and the muscles controlling the alignment of the whole lower limb. Getting lasting results means addressing all of these, not just the knee in isolation.

Taping. Where appropriate, we use the McConnell taping method, developed by Australian physiotherapist Jenny McConnell and taught to physiotherapists worldwide. This involves applying rigid tape across the kneecap to help correct its position within the trochlear groove. Taping is used as a short-term tool alongside exercise; it can reduce pain almost immediately, which allows the VMO to activate more effectively and lets you strengthen without aggravating your symptoms.

Progressive, pain-free VMO strengthening. Once your pain is settled enough to exercise comfortably, we build a strengthening programme specifically targeting the VMO, alongside the surrounding hip and gluteal muscles that control leg and knee alignment. Exercises are introduced and progressed gradually, always staying within a pain-free range, so we build genuine strength and control rather than just pushing through discomfort, which can flare symptoms and set recovery back.

Addressing the whole picture. Because patellofemoral pain often recurs if the underlying contributing factors aren’t fully addressed, we look beyond the knee itself, assessing hip strength and control, foot and lower limb alignment, and movement patterns during activities like running, squatting and stairs, to reduce the risk of your symptoms coming back once you’re pain-free.

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Frequently asked questions

Pain at the front of the knee is most commonly caused by sudden spikes in activity, overuse or muscle imbalances.

It is most often described as a sharp or aching pain around or under the knee cap. It is commonly aggravated by activities that load the front of the knee joint. These may be things such as walking down a hill, going down stairs, squatting or sitting for long periods.

Most often no! This injury can be resolved through physio alone. We will work with you to come up with a plan to reduce the aggravating load, build the strength of the muscles involved, and progressively get you back to all the activities that are important to you.

An initial short period of rest may be required, however generally modifying aggravating activities whilst building the knee’s overall capacity will be the best way to overcome this injury

Patellofemoral pain usually improves gradually with the right treatment and exercise. Many people notice improvement within 4–6 weeks, although it can take 6–12 weeks or longer for symptoms to fully settle, especially if the pain has been present for a long time.

This condition can be prone to recurring if the underlying causes, such as weakness in the VMO, hips or glutes, or poor movement control, aren’t fully addressed alongside settling the initial pain. This is why our approach looks at the muscles above and below the knee, not just the knee joint itself, to build lasting strength and reduce the chance of your symptoms returning.

Reference: Barton CJ, Lack S, Hemmings S, Tufail S, Morrissey D. The ‘Best Practice Guide to Conservative Management of Patellofemoral Pain’: incorporating level 1 evidence with expert clinical reasoning. British Journal of Sports Medicine. 2015;49(14):923–934. https://pubmed.ncbi.nlm.nih.gov/25716151/

Contact New Lynn Physio to book your rehab assessment and take the next step,
reclaiming your knee and rebuilding your confidence!

Book a Knee Assessment