Patellofemoral pain of the knee – how do you treat it?

Patellofemoral Pain – what is it?

Most of us will experience anterior knee pain at some stage in our lives. This will usually be fleeting and resolve without trouble. Great!  But what if that pain doesn’t resolve and stays with you for an extended period of time.  Patellofemoral pain, which refers to pain around or behind the kneecap, affects up to 23% of the general population. Often it persists for greater than a year. Even though it is supposed to be self-limiting benign condition.

The experience

How would you behave if you had pain with every day activities? Climbing stairs, going for a walk or playing sport for example.  So it’s not surprising that the experience leads to a reduction in physical activity. But why does it not get better? If it’s a benign self-limiting condition.

Many individuals will report confusion about their pain and difficulty making sense of it.  Will have pain related fear, including avoidance behaviours and the belief that they are causing harm. Unfortunately it is healthcare professionals that often contribute to this fear. Often through negative language and erroneous beliefs. Negative phrases such as ‘you have an overuse injury’ or ‘there is wear and tear’ can have a detrimental effect.


Iatrogenic disorders are conditions created out of healthcare assessment or treatment. Unfortunately persistent patellofemoral pain may fall under this category. As mentioned at the start of this article most of us will experience short periods of knee pain which resolves quickly. Usually we will confront the pain at some point and then get better. However, if you’re worried about degeneration or causing more harm (as a result of what you have been told) you may become over protective. Quite rapidly this can lead to deconditioning, more pain … a vicious circle!

The way out

By changing beliefs around pain dramatic improvements often occur. Finding ways to challenge behaviour and overcome fear is key to improving the pain. Exercise and loading keeps our joints healthy. Physiotherapy can be very useful to guide such individuals on the right path to recovery.


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