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Some Knee Pain is Likely to Recur for Years if Not Properly Addressed

Patellofemoral Pain Syndrome - There are many reasons someone may experience knee pain. Patellofemoral pain syndrome (PFPS) ranks as one of the most common. Roughly one out of four people will experience PFPS.

It’s even one of those orthopaedic complaints that affects teens, often sidelining teenage athletes indefinitely. Several long-term studies demonstrate that symptoms continue to bother between 73% and 96% of people even four years after initial diagnosis.3-4 Pain will come and go, and people change their lives to avoid triggers. Having the right knowledge about this common knee pain syndrome can help ensure that you or your teenage athlete are among the people who overcome patellofemoral pain syndrome.

What is Patellofemoral Pain Syndrome?

PFPS describes a set of common pathologies that cause pain behind or around the knee. PFPS pain typically occurs when loading weight on the knee, but can also be triggered by prolonged sitting. The likely mechanism is suboptimal tracking of the knee cap.

Evidence-based Treatment of Patellofemoral Pain Syndrome

Recently, our practice principal, Cameron Bulluss, attended the 5th International Patellofemoral Pain Research Symposium which was led by Dr. Natalie Collins of The University of Queensland. Fifty-one authorities representing ten countries convened to synthesise the research on treating PFPS. Their consensus statement was published in the British Journal of Sports Medicine.5  

Proper function of the quadriceps (the large muscles on the front of your thigh) stands apart as the most agreed-upon risk factor and target for treatment. The research also supports hip abductor strengthening and iliotibial band stretching as effective treatments. Additionally, some scientific evidence supports targeted stretching of the hamstrings, quadriceps, gastrocnemius, and anterior hip. Taping, knee sleeves, footwear improvement, foot orthotics, general fitness improvement, and ergonomic corrections can also be helpful.

Download our free E-book: Guide to Knee Pain


  1. Smith BE, Selfe J, Thacker D, Hendrick P, Bateman M, Moffatt F, Rathleff MS, Smith TO, Logan P. Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis. PloS One. 2018 Jan 11;13(1):e0190892.
  2. Rathleff MS, Rathleff CR, Olesen JL, Rasmussen S, Roos EM. Is knee pain during adolescence a self-limiting condition? Prognosis of patellofemoral pain and other types of knee pain. The American Journal of Sports Medicine. 2016 May;44(5):1165-71.
  3. Lankhorst NE, van Middelkoop M, Crossley KM, Bierma-Zeinstra SM, Oei EH, Vicenzino B, Collins NJ. Factors that predict a poor outcome 5–8 years after the diagnosis of patellofemoral pain: a multicentre observational analysis. Br J Sports Med. 2015 Oct 13:bjsports-2015.
  4. Nimon G, Murray D, Sandow M, Goodfellow J. Natural history of anterior knee pain: a 14-to 20-year follow-up of nonoperative management. Journal of Pediatric Orthopaedics. 1998 Jan 1;18(1):118-22.

Collins NJ, Barton CJ, van Middelkoop M, Callaghan MJ, Rathleff MS, Vicenzino BT, Davis IS, Powers CM, Macri EM, Hart HF, de Oliveira Silva D. 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. 

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