Patellofemoral Pain in Sport: Causes, Exercises & Physio Treatment

Patellofemoral pain (pain around the knee cap) is one of the most common knee complaints in sport and if you play sport, you’ll know that knee pain can be hard to ignore. When your pain can be subjective; only flaring up at certain times, or if the injury is not related to a specific cause, it can be hard to distinguish between something that can be ‘brushed off’ and a real problem, especially as a young person. You might experience differences in pain intensity throughout the day, or instability in the knee, which can make it confusing to gauge the severity of your injury.

Oftentimes you can think that the pain is ‘just part of the game,’ and something that will go away with rest, but that’s not always the case. 

What is Patellofemoral Pain?

Also known as ‘runner’s knee,’ patellofemoral pain is described as a dull ache around the front of the knee or around the kneecap, that can worsen with dynamic movement. It most commonly occurs in women, and young people, who play sport. While patellofemoral pain can be long term and affect how you move, the good news is that physiotherapy and targeted exercise programs are highly effective in managing symptoms and improving long-term knee health.

For athletes, patellofemoral pain can be particularly frustrating because it often develops gradually rather than from one specific injury. Many people notice the pain beginning during periods of increased training load, pre-season preparation, or after returning to sport too quickly following a break or injury. 

There are several factors that can contribute to patellofemoral pain. Muscle weakness around the hips and knees is a common cause, particularly weakness in the gluteal muscles and quadriceps. The kneecap (patella) moves within a groove at the front of the thigh bone as the knee bends and straightens. When movement patterns, muscle strength, or training loads are not well balanced, excess pressure can build up around the kneecap joint. This can irritate the surrounding tissues and lead to pain. 

Exercises to help Patellofemoral Pain: 

Physiotherapy plays a key role in both treatment and prevention of original and increasing injuries. Rather than simply resting the knee, physiotherapy focuses on identifying the underlying causes of pain and improving how the knee functions during movement.

Exercise is one of the most effective treatments for patellofemoral pain. Strengthening the muscles around the hips and knees helps improve knee alignment and reduce stress on the kneecap, which can be a cause of pain.

Sidelying Clamshells
Lie on your side with your knees bent and feet together

Keeping your feet touching, lift the top knee while keeping your pelvis stable.

Clamshells target the hip muscles that support proper leg alignment.

Wall Sits
Stand with your back against a wall and slowly slide down into a partial squat position.

Keep your weight on your heels, knees over your mid foot.

Hold for 20–30 seconds (or until your quads fatigue) before returning to standing.

This should be pain free.

This exercise strengthens the quadriceps and improves knee endurance.

Single Leg Heel Raise

Standing on one leg, rise up onto your toes and slowly lower. Have a wall nearby for support/balance.

This exercise can be done on both feet if it is too difficult doing a single leg.

This exercise improves balance, calf and knee strength, and control.

One of the biggest mistakes athletes make is trying to “push through” their knee pain. Continuing to overload the joint without addressing the underlying issue can lead to longer recovery times and ongoing symptoms. Early treatment often leads to faster recovery and a safer return to sport.  Importantly, physiotherapy does not only focus on recovery but also injury prevention. By improving strength, movement quality, and training management, you can reduce the likelihood of recurring knee pain and improve overall sporting performance. 

If knee pain is limiting your training, performance, or confidence in sport, seeing a physiotherapist at Inner Strength Bayside can help you address the problem early and get back to doing what you love safely and effectively.

Click here to book a physiotherapy appointment today.

Written by Year 10 Work Experience Student, Georgia, who has an interest in sporting knee injuries.