Patellofemoral Pain Syndrome (PFPS)

Common Symptoms

• Front-of-knee or around-the-kneecap pain
• Discomfort with stairs, hills, or squatting
• Pain after prolonged sitting, often called the 'theater sign'
• Aching with running, especially downhill
• Sense of grinding or clicking that may or may not be painful

What May Contribute

PFPS is rarely caused by a single thing. It usually reflects a mismatch between the load placed on the knee and what it has been prepared for.

• Sudden increases in running mileage, training load, or sport demand
• Reduced hip and quadriceps strength
• Foot, hip, or trunk mechanics that shift load onto the knee
• Changes in footwear or training surface
• Periods of low activity followed by sudden return to high demand

How Form and Function Approaches This

PFPS responds well to graded loading and a clear understanding of what the knee is currently tolerating. We work backward from your goals to a plan that fits your week.

• A thorough mechanical and functional assessment to identify what is driving symptoms
• A care plan that may combine hands-on care, movement, education, and recovery strategies based on your presentation
• Clear reasoning at each step, so you understand what we are doing and why
• Coordination with medical providers when imaging, medication, or specialist input would be helpful

Read more about our overall approach to care.

Treatment Options May Include

• Education about load, tolerance, and how symptoms behave
• Progressive strength work for the hips, quadriceps, and trunk
• Adjustments to training volume, intensity, or running mechanics where helpful
• Soft-tissue work for the quadriceps, hip, and surrounding tissue when guarding is limiting movement
• Footwear or orthotic input when clearly indicated
• Coordination with an orthopedist if knee pain blocks meaningful loading after a fair trial of care

How This Condition Is Commonly Diagnosed

Patellofemoral pain is a clinical diagnosis based on the pattern of pain and aggravating activities.

• History of symptom behavior, activity, and training load
• Examination including single-leg squat, hop, and step tests
• Strength assessment of the hip and quadriceps
• Imaging reserved for atypical knee pain or to rule out other causes

Expected Recovery and Prognosis

Most cases of PFPS improve within several weeks of a structured plan, though full return to running or sport may take longer depending on demand.

Long-term comfort is usually built around consistent strength work and thoughtful training progression rather than around avoidance.

Related Conditions

• Iliotibial Band Syndrome
• Patellar Tendinopathy
• Stress Fractures

Related Services

• Movement-Based Rehabilitation
• Sport-Specific Rehabilitation
• Chiropractic Care

When Symptoms May Require Emergency Medical Evaluation

• Sudden or progressive weakness
• Loss of bowel or bladder control
• Numbness in the groin or saddle region
• Fever, chills, or unexplained weight loss
• Severe trauma or suspected fracture
• Persistent night pain or rapidly worsening symptoms
• Shortness of breath, chest pain, or other non-musculoskeletal symptoms
• Symptoms that are severe, spreading, or not improving as expected

These symptoms are uncommon, but they can indicate conditions that may require urgent medical evaluation. If you are unsure whether your symptoms fit this category, Form and Function can help guide appropriate next steps or referrals when needed.

Frequently Asked Questions