Patello-femoral joint pain (PFJP) - what's the approach?


Patello-femoral joint pain is one of the most common causes of knee pain, and is characterised by discomfort around, behind, or under the knee cap during activities such as squatting, running, prolongued sitting with the knees bent, stair climbing or jumping. PFJP affects 23% of the general population, and 29% in adolescents.


Historically, a conservative approach looked to strengthen the muscles around the knee, with a particular focus on the Quadriceps muscle group; However, more recently hip muscle strength deficits have shown to be an important factor when approaching patients with PFJP. Poor muscular conditioning of the hip abductors and external rotators can impose greater load on the patello-femoral joint leading to pain and reduced function.


An area of interest is to observe whether patients with PFJP respond more favourably to hip, knee, or a combination of both hip and knee strengthening exercises in reducing pain. It was concluded that the intervention group who underwent a hip strengthening programme reported less knee pain after a six-week period, when performed three-times weekly, when compared to the knee strengthening group. It was later advised that patients should follow a hip and knee strengthening programme to show gains in pain reduction, function and muscle strength.


Manojlovic, D. et al. (2021). Trunk, Hip and Knee Exercise Programs for Pain Relief, Functional Performance and Muscle Strength in Patellofemoral Pain: Systematic Review and Meta-Analysis. Journal of Pain Research. 14: 1431-1449.