Patellofemoral pain is pain around or behind the kneecap that is brought on by activities that load a bent knee, such as squatting, stairs, running and sitting for long periods. It is one of the most common causes of knee pain in active teenagers and adults. International consensus recommends exercise therapy, especially combined hip and knee strengthening, as the main treatment.
Also known as runner's knee, anterior knee pain, patellofemoral pain syndrome, PFPS
Symptoms
- Dull, aching pain around or behind the kneecap
- Pain going up or down stairs, squatting, kneeling or running (especially downhill)
- Pain or stiffness after sitting with the knees bent for a long time
- Pain that builds during or after activity
- Occasional clicking or grinding without significant swelling
Causes and risk factors
- A sudden increase in running, jumping or training load
- Weakness of the thigh (quadriceps) muscles
- Hip muscle weakness or differences in how the hip and knee move when running or landing
- Being an adolescent or a physically active young adult
- Sports and jobs that involve lots of squatting, stairs or kneeling
What the evidence says helps
- Exercise therapy is recommended to reduce pain and improve function in the short, medium and long term, according to the 2016 international patellofemoral pain consensus.2
- Combining hip and knee strengthening exercises is recommended over knee exercises alone.25
- Foot orthoses (insoles) may help reduce pain in the short term for some people, though responses vary.2
- Combined approaches, for example exercise alongside taping or insoles, are recommended for short- to medium-term pain relief in adults.2
- The consensus panel did not recommend knee, kneecap or lower back mobilisations or electrotherapy on their own, as evidence suggests they do not improve outcomes.2
- Limited evidence suggests that running retraining and hip strengthening can both improve pain and function in runners with patellofemoral pain.4
Things you can try at home
- Reduce, rather than stop, the activities that flare your pain, then build back up gradually
- Strengthen your hips and thighs regularly, aiming for exercises that feel challenging but manageable
- Break up long periods of sitting and straighten your legs often
- If you run, try shorter runs on flatter routes while symptoms settle
- Use pain as a guide: mild discomfort during exercise is acceptable if it settles by the next day
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Your knee is suddenly hot, red and swollen and you feel feverish or unwell: get same-day medical help (NHS 111, or A&E if very unwell), as a joint infection needs urgent treatment.
- After a fall, collision or twisting injury you cannot put weight on the leg, the knee looks deformed, or it swells up within a few hours: go to A&E or an urgent treatment centre.
- Your knee locks and you cannot straighten it, or it suddenly gives way repeatedly: see a GP or urgent care promptly.
- Your kneecap has dislocated (moved out of place) or the knee swells significantly: see a GP or urgent care.
- Knee pain in a child or teenager comes with a limp, hip or thigh pain, or fever: see a GP the same day, as hip problems can cause pain felt in the knee.
How Apollo can help
We assess how your hips, knees and feet work together and explain what is likely to be loading your kneecap. We then set a progressive hip and knee strengthening programme and help you adjust your training or daily activities. Where useful, we can look at your running with a gait and biomechanics assessment, test your strength objectively, and discuss whether insoles might help you in the short term.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Can I keep running with runner's knee?
Often yes, but you may need to reduce how far, how often or how hilly you run for a while. Many people can keep running at a level that only causes mild discomfort that settles by the next day, while they build strength.
How long does patellofemoral pain take to get better?
It varies. Many people notice improvement within six to twelve weeks of a consistent exercise programme, but research shows symptoms can persist for years if not managed, so sticking with your exercises matters.
Should I wear a knee brace or tape for kneecap pain?
The evidence is uncertain. Taping or bracing may help some people in the short term, particularly as part of an exercise-based plan, but they are not a substitute for strengthening.
References
- Crossley KM, Stefanik JJ, Selfe J, et al. (2016). 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 1: Terminology, definitions, clinical examination, natural history, patellofemoral osteoarthritis and patient-reported outcome measures. British Journal of Sports Medicine, 50(14), 839–843. View source
- Crossley KM, van Middelkoop M, Callaghan MJ, et al. (2016). 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: Recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). British Journal of Sports Medicine, 50(14), 844–852. View source
- Smith BE, et al. (2018). Incidence and prevalence of patellofemoral pain: a systematic review and meta-analysis. PLoS ONE. View source
- Neal BS, et al. (2016). Runners with patellofemoral pain have altered biomechanics which targeted interventions can modify: a systematic review and meta-analysis. Gait & Posture. View source
- Lankhorst NE, et al. (2012). Factors associated with patellofemoral pain syndrome: a systematic review. British Journal of Sports Medicine. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
