Pain in the Front of the Knee

Patellofemoral pain syndrome is a type of knee pain that affects the front of the knee.  The patellofemoral joint is the small space between our knee cap and the thigh underneath it.  “Patellofemoral” is a general term, similar to saying “knee pain”.  It doesn’t really tell us everything that is happening with the injury, but it gives us an idea and is used quite frequently in rehabilitation.

knee pain patella final

Patellofemoral pain syndrome typically causes an achy pain in the knee.  It is caused by overuse, usually in active people such as runners.  The function of the knee is usually altered and pain occurs with movements like running, jumping and squatting.  Patellofemoral knee pain comprises approximately one quarter of all athletic knee injuries.  It is more common in women than men and is the most frequent cause of adolescent knee pain.

A 2011 study published in the American Journal of Sports Medicine described the link between hip strength and patellofemoral pain syndrome.  In particular, it determined that poor control of the hip muscles can affect certain movements, especially when we’re standing on one leg.  This dysfunction in the muscle co-ordination and strength can result in a poor movement pattern.  Typically, this less optimal movement would include femoral adduction, internal rotation, valgus collapse at the knee, tibial rotation and foot pronation.

Those with patellofemoral pain syndrome have been shown to have weaker hips.  In particular, they’re weaker with hip abduction, extension and external rotation.  They also usually have an increased hip adduction angle.  Also, a high abduction moment has been linked to this type of knee pain.

So what does all this mean?  If you have patellofemoral pain syndrome, you may have weak hip muscles.  Strengthening the hip may be a very good idea.  In particular, single stance exercises may allow a functional strengthening of the hip as it relates to knee function.

Experiencing pain in the front of your knee and think it may be patellofemoral pain?  Give us a call.  We can assist you in identifying the nature of your pain and the appropriate rehabilitative exercises for your condition.


Earl JE, Hoch AZ.  A proximal strengthening program improves pain, function and biomechanics in women with patellofemoral pain syndrome.  American Journal of Sports Medicine 2011; 39(1): 154-163.