Why is hip strength relevant to knee pain?

Hip abductor and external rotator weakness is strongly associated with PFPS. Weak hips cause the femur to rotate inward, altering the angle at which the patella tracks in its groove. Hip strengthening programmes consistently produce good outcomes for PFPS, often more so than quad-focused exercises alone.

What complementary therapies help with PFPS?

Acupuncture assists with pain management. Massage and myofascial release of the quadriceps, IT band, and TFL reduce lateral patellar tension. Patellar taping provides short-term symptom relief and may allow more comfortable rehabilitation. The core treatment remains a targeted exercise programme addressing hip and quad strength.

Foot orthotics can modify lower limb mechanics and reduce patellofemoral loading, particularly where excessive foot pronation contributes to altered knee mechanics. A biomechanical assessment can determine whether orthotic support is appropriate for your specific presentation.

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Patellofemoral pain syndrome

Q: What is patellofemoral pain syndrome?

Patellofemoral pain syndrome (PFPS) describes pain arising from the joint between the kneecap and the femur, typically worsened by squatting, stairs, prolonged sitting, and running. It is particularly common in young active people, adolescent girls, and runners. Poor patellar tracking, hip weakness, and biomechanical factors are the main contributors.

Patellofemoral pain syndrome causes aching pain at the front of the knee, typically worsening with stairs, squatting, or prolonged sitting. Targeted physiotherapy, biomechanical assessment, and progressive strengthening

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Reviewed by Dr. Ian Henderson · Microbiobial Health & Medicine26 March 2026Research-supported

Quick answer

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Patellofemoral pain syndrome — pain at the front of the knee — is most commonly triggered by activities that load the kneecap against the thigh bone: squatting, climbing or descending stairs, kneeling, and sitting for prolonged periods with bent knees (sometimes called "cinema sign")
Many people describe a dull, aching discomfort rather than a sharp pain, along with occasional clicking or a sense of the knee giving way
The pain is often worse after activity than during it
Many active young people find it deeply frustrating that a condition without a clear structural injury can be so persistent and limiting

What is Patellofemoral pain syndrome?

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Patellar Tendinitis

Iliotibial Band Syndrome

Musculoskeletal Pain

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