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Patellofemoral Pain Syndrome (Kneecap pain) The knee joint is comprised of the patella (kneecap), femur (thigh bone) and the tibia (shin bone). The femur has a cartilage lined groove at the distal end where the patella sits. The quadriceps tendon inserts at the superior aspect of the patella, whilst the patella tendon runs from the inferior aspect to the tibia (shin bone). When the quadriceps muscles contract, the patella acts as a pulley to straighten the knee. This occurs in many daily activities such as standing from a chair and walking upstairs. Patellofemoral pain is an umbrella term that covers a number of issues affecting the articulation between the patella and the femur. There are multiple predisposing factors to PFPS and more than one is often present, placing excess strain on the joint. Some common factors are: Muscle imbalances and poor core and hip control Gender (increased likelihood if female) Poor training technique Sudden increase or change in training load Patella alta (abnormally high patella in relation to the thigh bone) Poor foot biomechanics eg. Flat foot or high arches Genu valgum “knock knees” and femoral internal rotation Past injury A thorough clinical examination should be undertaken by a trained physiotherapist to diagnose, identify and then address the drivers of the pain. Treatment involves not only settling the pain preventing you from living your life or playing your sport but preventing future recurrence. Your physiotherapist will conduct a full biomechanical analysis and educate you on how best to manage your condition. Your physiotherapist will often utilise soft tissue releases, joint mobilisations and any other necessary techniques to settle your pain. You will then be supplied with an individually tailored progressive home exercise program.