Patellofemoral pain syndrome is one of the most common causes of anterior knee pain encountered in adolescents and adults younger than 60 years old.
What is the recovery time for patellofemoral pain syndrome, can it be cured completely.
Many of you search for answers on the internet to these questions every month, you worry about the duration of pain and discomfort.
As a diagnostic radiographer I will answer some the common questions based on:
⚫My knowledge as a radiographer for 9 years.
⚫A thorough study of all the research published on the subject matter (references at the end of this article).
Happy reading!😀and feel free to ask questions in the comments or share your own experience.🙏
Last updated: June, 2025. Written by Juliet Semakula, a diagnostic radiographer.
Disclaimer: No affiliate interest in this article.
▶️What is patellofemoral pain syndrome?
Do you have knee pain which is normally at the front of the knee around the area known as the patellofemoral joint.
This is the joint between the kneecap (patella) and the thigh done (femur)
Does this pain occur mainly during activities such as knee flexion, doing squats, cycling, running or hiking.
Then you may have patellofemoral pain syndrome but the only way you can confirm it, is to visit a doctor who specializes in diagnosing the condition.
▶️Different names for patellofemoral pain syndrome.
When you go to the doctors, and it gets confirmed that you have got patellofemoral pain syndrome.
Normally your doctor may use different medical terms which all refer to patellofemoral syndrome.
Here are some names that are normally used to refer to patellofemoral pain syndrome.
⚪Runner’s knee or jumper’s knee.
⚪Anterior knee pain or idiopathic
⚪Retro-patellar pain syndrome.
⚪Chondromalacia patellae is a condition associated with the degeneration of cartilage in the joint.
⚪Lateral facet compression syndrome
All these terms refer to the same condition (patellofemoral syndrome)
▶️ What are the main symptoms of patellofemoral pain syndrome?
The common symptoms of patellofemoral pain syndrome are:
🔴Pain in or around the anterior knee that intensifies when the knee is flexed during weight-bearing activities.
🔴The pain often worsens with prolonged sitting or descending stairs
🔴Pain when squatting.
Gaitonde,2019
▶️What really causes Patellofemoral pain syndrome?
Patellofemoral pain syndrome can occur without any injury to the knee, but it can also very occasionally be because of an injury.
🟪Starting a new activity
🟪Increase in the intensity and/or frequency of an existing activity
🟪Following a period of reduced activity that leads to weakening of the muscles
🟪Muscle tightness or weakness around your hip and knee
🟪Unsupportive footwear such as high heels or very flat shoes
🟪 Having a job which requires frequent, prolonged kneeling
🟪Being overweight
The figure below summarizes a possible pathogenesis for the patellofemoral pain syndrome based on findings from the medical scientific studies.
This system summarizes the findings from the literature, which explains the pathogenesis for patellofemoral pain syndrome (Petersen et al 2014)
The exact cause of pain in patients with patellofemoral pain syndrome is unclear. Most probably the pain develops in the insertions of the extensor mechanism or within the subchondral bone
Some people wonder why overuse can cause pain to the knee.
Depending on your day-to-day routine, you will have a level of activity that your knee is happy with. This can be thought of as your knee’s comfort zone or happy place.
Any sudden change to your daily activities which leads to putting more weight through your knee can take your knee out of its comfort zone.
Just imagine standing for 12 hours something you do not do often and if you’re overweight, this can take a toil to your knee and you will start feeling pain.
▶️Is patellofemoral pain syndrome a form of arthritis?
I always here people ask this question, the answer is No, patellofemoral pain syndrome is NOT a form of arthritis but can be a complication of patellofemoral osteoarthritis
Thomas,2010
A Study that did a seven-year follow-up evaluation, the outcome was assessed with use of magnetic resonance images, scan and x-ray of the involved and contralateral knee joints and osteoarthritis.
Special attention was paid to the patellofemoral joint about both early and advanced signs of osteoarthritis
Results:
⚪These images showed no abnormalities in 24 patients and mild abnormalities such as slight reduction in the thickness of the patellar cartilage
⚪Only severe patellofemoral osteoarthritis was found in 2 patients.
Patellofemoral pain syndrome does not necessarily lead to patellofemoral osteoarthritis or osteopenia, only in very severe cases that osteoarthritis may be an issue.
Therefore, in most of the patients the chronic patellofemoral pain syndrome did not progress to patellofemoral osteoarthritis during the seven-year follow-up interval.
▶️Patellofemoral pain syndrome test and diagnosis. Is it a common condition?
Yes, patellar syndrome is highly common, and it is the most common diagnosis in outpatients presenting with knee pain.
⚪In the USA alone the incidence of people who complain of having patellofemoral pain syndrome are between 3% and 6%.
⚪Within one year ,10% pf adolescents will experience pain.
Gaitonde,2019
When you go to the doctor your knee will be examined by different tests. The most sensitive physical examination finding is pain with squatting.
Your gait, posture, and footwear will be examined, this sometimes helps to identify contributing causes.
Usually x-ray of the knee is not necessary for the diagnosis of patellofemoral pain syndrome, it will only be done if conservative treatment measures are unsuccessful.
And if done it will be for the reason of excluding other diagnoses, such as osteoarthritis, patellar fracture, and osteochondritis.
Also, other modalities such as Ultrasound, CT and MRI are not necessary to diagnose runner’s knee because the specific anatomical structures causing patellofemoral pain are not definitively known.
In summary, a clinical diagnosis of patellofemoral pain syndrome is usually made based on the symptoms you have by a physical exam finding, and a review of your medical history
▶️What can help patellofemoral pain syndrome? Treatment options.
Usually, treatment of patellofemoral pain syndrome focuses on ways to help with early pain relief.
Treatment normally are conservative methods that will include:
🟠Rest: You will be advised to rest your knee, reduce activities that do put pressure on your knee.
🟠A short course of nonsteroidal anti-inflammatory drugs injected into the knee are known to help reduce pain, but the effect may be limited to one week.
🟠Cold therapy
🟠TENS (Transcutaneous electrical nerve stimulation.
🟠Ultrasound therapy
🟠Dry needling
🟠Manual therapy
🟠Using a patellar Kinesio taping improves patellar maltracking and may reduce short-term pain as an adjunct to exercise.
However, there is little evidence available to support its routine use
Proper placement of kinesio tape. The initial piece of tape is placed as an inverted Y along the anterior portion of the thigh with distal pieces placed on medial and lateral aspects of the patella. A second piece of tape is placed over the distal portion of the Y tape anchoring the tape inferior to the patella.Gaitonde,2019
🟠Physical therapy directed at strengthening the hip flexor, trunk, and knee muscle groups. Physical therapy is usually the foundation of treatment, a study done by Thomas,2010 had an observation.
Patients who exercise generally had improvement in short-term and long-term pain, both at rest and with activity, when compared with those who do not exercise.
🟠Surgery: it is very rare to have surgery for patellofemoral pain syndrome, if done it is normally performed only after conservative strategies have failed and imaging explains a surgical indication.
This method has not been studied sufficiently to demonstrate improved clinical outcomes over conservative strategies.
▶️What is the best exercise for patellofemoral pain syndrome?
Usually your doctor may prescribe you a physiotherapist to help with your exercises but you can also try these exercises at home.
Remember always the kind of therapy you get is individualised.
Most exercise regimens for patellofemoral pain syndrome do focus on the hip, trunk, and knee. There are no high-quality data to recommend one type of exercise over another
Here are some of the exercises done to help with patellofemoral pain syndrome.
1️⃣Core muscle strengthening reduces pressure on the patellofemoral joint by stabilizing muscle recruitment.
A hip abductor strengthening exercise is known to reduce pressure on the patellofemoral joint.
(A) Stand with the foot of one leg on a platform, keeping the pelvis parallel with the floor. (B) The opposite leg is lowered slowly while the supported leg remains in knee extension. (C) The gluteal muscles are contracted, which elevates the unsupported leg and returns the pelvis parallel with the floor (Image from Jones,2015).
This exercise is performed for three sets of 10 repetitions each.
2️⃣ Strengthening exercises targeting the quadriceps and hip musculature, Quadriceps straight leg raises.
Sit or lie on a flat surface with the affected leg outstretched and the unaffected leg flexed. Then lift the affected leg 8 inches off the surface and slowly lower the leg to the ground over two to four seconds (Image from Jones,2015)
This exercise is performed for three sets of 10 repetitions each
3️⃣Hamstring stretch for patients with patellofemoral pain syndrome.
(A) You lie in the supine position, with the knee of the affected leg bent and gripping the thigh to hold it steady. (B) Extends the leg at the knee, holding for 30 to 60 seconds.(Image from Jones,2015)
This exercise is performed twice daily for two repetitions each time
4️⃣Isometric quadriceps strengthening exercise for patients with patellofemoral pain syndrome
(A) You sit on a flat surface with the affected leg bent. (A rolled towel can be placed under the knee.) (B) Then extend the leg at the knee, pressing toward the ground for 10 seconds.
This exercise is performed for three sets of 10 repetitions each.
Whether these exercises are performed with a home physiotherapist, unsupervised, or at a physiotherapy clinic, the role of the physiotherapist is mainly to help you identify the appropriate level and type of exercise for you.
▶️What improvements can be expected from the exercises?
🟠Reduced pain in the short and long term.
🟠Increased ease of using the knee in daily activities in the short and long term.
🟠Fewer symptoms of patellofemoral syndrome in the long term.
▶️Should I wear a knee brace if I have patellofemoral syndrome?
There is no evidence that orthoses decrease pain or improve function in patients with patellofemoral pain syndrome.
However, some people who have used braces and orthoses with or without physical therapy claim they are effective for the treatment of anterior knee pain.
▶️Does walking help patellofemoral pain syndrome?
Walking is known to be beneficial for patellofemoral pain syndrome, but its effectiveness will depend on the individual and how it’s performed.
Here are some of the benefits of walking to help with patella pain.
🟠Walking can help prevent the knee joint from becoming stiff and more painful.
🟠Regular gentle walking can help maintain joint mobility.
🟠Walking can help to take pressure off the kneecap.
How can you make walking safer and more beneficial?
🟠When walking, focus on glute muscle engagement and avoid overusing the quadriceps.
🟠You can use walking aids such as a cane or walker to help reduce the pressure on the knee.
🟠You can modify your activities such as walking, climbing stairs, running or squatting until the pain improves.
However, although walking can be good for your knee pain it can also exacerbate knee pain if the muscles are overused this can create imbalances.
Potential issues you may encounter if you are overactive using your knee.
♦️ Muscle imbalance: over walking can compress the kneecap against the thigh bone worsening pain.
♦️ Aggravating walking, especially downhill can put stress on the knee joint which may cause pain and discomfort.
▶️What is the best sleeping position for patellofemoral pain syndrome?
If you are experiencing patellofemoral pain syndrome and you are finding it hard to sleep.
The best sleeping positions generally involve keeping the knee in a neutral or slightly extended position.
This can be achieved by sleeping on your back with a pillow or rolled-up towel under your knees to provide gentle support and reduce stress on the patella.
Here is a full article about practical tips on how you can sleep when you have knee issues.
▶️How long does patellofemoral pain syndrome last? And what is the average recovery time
Over the years so many studies have been done on how long this pain syndrome last, the first studies date back in the 1970s and since then there have ben 1000 studies published on this syndrome
Most studies however did focus on patients who had suffered severe patellar pain syndrome because most patients do not seek medical attention and there are no studies focused on them.
Scientific studies about how long patellar pain syndrome lasts.
A study that followed 134 patients with patellar pain syndrome for over years. Here is what they found:
Data that was analysed at the beginning and end of their treatment observed a significant improvement of no pain.
⚫At a 1 year follow up there was improvement in pain in most patients and a third of them no longer had pain or discomfort.
⚫And at year 2 follow up no patient presented with relapses
⚫Only 4 patients occasionally experienced symptoms years later.
Another study done by Kannus et al 1999, which did a prospective seven-year follow-up of patients who had chronic patellofemoral pain syndrome had this observation.
⚫There was good subjective and functional improvement in knee pain after 6 months of treatment.
⚫Two-thirds of the patients had complete clinical recovery at 7 years.
The median time to recovery from mild patellofemoral pain syndrome can last 3 to 8 weeks after treatment and in severe cases it can take 10 weeks.
Some people with patellar pain syndrome become pain-free within 3 to 4 weeks and may not necessarily need to stop participating in sports.
On the other hand, others may take several months or even years to fully recover, without it being a cause for concern, although it can be challenging.
We have come to the end of this article,wishing you a quick recovery!🙋
Any questions let’s meet in the comments section
📚Sources:
Gaitonde DY, Ericksen A, Robbins RC. Patellofemoral Pain Syndrome. Am Fam Physician. 2019 Jan 15;99(2):88-94. PMID: 30633480.
Kannus P, Natri A, Paakkala T, Järvinen M. An outcome study of chronic patellofemoral pain syndrome. Seven-year follow-up of patients in a randomized, controlled trial. J Bone Joint Surg Am. 1999 Mar;81(3):355-63. doi: 10.2106/00004623-199903000-00007. PMID: 10199273.
Dixit S, DiFiori JP, Burton M, Mines B. Management of patellofemoral pain syndrome. Am Fam Physician. 2007 Jan 15;75(2):194-202. PMID: 17263214.
Thomas MJ, Wood L, Selfe J, Peat G. Anterior knee pain in younger adults as a precursor to subsequent patellofemoral osteoarthritis: a systematic review. BMC Musculoskelet Disord. 2010 Sep 9;11:201. doi: 10.1186/1471-2474-11-201. PMID: 20828401; PMCID: PMC2944218.
Jones BQ, Covey CJ, Sineath MH Jr. Nonsurgical Management of Knee Pain in Adults. Am Fam Physician. 2015 Nov 15;92(10):875-83. PMID: 26554281.
Mulvad B, Nielsen RO, Lind M, Ramskov D. Diagnoses and time to recovery among injured recreational runners in the RUN CLEVER trial. PLoS One. 2018 Oct 12;13(10):e0204742. doi: 10.1371/journal.pone.0204742. PMID: 30312310; PMCID: PMC6193581.
Petersen W, Ellermann A, Gösele-Koppenburg A, Best R, Rembitzki IV, Brüggemann GP, Liebau C. Patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2264-74. doi: 10.1007/s00167-013-2759-6. Epub 2013 Nov 13. PMID: 24221245; PMCID: PMC4169618.