Front Knee Pain (Patellofemoral) Physio in Amman

What is patellofemoral pain?

The kneecap is a small bone at the front of the knee that glides in a groove at the end of the thigh bone every time you bend or straighten the knee. Patellofemoral pain is pain around or behind the kneecap that gets worse with activities that load the knee while it is bent. It is common in teenagers, young adults and active people, especially those who run or jump. It is often linked to load on the knee that rose faster than the knee was ready for, such as a sudden increase in running, jumping, stairs or squats. The hip and thigh muscles are often weaker in people with this pain, and strengthening them is a key part of treatment. The pain does not necessarily mean the knee is damaged.

Common signs

Pain around or behind the kneecap, in one knee or both
Pain going down or up stairs, or when squatting
Pain with running or jumping, or after training
Pain after sitting for a long time with the knees bent, or when standing up afterwards
It usually starts gradually, without a clear injury

Common misunderstandings

"Clicking in my knee means it is damaged": painless clicking is common and normal for many people, and on its own it does not mean the knee is damaged
"The pain will go away by itself if I wait": in some people this pain lasts a long time or keeps coming back, so an active plan of exercise and load management usually helps more than waiting
"The problem is in the knee, so hip exercises are pointless": evidence suggests that strengthening the hip muscles together with the thigh muscles eases pain and improves function more than knee exercises alone

What usually helps?

Exercise is the core of treatment in the guidelines, and combining strengthening of the hip muscles, especially at the side and back of the hip, with strengthening of the thigh muscles works better than knee exercises alone. Types of exercise that usually help include lifting the leg to the side while lying on your side; lifting the hips while lying on your back; standing up from a chair and sitting down slowly; and stepping up onto and down from a step, followed by harder exercises that suit your activity. Understanding the condition and managing load also help: for a while we ease what provokes the pain, such as long runs, deep squats or lots of stairs, then build it back gradually, with weight management where relevant, and changes to running technique may help some runners. Kneecap taping or shoe inserts (foot orthoses) may ease pain for a short time in some people, alongside exercise rather than instead of it, and the evidence for taping is less clear. Manual therapy and kneecap mobilisation are used with exercise, not on their own, and the guidelines do not recommend machine treatments such as ultrasound, or dry needling, for this pain.

How we treat it at Revibe

We listen: when the pain started, what changed in your training or daily activity, and which movements bring it on
We examine knee and hip movement, hip and thigh muscle strength, and how you squat, step down and run if you are a runner, and recognise what needs a doctor’s review
We identify what keeps the pain going, such as load that rose too quickly or weak hip and thigh muscles
We treat: strengthening exercise for the hip and thigh muscles as the core of the plan, with manual therapy and kneecap mobilisation alongside exercise when useful, and adjustments to the load on the knee
We progress with a graded home exercise programme and a gradual return to running, sport and stairs

When do you need urgent medical care?

After a twist or a fall: large, rapid swelling, a kneecap that has moved out of place, visible deformity, or being unable to stand on the leg — go to the emergency department or call an ambulance: 911 in Jordan or 122 in Iraq and Kurdistan
A knee that locks so you cannot straighten it, or keeps giving way after an injury — see a doctor the same day
A hot, red, swollen knee with fever — see a doctor the same day
A child or teenager with knee pain and a limp — see a doctor soon, as the problem may come from the hip; go to the emergency department straight away if they cannot put weight on the leg or have a fever
Severe constant pain at night, or pain with unexplained weight loss, fever or feeling generally unwell

In these cases go to the nearest emergency department or a doctor straight away — instead of booking physiotherapy.

FAQ

Do I need an X-ray or MRI?

In most cases no; the diagnosis is based on your story and an examination. We refer you to a doctor or for imaging if there was an injury with large swelling, the knee locks or gives way, or things do not improve as expected.

Should I stop running or sport?

Usually you do not need to stop completely. For a while we reduce the amount and type of training to what the knee tolerates, then build it back gradually as you improve; complete rest on its own does not build the strength the knee needs.

Do I need a knee brace?

The guidelines do not usually recommend braces, sleeves or straps for this pain. Shoe inserts or kneecap taping may help some people for a short time alongside exercise, and we advise you on what suits you after the assessment.

How many sessions will I need?

It depends on your condition and how long you have had it; after the first assessment we explain the plan and the expected number of sessions.

More common questions: Knee pain questions — 36 questions