Knee & Leg
Patellofemoral Pain Syndrome
Also called: Runner's knee, kneecap pain
Pain behind or around the kneecap from how it tracks and loads in its groove — the most common knee complaint in active people. Driven less by the knee itself and more by hip strength, foot mechanics, and training load. Classic signs: stairs, squatting, and the 'movie theater sign' (aching after prolonged sitting).
Common signs
- Ache behind/around the kneecap with stairs (especially down), squats, running
- Pain after sitting long with bent knees
- Occasional grinding sensation; puffiness around the kneecap
- Usually no true locking or giving way
Seek help now if
- Significant swelling after trauma
- True locking (mechanical block)
- Kneecap dislocation event
- Night pain or systemic symptoms in an adolescent
Any of these: call 911 or get to an emergency room first. Everything else can wait.
What to do first
- Cut the provoking load ~30–50% (running volume, deep squats) — reduce, don't stop
- Start hip-focused strengthening immediately: glute medius and quad work is the core prescription
- Get assessed: hip control, foot posture, and training history explain most cases
If it's become chronic
- A 8–12 week progressive program (hips + quads + load recalibration) resolves the majority
- Runners: cadence and form retraining changes kneecap loading meaningfully
- Persistent cases: examine the whole chain and the training calendar, not just the knee
Natural healing options we use
- Manual therapy for quads, ITB region, hip musculature
- Chiropractic care for hip, knee, ankle mechanics
- Progressive strengthening program
- Attended e-stim for pain modulation; taping strategies short-term
About imaging
Rarely needed; reserved for atypical features, trauma, or refractory cases.
Daily self-care
- Step-downs and glute work as prescribed, consistently
- Temporarily reduce stairs/hills/deep flexion volume
- Cadence up ~5–10% if you run (shorter, quicker steps)
How we can help
More in Knee & Leg
Knee OsteoarthritisPatellar TendinopathyACL Sprain / TearMCL SprainPCL SprainMeniscus TearIT Band SyndromeBaker's Cyst
Please read: this page is education, not a diagnosis. A proper examination is how a condition gets confirmed and a plan gets built. See our medical disclaimer.