This is one of the most common knee complaints Physiotherapist’s see. It usually presents as front of knee pain, and is caused by a tracking issue of the patella (knee cap) within the groove.

This is usually because of tightness of muscles on the outside of the knee cap (pulling the knee cap out); and/or weakness of the muscles on the inside of the knee cap; and/or poor leg or foot posture.


Pain can then be brought on by repetitive loading (overuse) of this joint; or after trauma (such as an injury or surgery). Pain and sometimes inflammation behind the knee-cap often ensues.


  • Anterior knee pain (sometimes feels deep to knee cap). Pain can be diffuse and hard to localise.
  • Pain aggravated by loaded activities involving repetitive knee bending/straightening (such as stairs, cycling, squatting, running) and prolonged knee flexion (such as sitting down for long periods of time with the knee bent).


  • Alter training load – initially we recommend unloading the knee, then gradually introducing load/exercise.
  • Taping – usually the knee-cap into position. Sometimes the Physio may also use Rock-tape.
  • Patella mobilisations.
  • Release tight muscles – especially outer thigh (ITB), outer hip (glutes and TFL), calfs, hip flexors.
  • Rehab/Exercise Rehab – strengthen quads (VMO), gluteal strength/control, lower limb alignment.
  • Correct poor training techniques/movement patterns.

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