Best 5 Ways to Treat Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome (PFPS) is a painful condition that affects the front of the knee. It’s common in athletes. The pain is often around the knee cap.

PFPS is an umbrella term, so it includes a number of sub-diagnoses including prepatellar bursitis, suprapatellar bursitis, infrapatellar bursitis, chondromalacia patellae, patella maltracking and osteoarthritis of the patellofemoral joint. Don’t worry about all these sub-diagnoses, for now, it’s best to know that if you have pain on the front of the knee, it’s likely to be called Patellofemoral Pain Syndrome.

The best ways to treat PFPS are the natural ways. We always try the natural therapy first, and if that doesn’t work, then we can try things like steroid injections. We see a lot of PFPS at Surrey Physio.

1. Physical Therapy – including Osteopathy and Physiotherapy

Physical therapy (manual therapy) is a cornerstone of PFPS treatment. Our team of therapists can mobilise a stiff patella, soft tissue friction the patella retinaculum, and help elongate the quads to take load off the patella. We will also design a customised exercise program to stretch the right muscles, and strengthen weak muscles around the knee, often including the quadriceps, hamstrings, and hip adductors. Strengthening these muscles helps stabilise the knee joint and reduce stress on the patellofemoral joint.


Rest, Ice, Compression, and Elevation (RICE) can help reduce pain and inflammation associated with PFPS. Resting the affected knee allows it to heal, while applying ice packs (wrap a thin cover over it, don’t risk getting an ice-burn) for 10 minutes once per a day can help reduce swelling and pain. Compression at the same time from devices like Game Ready (we can rent a machine to you) also help a lot. While there are many different acronyms these days, including POLICE, PRICE, RICER and others, we still come back to the original RICE.

3. Stretching the Quads

This is my go-to exercise. The straightforward quad stretch. So many of my patients have short tight quadriceps. Yes, strengthening is important too, but stretching seems to be the one thing that really moves patients forward.

Simply pull your foot towards your butt, and hold the stretch for 30 seconds. Repeat three times. Perform it both sides, or on the shortest/painful side.

This exercise can be performed in multiple positions too.

4. Orthotics and Supportive Footwear

Improper foot biomechanics can contribute to PFPS. Using orthotic inserts or supportive footwear can help correct biomechanical issues, such as overpronation or supination, which may be putting excessive stress on the knee joint. However, caution is needed. Changing the foot mechanics can also impact other areas. So, tread carefully! Seek proper advice because it may be your problem can be corrected without orthotics.

5. Steroid injection / Cortisone Injection

We provide cortisone injections at Surrey Physio. We prefer to try other treatments first, but if you have exhausted all options, then this might be the next step. We will carefully place a steroid with anaesthetic into your knee. Its uncomfortable, but not usually too painful. Of course, any injection is not pleasant, but it’s over quickly and within a few hours you should start to notice less pain and inflammation. The steroid is a strong anti-inflammatory. Call us about having a steroid injection – we do them in Farnborough and Croydon.


Finally, if you have PFPS, it’s essential to consult with a healthcare professional, such as a physical therapist (osteopath or physio) to develop a comprehensive treatment plan tailored to your specific needs and severity of PFPS. Additionally, adhering to a consistent exercise plan, losing weight, living a healthy lifestyle, and getting the right treatment are key parts too.

(Therapists, osteopaths, sports therapists, chiropractors reading this page… if you love the exercises here, then please check out the amazing exercise prescription tool You can sign up for a free 14-day trial, and it’s affordable to buy, with pricing starting from £11.23 per month.

If you are a patient and struggling to exercise, please call us to discuss your case further. Surrey Physio have an amazing team of therapists that can help you rehab after surgery, or get back on your feet exercising or walking better once the knee pain goes. We’re here to help you recover from pain, and get you back to living a normal life. Call us on 0208 685 6930 or click the link at the top to book online.)