Triumph Podiatry Fact Sheet – Patello-Femoral Pain Syndrome (“Runner’s Knee”)

Patello-Femoral Pain Syndrome (PFS) is one of the most common knee injuries often presenting to Podiatry clinics. PFS is a term used to generally describe pain associated around the knee cap (patella) and the thigh bone (femur).


The kneecap normally should glide up and down over the knee joint, especially when a knee is bent. Due to muscle imbalance and poor biomechanics/posture, it will lead to the kneecap “maltracking” out of its position, meaning the kneecap would be pulled to one side more than the other. Which would cause pain and discomfort.

The easiest way to understand the cause is to picture a game of “tug of war”, where muscles in the inside and outside of the knee pull the kneecap in their directions, attempting to win the battle. Well, in the case of PFS, the outer thigh muscles win.

Other causes include:

  • Rapid increase of activity
  • Quadriceps muscle imbalance
  • Knock knees (“genu vakgum”)
  • “flat feet”, low foot arches


Symptoms arise from activities such as running, football, basketball, netball and hurdles; even walking down stairs. Basically symptoms are aggravated after repetitive knee bending exercises such as squatting and running.

Symptoms include:

  • “crepitus”, the “crackling” sound heard when the knee is bent and straightened – this sound appears as the kneecap rubs against the joint incorrectly (due to the imbalance)
  • knee stiffness and limited movement after prolonged sitting
  • walking downstairs or downhill – where the knee is vulnerable as it stabilizes your leg and body so you don’t fall over
  • feels “unstable”


  • Warm up before you exercise (remember not too stretch before exercising)
  • Warm down after exercise (stretch)
  • Wear supportive, comfortable and specialist footwear
  • Consult a Podiatrist to assess for any biomechanical/posture abnormalities to prevent injuries – the possibility of orthotic therapy
  • Strengthen leg muscles by completing special isolation type exercises using weights or resistance bands.
  • Maintain good fitness


At Triumph Podiatry, we utilize a 5 step rehabilitation process. They are as follows:

  1. Apply First Aid Principles (P.R.I.C.E.)
  2. Sports Therapy and Taping
  3. Muscle Strengthening and Conditioning
  4. Establish “Prevention of Injury” program (see above)
Grant Duong, Podiatry

At the Triumph Institute located in the heart of Bankstown, Sydney we also practice podiatry. It’s a medical field that specialises in the prevention, diagnosis, treatment and rehabilitation of problems and issues that affect the lower limbs, from the lower back right down to our feet.

Learn more about Triumph Podiatry →