Patellofemoral pain is pain around or behind the kneecap. It is one of the most common causes of knee pain in active teenagers. This page explains patellofemoral pain and how exercise, footwear and, for some young people, foot orthoses may help.
Patellofemoral pain refers to pain at the front of the knee, around or behind the kneecap (patella). It usually builds up gradually and is aggravated by activities that load the knee when bent, such as running, squatting, stairs, jumping and sitting for long periods.
It is common in adolescents, particularly girls and those involved in running and jumping sports. Contributing factors can include training load, hip and thigh strength and foot posture. It is different from Osgood-Schlatter disease, which causes pain below the kneecap.
Exercise therapy targeting the hip and knee is the main component of management. Research in adults suggests prefabricated foot orthoses may reduce knee pain in the short term for some people, particularly those with a more pronated foot posture, so orthotic therapy may be considered as part of the plan.
Children may not always describe symptoms clearly, so parents often notice changes in walking, activity or footwear first. Common signs include:
A podiatry assessment considers your child’s growth stage, symptoms, foot posture, walking pattern, activity levels and footwear.
Assesses foot, knee and hip mechanics during movement.
Screens knee function and symptom behaviour.
Hip and thigh strength and single-leg control.
Sport, training and footwear.
Medical or physiotherapy input as appropriate.
Management is tailored to your child’s age, activity level, foot posture and goals.
Where foot posture is thought to contribute, orthotic therapy may be trialled to influence how the foot and lower leg move and to reduce knee pain during activity. Research in adults has found prefabricated foot orthoses can provide short-term improvement for some people. Evidence in adolescents is more limited, so orthoses are used as part of a broader plan.
A podiatrist may assess whether orthoses change symptoms during movement tests before recommending them.
Hip and knee strengthening – the main component of care.
May be considered where foot posture contributes to symptoms.
Adjusting aggravating activities and building up gradually.
Supportive, well-fitted sports shoes.
Flexibility work for tight muscles.
Understanding pain and how to stay active.
Learn more about orthotic therapy, strengthening, stretching and strapping, or view all treatments. Related kids conditions include Osgood-Schlatter Disease, flat feet, shin splints, foot fatigue in sport, hypermobile feet.
Assessment can help identify contributing factors and create a plan to keep your child active.
Please see your GP if knee pain follows an injury, if the knee locks, gives way or swells, if pain is present at night, or if your child is limping. Hip problems can refer pain to the knee, so persistent knee pain with a limp should be checked promptly.
Pain around or behind the kneecap, often aggravated by stairs, squatting, running or sitting with bent knees.
Research in adults suggests foot orthoses may help some people in the short term. They are used alongside exercise therapy.
No. Osgood-Schlatter disease causes pain below the kneecap at the top of the shin bone.
Often yes, with modified load guided by symptoms and a structured exercise program.
We create a calm, supportive space to help children feel comfortable during assessment.
Where appropriate, prefabricated and custom foot orthoses are discussed based on assessment findings.
We help parents understand what is normal, what may need monitoring, and what can be supported.
Our clinic is located at 1/50 Kitchener Parade, Bankstown, and sees families from across Sydney, including Bankstown, Condell Park, Padstow, Revesby, Lakemba and Belmore. Visit our children’s podiatry page for more kids foot conditions, read about our clinic, or contact the clinic to make an appointment enquiry.
This information is general in nature and is not a substitute for individual assessment and advice. Outcomes vary between children. If you are concerned about your child’s health, please consult your GP or a registered health practitioner.
