Patellofemoral Syndrome Exercises & Stretches – Ask Doctor Jo


Hey everybody, it’s Doctor Jo, and today I’m
gonna show you some exercises and some stretches to help with patellofemoral syndrome. Huh?
Yeah, what is that? Well basically the “patello”part means the patella, which is your kneecap.
And “femoral” is the femur bone which is your thigh bona, and basically in just simple terms,
what that means is your kneecap is not tracking correctly on that thigh bone which can be
very painful. A lot of times that can be cased by weakness of the inner muscle and tightness
of the outer muscle, so I’m gonna show you today how to fix that. So the first set of
exercises we’re gonna do is called the 4-way hip, and I’m gonna have you do them today
on the ground. So you just lie down flat on the ground. The first one is just what we
call a straight leg raise. And so you’re gonna have one up for support and this actually
helps your back a little bit. Sometimes people keep both legs down. I like when you bend
the knee up a little bit because I think it takes the pressure off your back. You don’t
want to fix one thing and then irritate something else. So with the straight leg raise, you
want to pull your toes towards you, and that’s gonna straighten out your leg and tighten
up those muscles. Cause you want to keep you leg as straight as possible. When you start
lifting it up, you don’t want your knee to bend, so if your knee’s bending, try to squeeze
you leg nice and tight to keep it straight. So what you’re gonna do is just bring it up,
nice and controlled, and you’re just gonna bring it equal to the other side. So it’s
not coming straight up, but just to about tight here. And then you’re slowly gonna come
down. Don’t let gravity just drop your leg down. It’s just as important going down as
it is going up. So starting off you’re just gonna do 10 on each side. And then, I’m actually
gonna flip over this way and move to my right leg, but you wanna do them all on one side
and then go to the other side if you need to. So then the next one you’re gonna lie
on your side. You bottom leg is gonna curl up just a little bit. You can keep it bent
but the one on top you wanna keep straight. You want your body to be in a straight line.
So you don’t want your hip going forward like this cause that’s gonna change the muscles
that you’re working. So if you can, keep your body nice and straight. And same thing, you
want to pull your toes up towards you so you’re gonna lock your leg out. And then you’re gonna
keep it straight, keep it nice and tight, keep the toes pointed forward and you’re gonna
go straight up to the side. Same thing you just want it to be maybe a 45 degree angle.
You don’t want to kick it all the way up cause then you’re gonna start irritating stuff.
You’re just gonna bring it to about right here, and then nice and slow coming down.
as well. And 10 of those. And then you would flip sides to stay on the same leg, but I’m
just gonna show you going back to the other side. You’re gonna straighten out that bottom
leg. Some people cross their foot and put it on top, some people keep it in the back.Just
so you can see, I’m gonna keep mine in the back, but you wanna be still on your side,
so you don’t want your hips rolling forward, you don’t want then rolling back. You want
to be pretty much perpendicular to the ground. And what you’re gonna do, again keep that
leg nice and straight, pull those toes up towards you, and you’re gonna lift your leg
up this way. Now this isn’t gonna be a big movement. You’re not gonna be able to hike
it all the way up cause then your gonna have to use other muscles. So if you just bring
it about a foot off the ground, that’s fine as long as you’re controlling it. So going
slowly down, and slowly back up. And then the last one of the 4-way hip is gonna be
on your tummy. This one’s really important to try and keep your leg straight, cause this
is the one that if people are gonna bend their knee, they’ll probably bend their knee. If
you can, keep it nice and straight, pull your toes up towards you. Again this one’s not
gonna be very high either. You’re just gonna come maybe about a foot off the ground and
then nice and slow back down. So just start off with 10 in each direction. And if that’s
easy, you can bump it up to about 20. If you get t o20 and it’s still easy, then you can
add some weights to your ankle. The next one that you’re gonna do is to get the outer foot
going to the outer side going down to the ground. You want to get this inner portion
of your leg working and this is called your VMO, maybe that’s what your therapist will
call it. And that’s the muscle that helps track that kneecap or that patella. So you
really want to strengthen that one. This is called external rotation of the hip with the
straight leg raise. So you’re gonna turn your foot out towards the ground. Pull those toes
up towards you. And now you’re bringing up this way. Same kind of thing, you don’t want
to kick all the way up, that’s gonna start messing up some other stuff. But you want
your leg to be turned out and going up and down. Nice and slow and controlled. Same thing,
just start off with 10 of those to see how it feels, work your way up til you get to
20-25 and it’s easy. Start adding some weights on there. The last thing I’m gonna show you
is to stretch out your IT band. Cause just like you want to strengthen that VMO muscle
on the inside, you want to stretch out that IT band cause if it’s tight, it’s gonna pull
that kneecap towards the outside. And then the tracking that we were talking about, the
tracking of the knee, isn’t gonna be tracking like it’s supposed to and that what’s gonna
cause you pain. So you want your kneecap to be tracking very nicely on that thigh bone,
that femur, so then you’re gonna stretch out your IT band. Now I have a video that shows
you a whole lot of IT band stretches, so if you want to check out that, please go check
that out cause I’m just gonna show you one stretch right now. What you’re gonna do is
you’re gonna bring your leg up and back, it’s important instead of just going straight back,
to go up, and back cause that takes the IT band over the bone there so you can get it
nice and stretched out without irritating it. So you’re gonna bring it up, back, and
just drop it down. Now if your IT band is tight, just this is gonna be a good stretch.
If it’s not stretching a lot, you can get up on the couch, lie on the couch, so then
your foot can go down further. Again you can go check out that IT band video for other
stretches for that. Alright, so there you have it. Those were your exercises and stretches
for patellofemoral syndrome. No make sure you go get checked out by a doctor or therapist
because sometimes it can be your foot pattern when you’re running, so sometimes just some
inserts can really help that out as well, besides the stretches and the exercises. If
you have any questions, please leave them in the comments section. And if you want to
go check out the other videos, the IT band stretches video, please go to AskDoctorJo.com.
And remember, be safe, have fun, and I hope you feel better soon.

100 Replies to “Patellofemoral Syndrome Exercises & Stretches – Ask Doctor Jo”

  1. I'm a 17 year old female and this problem has started ever since I discovered I had a severe Vit D defeciney. Along with general muskoskeletal pain this issue of my knee joints started. Doctor diagnosed me with Chondromalacia Pattela. Not sure if it's the same as Patellofemoral syndrome. My symptoms almost subsided after I started taking vitamin D supplements, except for the occasional pain . now my whole body pain along with this knee pain and returned. I can hear a kind of grinding noise, in my knees a kind of "whirrrring" even if it's stationary. I want to know if this is a permanent problem, the internet is scaring me, and I don't want to not be able to squat forever.

  2. My knee was really bothering me last night. I did some exercises last night and today and no knee pain. Thank you. I cannot have them hurting right now.

  3. Doctor Jo, I had an appointment with a physical therapist for patella femoral pain syndrome who instructed me to do 3 sets of squats 20x each. I experience grinding in both my knee caps each time I do so. Is this wise advice since I've read from numerous articles to not squat while having this condition as it could put more stress on the knees. Thank you

  4. Hello Doctor, I've been doing these exercises and a lot of foam rolling for about 2 weeks and I feel a lot better, basically no pain at all. I plan to return to road cycling, and I also can do gym workouts (leg press, extension, curls), how do you suggest to distribute my time along these in the next weeks?

  5. Hey Doctor Jo! I just recently found out that the pain that has been nagging my left knee for two years now and was beginning to affect my right as well was PFPS. However my situation is the reverse of how you describe it. My VMO is the one that is too tight and pulling my patella medially. It’s gotten a lot better just by intensely massaging it out but I was to do some strengthening of the lateral side too. Would you still prescribe these same exercises for my situation? (ps I am a professional dancer if that helps with the answer)

  6. i think i have patellofemoral pain or chondromalacia too. my PT told me about that first exercise u did. it only makes my anterior knee pain even worse especially when i pull my feet towards me & stretch my calves. i feel it puts more pressure on my knee cap. my pain is mostly in front part of my knee cap & also below it. its a 'burning' type of pain thats SO annoying & it gets worse w/ stairs, squats, & getting up from my seat. my dr still doesnt know if its chondro or patella tendonitis. do u know which one it cud be?? thanks!

  7. How frequent do you recommend doing these exercises and how will you know when to stop doing these exercises all together? Thanks for a great video!

  8. I was doing exercise and stretching my knee but suddenly my knee went bent down with two to three bone sound pain
    I can walk but it's very painful how can it be cured or is this a symptom of fracture.

  9. hello, I feel the pain on my left kneecap to the right side, what this means? that my itb is too weak and vmo is too strong pulling the cap in that direction?
    how can I correct its tracking, does this help too in this situation as well? thanks

  10. I have pain in front of my knee when I do squats or lunges. I also have pain on the outer side of my knee when I keep it bended for long time. Will these exercises help me or should I be doing something else.

  11. what is the difference between patella femoral syndrome and condromalacia patella? I have checked my left to 4 different docs all said you have condromalacia patellar in the left of your left leg patella bone…But i have pain on the top of my patella and right side… For example when i drive manuel steer up car for one hour; i have so much pain…By the way i am cyclist and every week i have 200 km cycling

  12. Hi Doctor Jo , I m Dr Deepak . From last year I felt continuous milder form of pain on my left knee joint , for which today I met orthopaedic surgeon , they told me that you r suffering from  "theatre sign" or PFS. And for that he send me physiotherapist . Is physiotherapy improve my condition.

  13. Hi doctor jo. I play football and sustained patello femoral pain. Very mild though so I’m lucky. I wanted to know how often should these exercises be done? What’s the next step to progress to heavier weight training? Thank you.

  14. Dr. Jo, I have tried to do these stretches but they cause my thigh more pain. I have
    improved since I last commented. I can walk now but have pain like I'm being hit in the thigh with a hammer at half speed. A thigh brace/knee brace has really helped. I will try and do 2 a day and then increase reps.
    Thank you for all your help.

  15. Hey Dr. Jo. I just started practice your exrx a week ago and it really helped me. Today I tried to squat and i have knock(cliks) while getting down. What shuld I change in your exrx to make it stop? Is it too early?
    Thnx a lot

  16. Hi
    Should I do this exercise and stretching every day? Once day or more?

    Is it enough to solve the problem? Or do I need to do anything else regarding exercise

  17. Hi Doc, well i have pain in my left leg and as well as in right but left one hurts really bad and basically i have itching under knee cap and also it is painful after long walks , cracking sounds is there when i take turn from right to left and left to right, what should i do , i consult with 2 docs and one is told me that i have gap in my knee , 2nd says – i have ortheoarthtis and last says i have retropatelar arthritis and second doc advise me to give me injection after 10 days of Panadol + Mobic meloxicam….
    i don't understand what should i do …i am very tensioned and i love travelling.

  18. Hey doctor Jo, do you have a video specifically for patella compression syndrome (causing anteromedial knee pain)?

  19. there are a MIRACLE! I can walk with little pain after one set. I wont run a marathon mind you but will do them faithfully. I was diagnosed by my GP with this.

  20. Thank you this video.
    I have patella tendon inflammation.
    I have little pain now.
    Through this video, I am going to do a rehabilitation exercise.
    When I do the four ways to raise my legs in by 10 (40 total), how many sets do I recommend a day?

  21. Hi. I'm an avid cyclist and suffer from patellofemoral syndrome. I've been watching your newer videos about knee strenghtening and I wonder if you think those exercises are better than the ones in this patellofemoral's video.

    Many thanks

  22. How often do you do these exercises and stretches? Also, I have a problem with only one knee, will I do it with the one side?

  23. is it normal for a physical therapy doctor to tell me the videos i am discovering on the internet (such as yours) are "outdated info" and to only listen to him? he diagnosed me with patellofemural pain syndrome and i wanted to learn as much as i can about this condition. i began doing his exercises plus yours and the "most famous" physical therapists on the internet as they are called, plus another one along with his..i can't afford therapy 3 x a week. i have to be self motivated. and for him to tell me not to listen to anyone else, has taken the wind out of my sails! (he only gave me 5 things to do, one stretch which is painful- called the pigeon! yours haven't hurt me at all.)

  24. Thank you so much!! Having knee problems again and can’t find my physical therapy exercises. How long after a subluxation do you suggest stretching??

  25. Thanks a lot for this video. I had a surgery on my knee and your video is helping me a lot with my recovery. Great work. (XO XO XO)😋

  26. I have pain at back of knee as well as front. I love to jog but hurt my knee when out jogging,, I was told by doctor in A&E that it wad a bad sprain. I also have what feels like nerve pain traveling from my knee down front of leg to my ankle. Will these exercies work for this.??

  27. Hello. Thank you for the video. But if one is to work the addcutors, isn't it a simpler way to use an adductor fitiness machine in some sport place ?

  28. Mam I have acl surgery on 28sept but I straight my leg on bed after sometime I up my knee it rub and sound what I do

  29. Hey ! Thank you so much for sharing such valuable info. I’ve been suffering from knee pain from past 5 months , your exercises are proving to be helpful .
    I used to do kickboxing n jogging but i stopped because of knee pain, just wanted to know is it okay if i start doing them again .

  30. I’ve had this for about a year, I went through 3 months of physical therapy and it did nothing. When it was over they told me to continue treatment on my own for a couple months before I go back and ask for an mri. Should I still try these exercises or just go for the mri?

  31. This was immensely helpful. I have been strengthening the outside of the leg with resistance bands, but it just made things worse. Now I know to strengthen the inner thigh and give the outer thigh a little stretch! Thank you so much!

  32. Hello Doctor Jo … I was finally able to see an orthopaedic surgeon here in Canada regarding bilateral knee pain I've had for years. All this time, I thought I had no cartilage left in my knees and I thought I was going to need knee replacements … well, turns out I have lots of cartilage 🙂 and I suffer from patellofemoral syndrome and have bone spurs … and you're right it is so painful. So, my plan is to lose some weight, but also to go to rehab. It can take months to get into seeing someone, so I decided to do some research on my own. My question is, after all these years of restricted movements, do you think its reasonable to think that I could do squats and lunges one day and to be pain free? I ask because I don't really remember a time where I didn't have knee pain. Thank you for the video, I'm going to get started on these right away.

  33. Is the first exercise helps hamstring? The physiotherapist told me to do it for my back knee pain but when my leg is up I should do circles with my feet in the air , will this help please

  34. i immedianlty felt relief as i was performing the exersices so a big thanks! i have 2 questions: 1=some researchs say also problems on waist triggers this pain.so if yes?must do +exercise for waist too? 2= some nights lying in bed i feel like there is a pulse in my knee:does ache slightly.might it be releated to this sendrom i am having?thank you🙏

  35. Hi this is Baishakhi from Sydney…I am suffering from chondromalacia Patella….your exercises helped me a lot…I am doing with ankle weights also…I am a dancer…when I am trying to dance again the pain is coming back ….can you suggest me where I am wrong and one more think…are you from Australia?

  36. Hi! Im hoping you might be able to explain my recent problem.

    For over a week now I have been experiencing an intense sharp pain on the medial side of my left knee. It feels almost like someone electrocutes me, the pain is extreme and lasts <1 second. I get these mostly when I sit down for longer period, sometimes it happens when Im standing, and rarely when I walk. It almost never happens when Im lying in bed with my leg extended and completely relaxed. In addition to this, the last 1-2 days I have also begun to experience a dull pain when I walk. I have not had any trauma or injury to my knee that can explain this.

    I cant stress enough how extremely painful the sharp pains are. I really think I would pass out if they would last longer than 1 sec. On a scale from 1-10 the sharp pains vary from 7-10. The dull pain when I walk is just around 3-4.

    About me:
    27 year old man.
    Normal BMI.
    Dont really do that much sports and dont exercise that much.

    Do you think this is patellofemoral pain?

  37. Hi Dr Jo, love your videos., keep them coming. 😀In this video I don’t recall you saying how many reps we should do on the IT band stretch. Is it just the one time or the normal 10?
    Thanks in advance for your quick reply.

  38. I will start today …my knee is tracking inward…I’ve never been a runner..a gym rat yes…I pronate my right foot like a duck…I’ve had casts for long periods on that leg..is it still ok to do these exercises? My trainer does a few of them..And we do some Stimpy for the quad….But sometimes I wonder if all of these leg machines he then puts me on do you hard it’s very hard for me to feel if my knee is tracking correctly with certain movements and machines

  39. I have patella femoral syndrome. Its awful and I am supposed to do these exercises till I "stop growing" I have had knee pain since I was four which is when I tore my ACL. I just don't have time. I wish I did. It seems like I'm always chasing after time!😞

  40. Wow Doc…I’ve done these two days in a row and I feel more than 50% less sore!!! Today I will also incorporate your IT band upload, I have now subscribed and I cannot thank you enough looking forward to seeing all of your feelings maybe not feeling all of that pain but looking forward to checking them out LOL

  41. Thank you Dr Jo! My PT has advised me to walk carefully with a definite heel rolling to toe action and a toes pointing straight forward. Do you agree with this deliberate walking style? .

  42. Hi Dr Jo, would these work for a Baker’s Cyst also? Would any other exercises be useful for that? Thank you so much!

  43. Hi I feel stiffness wen I sit for long .. you really think this will help.. xrays show nothing and no arthritis either .. I do cycling class once a week? Do you recommend me to stil cycle?

  44. Thanks for getting straight to the point rather that bloviating like a lot of other people do. Your exercises are great.

  45. Hi Doctor Jo, I spent 3 months doing these exercises with ankle weights and the pain went away, but the crackling and clicking in the knee every time I bend it is still there and after I stopped the exercises the pain has started coming back. I did some other exercises that the hospital gave me as well and one of the exercises included bending the knee on a step and when doing this exercise, the left knee kept crackling and clicking as I brought it up and down and I could feel the inside of my knee clicking when I touched it with my finger as I did the exercise. I had an X-Ray done and nothing was found. I don't know whether I should continue doing your exercises, or should I get an MRI scan done? Does it sound to you like I may have patellofemoral syndrome or could it be something more serious which requires surgery? I can walk and run without any problems. I just don't know how to proceed with this! My legs have strengthened a lot from doing exercises, but the clicks and crackling sound it makes every time I bend it is as loud as ever! I've had this problem for 5 years, probably due to overusing my knee moving dumbbells around in the gym. Many thanks for your help!

  46. See, you do not event say to hit the subscribe button or follow you on social media, but I'mma do it in spite of that, because I like your stuff

  47. Im 25 yr male
    I have been doing this
    And for a week's I was pain free and there was no clicking sound of patella when I extend my knee
    Now I reduced the frequency of exercise and it's coming back
    How long does it take to completely go away
    Whether there is cure from this or not??
    Plz Dr Jo help me
    I'm worried about this😓😓

  48. hi doctor ,How many months will it take to heal? Do we have to do these exercises through out our life.Last but not the least shall I be able to jump in volleyball again.Pls reply

  49. Hi Doctor Jo, I have finally been diagnosed with Chondromalacia after having an MRI scan due to a sports injury. I have read that I should be focusing on strengthening my glutes and hips and outside of my thigh, as well as the VMO. When I do these exercises should I be changing the amount of sets and repetitions that I do each week and try to make the exercises more difficult as I progress,… or should I do the same exercises with the same sets and repetitions every week until I get better? Thanks for your help!

  50. I was diagnosed with patellar alta recently ….right now my pain is usually minimal like a 1-2 on a scale of 0-10. The physical therapist told me it can turn into osteoarthritis eventually and I’m scared because I’m a floor nurse I need my knees. I’ve been doing exercises for a month and I was feeling better but last night my knee started hurting again for some reason , idk what to do anymore please any advice ?

  51. when i stretch my right legs. my lower knee cap hurts very bad. 🙁 and if i stretch and bend it. the pain is getting worst 😥😓 help pls

  52. Hi Dr Jo
    Im having patellofermoral pain
    From 3 months
    Now it's been better I have strengthened my vmo muscle
    But some days a still get that clicking some times 10times a day
    I'm afraid it's coming back?
    How long should I do these exercise
    How long does it take to go away that patellat clicking permanently?
    Can I be normal once again ever?😕
    Thanks Dr for your concern
    Happy doctor's day

  53. Hi Dr. Jo- my patella seems to be tracking (pulling) to the inside. On the X-ray (sunrise view) my cartilage under my patella is all worn on the inside, still thick on the outside. I work in dentistry and straddle the chair when I sit done. All of the exercises I find talk about tracking to the outside. Do you have any advice on which exercises to help my knee track better? TIA

  54. Hello. I had a patellofemoral replacement 2 years ago and I can't get it as strong as I'd like. Would these exercises help? I'm only 46 now so still got some zip in me! And I wanna get it good, maybe playing football (soccer) again good. Whadda you reckon Dr. Jo??!

  55. Hi Dr. Jo, I was wondering whether i can stretch my quads, hamstrings , glutes , and especially the inner thigh while doing these exercises for patellofemoral syndrome? Don't they worsen the problem? I mean in general when we are trying to fix a misalignment problem should we do exercises & stretches on certain muscles only??

  56. I'm 29 and I have a grade 4 chondromalacia patellae and currently my knee is swallen and I can't flex it more than 90°. I'm waiting to visit a doctor and I'm doing RICE, do you think I can add this kind of stretching? I tried them and doesn't hurt…

  57. Hey! How long will it take to have my knee back in good shape if I do this at least 3 times a week because I can't even do a full squat?

  58. If you see this, your video(s) just saved me $200 two times a week for 6 weeks after a already expensive eval. Thank you for sharing this content!

  59. Hi, I have Patellar Maltracking in both knees and have been told to work out on the Cross-trainer machine and Bicycle machine to help with my rehab. My legs do feel good like they are having a good workout after using them, however, do you know of anything else that I can do to replace the machines for the days that I am not able to attend the gym and have to do the exercises at home? Thanks.

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