Does the front of your knee ache when you climb stairs, squat down or sit for long periods? You are not imagining it – and you are certainly not alone. Anterior knee pain, also called patellofemoral pain, is one of the most common musculoskeletal complaints we see at BOOST PHYSIO. It affects people of all ages and activity levels, from regular runners and gym-goers to desk workers who find that long days sitting leave their knees feeling sore and stiff.

The good news is that patellofemoral pain responds very well to the right approach. In this article, our physiotherapist [Rebecca] explains what is actually happening inside your knee, why your glutes often play a bigger role than people expect and shares three targeted exercises that can make a real difference.

What is patellofemoral pain – and what causes it?

Your kneecap (the patella) sits in a groove at the front of your knee joint and glides smoothly up and down as you bend and straighten your leg. When the muscles around your hip and thigh are not working together properly, the kneecap can be pulled slightly off-track during movement. This creates friction and irritation in the joint, resulting in the familiar dull ache at the front of the knee.

Common activities that trigger patellofemoral pain include:

  • Going up or down stairs
  • Squatting or kneeling
  • Running or cycling
  • Sitting with the knee bent for long periods – sometimes called cinema knee

The condition is extremely common. Research published in the British Journal of Sports Medicineidentifies patellofemoral pain as one of the most prevalent knee complaints in active populations, accounting for around 25% of all knee injuries seen in sports medicine clinics.

Why your glutes matter more than you might think

Here is something that surprises many of our patients: anterior knee pain often has more to do with your hip than your knee.

When the gluteus medius – the muscle on the outer part of your hip – is weak or not activating correctly, your thigh tends to rotate inward during movement. This places extra strain on the kneecap and disrupts the smooth tracking it needs. Strengthening and retraining this muscle is one of the most effective and well-evidenced approaches to reducing patellofemoral pain and preventing it from returning.

This is why treatment that focuses purely on the knee – stretching the quads or applying ice – often provides only short-term relief. Addressing the underlying hip control issue is what creates lasting improvement.

Three exercises for knee cap pain – explained

These exercises are chosen specifically because they load and retrain the muscles that support correct kneecap tracking. They are suitable as a starting point for most people with anterior knee pain, though the technique, range of movement and load should always be tailored to you – which is where a physiotherapy assessment is invaluable.

1. Spanish Squat

The Spanish Squat is an excellent way to load the quadriceps and the knee joint in a controlled, pain-friendly position. By using a resistance band fixed around a post, you can shift your weight backwards, keeping the shins more vertical and reducing compressive forces on the kneecap. This makes it ideal for people who find standard squats aggravate their symptoms.

Key technique points: Keep your chest up, drive your knees outwards and lower slowly. Start with bodyweight only and progress the depth gradually as your comfort improves.

2. Lunge

The lunge builds single-leg strength and hip control simultaneously – two things that are directly relevant to the demands of walking, stair-climbing and sport. When performed with attention to knee alignment, it effectively trains the gluteus medius to prevent the thigh rotating inward under load.

Key technique points: Step far enough forward that your front knee stays above your ankle (not pushing past your toes). Keep your trunk upright and focus on driving the front knee outward, in line with your second toe.

3. Single-Leg Balance with Forward Lean

This exercise challenges the gluteus medius in precisely the way it needs to function during normal walking and stair-climbing – under load, on one leg, while the trunk moves. It is deceptively demanding and targets the hip stabilisers that are so often underactive in people with anterior knee pain.

Key technique points: Stand on one leg with a slight bend in the knee. Hinge slowly forward from the hip while keeping your standing knee aligned over your toes. Your lifted leg acts as a counterbalance. Control the return movement slowly.

Important note on technique: How you perform these exercises matters enormously. The correct range of movement, loading and progression vary from person to person. If you are unsure, or if any exercise causes pain, stop and seek a professional assessment before continuing.

Frequently asked questions about anterior knee pain

Yes - the terms are used interchangeably. Anterior knee pain simply describes pain at the front of the knee, while patellofemoral pain syndrome (PFPS) is the clinical term for the same condition when it relates to the kneecap and its surrounding structures. Other terms you may come across include runner's knee or chondromalacia patellae, though these refer to more specific presentations within the same broad category.

In most cases yes, but with modifications. Complete rest is rarely necessary and can actually slow recovery. The key is to reduce activities that provoke significant pain while maintaining movement and targeted strengthening. A physiotherapist can help you identify safe exercise thresholds and adapt your training so you stay active throughout your recovery.

This depends on the severity and duration of your symptoms, your activity goals and how consistently you can follow your home exercise programme. Many patients see significant improvement within four to six sessions, though more complex or long-standing cases may require a longer course of treatment. Your physiotherapist will give you a realistic expectation at your first assessment.

Yes. We are recognised by Bupa, AXA Health, Vitality and WPA. If you have private health insurance, please check your policy for physiotherapy cover and contact your insurer for a pre-authorisation number before your first appointment. We are also happy to see patients on a self-pay basis - please call us on 020 8201 7788 or book online and our team will talk you through the options.

Absolutely. Recurrent patellofemoral pain is very common and usually indicates that the underlying cause - such as hip weakness or a movement pattern issue - has not been fully addressed. Physiotherapy is especially effective in these cases because it identifies and corrects the root cause rather than simply managing symptoms. Our aim is always to give you the tools and understanding to prevent future episodes as well as resolving the current one.