A painful mystery at the movies

When I sit for a long time, like at the movies, getting up and walking on my knee is really sore.’ When your physio hears this, they start to smell a plot developing. Like a detective in a mystery film, they’ll then ask you some follow up questions: ‘Where is the pain?’ ‘What does it feel like when you’re exercising?’ ‘Does the pain linger for long?’

Your physio is thinking about ‘Movie-Goers Knee’ (or patellofemoral pain syndrome) in terms of victims and culprits. The victim is the sore knee. But who is the culprit? Whodunnit?

Patellofemoral pain syndrome is irritation of the kneecap as it slides along the front of the knee. There are four main culprits with patellofemoral pain syndrome and your physio will help you to work out which one (or which combination) is responsible.


If a hip is weak or stiff, it can cause the kneecap to run in a compromised position. Your physio has some good tests to assess whether the primary problem is actually around the hip region, in which case exercises targeted at this area will be helpful in resolving the pain and getting you back to what you need to do.


Some people’s foot position makes it hard for their knee to drive movement in a comfortable way. One step may be okay but with all the repetition of something like running, over time this can stress the knee out. Any foot issues can be addressed with exercises for the foot or with orthotics if necessary.

The knee itself

Sometimes the culprit is the most obvious one: the knee itself. This might be the case if the kneecap is stiff or poorly controlled by the muscles around it. If the problem is stiffness, by releasing the structures around your kneecap, your physio can often make an improvement in your pain and then teach you how to do this at home yourself. If the problem is strength, good news… you’ll have some exercises to do!


This is the sneakiest of all possible culprits because it can’t be seen or heard… The body is great at making adaptations to changes over time. It sometimes does struggle though with quick or intense changes and so knowing how much to do is as important as how to do it. Your physio can address the amount of load that you’re putting into the knee and give you good advice on how much to do in order to improve your pain.

Often, patellofemoral pain can result from an interaction between these four (and other) factors. A thorough assessment is the best way to be able to weigh the contribution of each area up. This is the basis for a good management plan that will help you to get back to what you want to do, whether that’s watching movies or running marathons.

To work out what’s causing your knee pain, call (08) 9364 4073 or book online.