“You all did so much to relieve my anxiety and concerns with my knee replacement. I shall remember you with gratitude every time I walk the dog in the future. Thank you”

“To speak to medical professionals who specialise in sports injury was a breath of fresh air. The experience for me was the best it could be, especially as an athlete with a potentially career-ending injury. Everyone was caring and I was given the hope I so badly needed. It was now possible that... Read More

“Everything was wonderful. I am now completely pain free and absolutely thrilled.”

“Thank you for the excellent operation you did on my knee. It has healed up really well with only a very small scar left. Most of the acute pain is now gone and each week it pains a little less. I am looking forward to the long (pain free) walks I used to do before. So many thanks, you are the... Read More

“Thank you so much for seeing me and treating me so quickly after my skiing accident! I was amazed and impressed that you managed to arrange my surgery so quickly. Mum and I have a nickname for you - GOD!”

“'Thank you' seems inadequate words for the debt of gratitude I owe you all. Your expertise and skills heal body and soul. Your care and kindness humble me.”

“I felt fully engaged from the start and actually found the whole process quite enjoyable! I felt informed without being patronised, well prepared, both by the consultation with Neil, the paperwork and booklets. The outcome has exceeded my expectations and the care was tremendous, as was the pain... Read More

“Neil performed a PCL replacement in my right knee back in 2000. At the time, it was a procedure that few knee surgeons had the skills to perform. He fully informed me of the risks attached to the procedure, the likelihood of success and allowed me to take my time to decide on how I wished to... Read More

“You fitted me with a completely new knee on 20th June. It is absolutely amazing and I'm getting on and off, riding and jumping with ease. It has brought back all the possibilities in retirement that had come to an end with a bad knee. It's not yet four months since the operation.....lets hope the... Read More

Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome


Patellofemoral pain syndrome is a common cause of pain around the front of the knee. It happens when your kneecap (patella) and cartilage in your joint is affected by imbalances in the muscles or wear/damage to the articular cartilage behind the kneecap or in the groove in which the kneecap runs called the trochlear groove. It usually gets better with simple treatments such as physiotherapy and exercises. You may need to adjust your training programme if you do a lot of sport.

What causes Patellofemoral Pain?

It is probably due to a combination of different factors which put extra strain on the knee joint and on the surrounding muscles and ligaments.

The most common cause is overuse of the knee, associated with certain sports such as running, particularly at times of increased training. Some people may have a slight problem in the alignment of the knee; this may cause excessive stress on one part of the patella-femoral joint. The pain may also be due to the way the knee has developed or it may be due to an imbalance in the muscles around the knee. If one side of the quadriceps muscles pulls harder than the other side, then the patella may not glide correctly and may rub on one side.

Foot problems can play a part, for example, where the feet do not have strong arches (flat feet). This makes the foot roll inwards (pronate), which means the knee has to compensate for the inward movement.

Symptoms include pain around the knee. The pain is felt at the front of the knee, around or behind the kneecap. Often, the exact site of the pain cannot be pinpointed; instead the pain is felt vaguely at the front of the knee.

The pain may come and go and is typically worse when going up or down stairs or with certain sports. Also, it may be brought on by sitting still for long periods. There may be a grating or grinding feeling or noise when the knee moves. This is called crepitus. Sometimes there is fullness or swelling around the patella.

What is the treatment for patellofemoral pain?

You will be advised to avoid strenuous use of the knee – until the pain eases. Symptoms usually improve in time if the knee is not overused. Aim to keep fit, but to reduce the specific activities which cause the pain.

In the longer term, certain treatments aim to correct some of the underlying causes – for example, by strengthening muscles and helping with foot problems. Treatments include:

Physiotherapy – improving the strength of the muscles around the knee will ease the stress on the knee. Also, specific exercises may help to correct problems with alignment and muscle balance around the knee. For example, you may be encouraged to do exercises which strengthen the inner side of the quadriceps muscle. You may also be taught exercises to stretch tight ligaments. The specialist physiotherapist can give advice tailored to your individual situation.

Taping of the patella – this is a treatment which may reduce pain. It is where adhesive tape is applied over the patella, to alter the alignment or the way the patella moves. Some people find this helpful.

Surgery is not often used for patellofemoral pain. However, it may be helpful in certain situations. For example, surgery to correct the alignment of the patella.