Main Article Content

Kirran Sikandar Gondal
Mishmal Ameer
Aneeqa Farooq
Abdullah Warad
Huma Tabassum
Muhammad Ali


patellofemoral, quadriceps tightness, knee pain, Runner’s knee


Objective: The purpose of this research was to find out the prevalence of patellofemoral pain (PFP) among young adults with quadriceps tightness

Methods: An observational research was carried out on a total of 160 participants in Sargodha, Punjab in Pakistan with a focus on individuals aged 16 to 35 years. Participants from diverse backgrounds were included, and PFP diagnosis was established through clinical examination during specific functional activities. The Pain Numerical Scale and a questionnaire on personal and medical history as well as lifestyle choices were used to compile the data. The SPSS 26 statistical software was used for the analysis.

Results: The research found almost balanced gender distribution, with 51.9% men and 48.1% females. Participants aged 23 and 24 showed the greatest frequency of PFP with quadriceps tightness. Physical activity was prevalent among 74.4% of participants. 33.8% experienced discomfort in their left knee, 36.9% in their right knee, and 29.4% in both knees. 37.5% of participants reported experiencing pain for more than three months. Some activities, like jogging or climbing stairs, were linked to an increased risk of discomfort. Thigh pain during activities varied, with 41.9% during bending the knee and 26.9% during running. According to the Pain Numerical Scale, 26.3% of people expressed having no pain at all, 70.0 % felt moderate pain, and 3.8 % felt extreme pain.

Conclusion: The results of this research highlight valuable insight into the frequency and causes of quadriceps tightness among adults. The results demonstrated the necessity for individualized therapies targeting particular activities and risk factors to reduce pain and improve the quality of life for people with PFP. More research is needed to better understand the causes of PFP and develop effective interventions for a wide range of people.

Abstract 119 | pdf Downloads 21


1. Gaitonde DY, Ericksen A, Robbins RC. Patellofemoral pain syndrome. Am Fam Physician. 2019;99(2):88–94.
2. Kary JM. Diagnosis and management of quadriceps strains and contusions. Curr Rev Musculoskelet Med. 2010;3(1–4):26–31.
3. Crossley KM, van Middelkoop M, Callaghan MJ, Collins NJ, Rathleff MS, Barton CJ. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions (exercise, taping, bracing, foot orthoses and combined interventions). Br J Sports Med. 2016;50(14):844–52.
4. Willy RW, Hoglund LT, Barton CJ, Bolgla LA, Scalzitti DA, Logerstedt DS, et al. Patellofemoral Pain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2019 Sep;49(9):CPG1–95.
5. Powers CM. The Influence of Altered Lower-Extremity Kinematics on Patellofemoral Joint Dysfunction: A Theoretical Perspective. J Orthop Sports Phys Ther. 2003 Nov;33(11):639–46.
6. Taha AMS, Feldman DS. Painful flexible flatfoot. Foot Ankle Clin. 2015;20(4):693–704.
7. Carvalho AP de MC, Magalhães E, Bryk FF, Fukuda TY. Comparison of isometric ankle strength between females with and without patellofemoral pain syndrome. Int J Sports Phys Ther. 2014;9(5):628.
8. Post WR. Patellofemoral pain: results of nonoperative treatment. Clin Orthop Relat Res 1976-2007. 2005;436:55–9.
9. Pourahmadi MR, Takamjani IE, Hesampour K, Shah-Hosseini GR, Jamshidi AA, Shamsi MB. Effects of static stretching of knee musculature on patellar alignment and knee functional disability in male patients diagnosed with knee extension syndrome: A single-group, pretest–posttest trial. Man Ther. 2016;22:179–89.
10. Witvrouw E, Lysens R, Bellemans J, Cambier D, Vanderstraeten G. Intrinsic Risk Factors for the Development of Anterior Knee Pain in an Athletic Population: A Two-Year Prospective Study. Am J Sports Med. 2000 Jul;28(4):480–9.
11. Bahar K, Yeral A, Aslan D, Aytutuldu GK, Develi E, Aklar A. Is there a relation between the lower extremity mechanics and patellofemoral pain syndrome? Int J Tradit Complement Med Res. 2022;3(3):125–31.
12. Myer GD, Ford KR, Foss KDB, Goodman A, Ceasar A, Rauh MJ, et al. The incidence and potential pathomechanics of patellofemoral pain in female athletes. Clin Biomech. 2010;25(7):700–7.
13. Fairbank J, Pynsent P, Van Poortvliet J, Phillips H. Mechanical factors in the incidence of knee pain in adolescents and young adults. J Bone Joint Surg Br. 1984 Nov;66-B(5):685–93.
14. Hall R, Foss KB, Hewett TE, Myer GD. Sport specialization’s association with an increased risk of developing anterior knee pain in adolescent female athletes. J Sport Rehabil. 2015;24(1):31–5.
15. Mølgaard C, Rathleff MS, Simonsen O. Patellofemoral pain syndrome and its association with hip, ankle, and foot function in 16-to 18-year-old high school students: a single-blind case-control study. J Am Podiatr Med Assoc. 2011;101(3):215–22.
16. Steinberg N, Siev-Ner I, Peleg S, Dar G, Masharawi Y, Zeev A, et al. Joint Range of Motion and Patellofemoral Pain in Dancers. Int J Sports Med. 2012 Jul;33(07):561–6.
17. Rathleff MS, Roos EM, Olesen JL, Rasmussen S. Exercise during school hours when added to patient education improves outcome for 2 years in adolescent patellofemoral pain: a cluster randomised trial. Br J Sports Med. 2015;49(6):406–12.
18. Nejati P, Forogh B, Moeineddin R, Baradaran HR, Nejati M. Patellofemoral pain syndrome in Iranian female athletes. Acta Med Iran. 2011;169–72.
19. Clarsen B, Krosshaug T, Bahr R. Overuse Injuries in Professional Road Cyclists. Am J Sports Med. 2010 Dec;38(12):2494–501.
20. Winslow J, Yoder E. Patellofemoral Pain in Female Ballet Dancers: Correlation With Iliotibial Band Tightness and Tibial External Rotation. J Orthop Sports Phys Ther. 1995 Jul;22(1):18–21.
21. Weiss BD. Nontraumatic injuries in amateur long distance bicyclists. Am J Sports Med. 1985 May;13(3):187–92.
22. Roush JR, Bay RC. Prevalence of anterior knee pain in 18–35 year-old females. Int J Sports Phys Ther. 2012;7(4):396.
23. Xu X, Yao C, Wu R, Yan W, Yao Y, Song K, et al. Prevalence of patellofemoral pain and knee pain in the general population of Chinese young adults: a community-based questionnaire survey. BMC Musculoskelet Disord. 2018 Dec;19(1):165.
24. Nilmart P, Yodchaisarn W, Vongsirinavarat M. Patellofemoral Pain Syndrome in Young Adult Women With Low to Moderate Physical Activity Levels. Iran Rehabil J. 2022;20(1):99–108.
25. Harrison E, Magee D. Patellofemoral pain syndrome: the ongoing challenges in etiology, diagnosis, and management. Crit Rev Phys Rehabil Med [Internet]. 2001 [cited 2023 Nov 24];13(2–3). Available from:,6ea649fb6bda11f1,5bbd329f2e8cefad.html
26. Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome: Epidemiology of patellofemoral pain. Scand J Med Sci Sports. 2010 Oct;20(5):725–30.
27. Dey P, Callaghan M, Cook N, Sephton R, Sutton C, Hough E, et al. A questionnaire to identify patellofemoral pain in the community: an exploration of measurement properties. BMC Musculoskelet Disord. 2016 Dec;17(1):237.
28. Collins NJ, Vicenzino B, Van Der Heijden RA, Van Middelkoop M. Pain During Prolonged Sitting Is a Common Problem in Persons With Patellofemoral Pain. J Orthop Sports Phys Ther. 2016 Aug;46(8):658–63.
29. Selhorst M, Rice W, Degenhart T, Jackowski M, Tatman M. Evaluation of a treatment algorithm for patients with patellofemoral pain syndrome: a pilot study. Int J Sports Phys Ther. 2015;10(2):178.
30. Keays SL, Mason M, Newcombe PA. Individualized Physiotherapy in the Treatment of Patellofemoral Pain. Physiother Res Int. 2015 Mar;20(1):22–36.
31. Witvrouw E, Callaghan MJ, Stefanik JJ, Noehren B, Bazett-Jones DM, Willson JD, et al. Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013. Br J Sports Med. 2014;48(6):411–4.
32. Crossley KM. Is patellofemoral osteoarthritis a common sequela of patellofemoral pain? [Internet]. Vol. 48, British journal of sports medicine. BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine; 2014 [cited 2023 Nov 24]. p. 409–10. Available from:
33. Rathleff MS, Roos EM, Olesen JL, Rasmussen S, Arendt-Nielsen L. Lower Mechanical Pressure Pain Thresholds in Female Adolescents With Patellofemoral Pain Syndrome. J Orthop Sports Phys Ther. 2013 Jun;43(6):414–21.
1. Cox CF, Black AC, Hubbard JB. Anatomy, Bony Pelvis and Lower Limb, Knee Lateral Meniscus. StatPearls [Internet]: StatPearls Publishing; 2023.
2. Loudon JKJIjospt. Biomechanics and pathomechanics of the patellofemoral joint. 2016;11(6):820.
3. Gupton M, Imonugo O, Terreberry RR. Anatomy, bony pelvis and lower limb, knee. 2018.
4. Şahin M, Ayhan FF, Borman P, Atasoy HJTjoms. The effect of hip and knee exercises on pain, function, and strength in patientswith patellofemoral pain syndrome: a randomized controlled trial. 2016;46(2):265-77.

Most read articles by the same author(s)