Patellofemoral pain syndrome can be a difficult condition to manage effectively. The success rate of most treatment regimes has been poor and in the long term the condition frequently recurs. The author has developed a treatment programme which has a ninety-six percent success rate. Long term follow up of patients, after twelve months demonstrated that all patients reviewed have remained pain free. The programme involves two major components: a thorough understanding of the mechanics of the patellofemoral joint so that an adequate assessment of the patient's lower limb can be made, and context specific training of certain muscles which contribute to patellar alignment. This training must be relatively pain free so that muscle control can be enhanced.
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