This rehabilitation protocol has been developed for the patient with general pain and tenderness around the knee cap which may increase in intensity with daily and sporting activities. The symptoms will often decrease with rest and are frequently bilateral. Sporting activities, especially running and jumping, stairs, sitting with knees flexed for a long period of time, and deep squatting activities may intensify the pain. Early intervention of strengthening and stretching is recommended to decrease pain and assist in returning to activity. The protocol is divided into phases. Each phase is adaptable based on the individual patient and special circumstances. Progress through the phases as pain, range of motion, swelling and strength allow.

The overall goals of the rehabilitation protocol are to:

• Control pain and swelling
• Regain normal knee range of motion
• Establish appropriate stretching and strengthening exercises
• Regain normal proprioception, balance, and coordination for daily activities
• Achieve the level of function based on the orthopedic and patient goals

Physical therapy is an important intervention to assist the patient in early rehabilitation in attaining a level of fitness to return to functional activity without pain. It is extremely important for the supervised rehabilitation to be supplemented by a home fitness program where the patient performs the given exercises at home or at a gym facility. Physical therapy for PF syndrome/jumper’s knee varies in length on factors such as:

• Structure(s) involved: infrapatellar tendon, patellar cartilage plica, or patellar tracking
• Acute versus chronic condition
• Lower extremity flexibility
• Lower extremity biomechanics: pronated foot, leg lengths
• Performance or activity demands
• Muscular strength and endurance