In patellofemoral pain syndrome, what knee flexion range is recommended to limit OKC/CKC exercises?

• A. Limit to 60-90° knee flexion
• B. Strengthen VMO and hip muscles; improve lower limb control; limit OKC/CKC exercises to 0-30° knee flexion
• C. Perform deep squats beyond 60°
• D. No knee strengthening

Answer: (B)

In patellofemoral pain syndrome, the goal is to reduce stress on the patellofemoral joint while rebuilding strength and control around the knee. Limiting knee flexion during early strengthening minimizes joint compressive forces that can irritate the patella, making it safer to train the muscles that stabilize the knee. Keeping both open- and closed-chain exercises to a shallow range—about zero to thirty degrees of knee flexion—lets you activate and strengthen the vastus medialis obliquus (VMO) and the hip muscles without overloading the joint. Strengthening the VMO helps with patellar tracking, while hip strengthening improves overall lower-limb control, reducing mechanics (like excessive knee valgus) that worsen PFPS. Deep squats and exercises with greater knee flexion increase patellofemoral stress, which is not ideal in the early rehab stage, and while strengthening is important, avoiding overloading the joint is the priority early on. So, the recommended approach is to limit both OKC and CKC exercises to a shallow range (0–30°) and focus on targeted VMO and hip strengthening to improve knee mechanics.