Patellofemoral pain syndrome is a condition of youth, frequently bilateral1 and a significant problem with high incidence among active university students (9%) and military recruits (15%).2 3 A long-term follow-up study reported that 94% of patients experienced some pain 2–4 years later, and 25% of these patients reported significant symptoms over 20 years.4 Although long-term musculoskeletal pain is not life threatening, the negative consequences for physical activity may have downstream implications for general health and well-being, potentially contributing to hypokinetic diseases or impeding their management through physical activity programmes.

This paper is much needed as it reports a quality randomised controlled trial (RCT) that evaluated a supervised exercise programme against the Dutch GP wait-and-see approach. The investigators implemented a well-designed RCT and recruited patients within an appropriate age range (131 patients, aged 14–40 years) using sound inclusion and exclusion …