What the 2018 consensus supports (5th International Patellofemoral Pain Research Retreat, Gold Coast):

Intervention	Recommendation	Detail
Exercise therapy	Appropriate	Reduces pain short, medium and long term; improves function medium and long term
Combined hip and knee exercise	Appropriate — preferred over knee exercise alone	Reduces pain and improves function short, medium and long term
Combined interventions (exercise + orthoses, taping or manual therapy)	Appropriate in adults	Reduces pain short and medium term; no evidence beyond 12 months. Uncertain for long-term pain in adolescents
Prefabricated foot orthoses	Appropriate for short-term pain	Uncertain for function. Custom-fabricated orthoses are not supported
Patellar taping and bracing	Uncertain	Evidence uncertain for tailored and untailored taping, and for bracing
Manual soft tissue techniques	Uncertain	Short-term benefit uncertain
Acupuncture / dry needling, BFR, gait retraining	Uncertain	Insufficient evidence to recommend for or against
Patellofemoral, knee or lumbar mobilisation in isolation	Inappropriate	PFJ mobilisation may form part of a combined approach only
Electrophysical agents (ultrasound, phonophoresis, laser)	Inappropriate	Not recommended

Dosage. The consensus explicitly states that the optimal exercise dose is unknown and that exercise prescription is poorly reported in the literature. The parameters below are therefore extrapolated from general strength-training principles, not from PFP-specific evidence. [verify]

Phase 1 · Settle and educate

Goals: reduce pain to a tolerable level, establish understanding, modify provocative load without full rest.

Interventions: education (mandatory at the first consultation), relative load modification, isometric quadriceps work, hip abductor and external rotator activation, prefabricated orthoses if foot-related aggravation.

Dosage [verify]: isometrics 5 × 45 s at ~70% MVC, 1–2× daily; pain during exercise acceptable up to 2–3/10 and settling within 24 h.

Progress when: pain predictable and settling within 24 h; able to perform a pain-acceptable squat to 60°.

Phase 2 · Load

Goals: build hip and knee strength and PFJ load tolerance.

Interventions: combined hip and knee strengthening — the single best-supported element. Squat and leg press through a tolerable range, split squats, step-ups and step-downs, hip abduction and external rotation under load.

Dosage [verify]: 3–4 sets × 8–12 reps at RPE 7–8, 2–3×/week, progressed weekly by load rather than reps.

Progress when: strength symmetry approaching the uninvolved side, pain-free through full functional range, AKPS improving.

Phase 3 · Return to load

Goals: restore the specific activity the patient wants back.

Interventions: graded reintroduction of the provocative activity, plyometrics and running progression where relevant, continued strength maintenance.

Dosage [verify]: graded exposure with 24-hour symptom response as the progression gate; strength maintained at 2×/week.

Progress when: target activity tolerated at full volume with stable 24-hour response.