Four psychological factors are consistently linked to worse PFP outcomes. Clinicians call these the psychological “yellow flags”.
1. Pain catastrophizing
Expecting the worst possible outcome from pain signals, which can amplify perceived pain intensity.
2. Kinesiophobia
Fear of movement, often leading to avoidance of activity altogether, which can slow recovery.
3. Anxiety
Heightened worry about re-injury or setbacks during the recovery process.
4. Depression
Low mood, which is linked to lower physical function in people with PFP.
Why do these matter clinically?
All four are associated with higher pain intensity and lower physical function. Psychological stress is also a primary reason why athletes and other physically active people fail to return to their sport/activity after PFP.
