Is his TFL tight? I find particularly with patients that have weak glut medius their TFL is overactive to stabilise the hip during single leg stance (as both TFL and glut medius are abductors). Overactivity in TFL causes Medial rotation of the femur (increased Q angle). Combine this with a tight ITB and the patella is pulled laterally. You may find soem deep soft tissue work through TFL realyl reduces the patients symptoms - but be careful as this is most likley not the main contributing factor - as long as glut medius is weak or ineffective in its action, TFL will be overactive

Lateral displacement of the patella changes the pressure distribution in the trochlear - causes pain.

I suggest assessing the TFL but also determine what angle of knee flexion the patient is getting pain, tape their patella medially and reassess in the same position (McConnell Critical Test). If this seems to reduce their pain then it is most likely of a PFJ origin and your treatment must be based around getting the patella to move up/down flush in the trochlear.

On top of this as previously posted you must address the shock absorbing muscles - gluteus maximus, quads and calf as inadequate strength in these muscles will increase the load through the PFJ.

The key to PFJ pain is making sure you adequately address the contributing factors or otherwise this guys pain will persist.

21stcenturyphysio