Ginger: You were talking about L3 and the femoral nerve affecting VMO and this being the key issue. I am curious as to whether this is your opinion or you have some articles for me to read that i am not aware of?

Whilst everyone has made some excellent suggestions I feel you can do everything right with patellofemoral pain syndrome, but it wont get better unless the correct relative rest is also provided. It sounds like your daughter is still participating in activities which are causing pain. I feel she would get better alot faster if her whole rehabilitation program is pain free. She should be able to do most activities just avoid activities which load the knee in a bent position, with gradual increases as symptoms improve.

Yes there is a large biomechanical component to the condition, i remember reading a recent Wikipedia reference-linkMRI study on patellofemoral pain in which they found the shape of the patella and the way it loads at 20 degrees flexion could predict who had patellofemoral pain syndome (sorry dont have the link). This study indicated that there are also biomechanical factors that we simply cannot alter through physiotherapy.