Anterior knee pain (or patellofemoral pain) continues to be a source of frustration and confusion among clinicians. There is wide variation in symptom history, physical exam findings, imaging, and treatment that often confounds the use of any straightforward algorithm or decision tree. This review aims to provide an approach that partners the adolescent athlete with clinician and an experienced physiotherapist. This team approach uses available evidence to develop a treatment program that is specific to the adolescent's symptoms, body movement patterns, and activity demands.