Discomfort felt behind or around the kneecap is a very common experience across all age groups and activity levels. This pain often arises from issues within the patellofemoral joint, the area where the kneecap interacts with the thigh bone. Understanding this discomfort is key to finding relief and improving daily function.
Understanding Your Knee
The knee is a complex hinge joint, connecting the thigh bone (femur) to the shin bone (tibia). The kneecap, or patella, is a small, flat, triangular bone positioned at the front of the knee. It rests in a groove on the end of the femur, known as the trochlear groove.
The patella’s primary role is to protect the knee joint and enhance the mechanical advantage of the quadriceps muscles located on the front of your thigh. These muscles connect to the patella via the quadriceps tendon, which then connects to the shin bone via the patellar tendon. Cartilage, a smooth, slippery tissue, covers the undersurface of the kneecap and the end of the femur, allowing for smooth gliding motion. Ligaments and other soft tissues stabilize the patella and guide its movement. This arrangement allows for bending and straightening of the leg, but also makes the area susceptible to pain when its components are not working in harmony.
Common Reasons for Pain Behind Your Kneecap
Pain behind the kneecap often stems from conditions related to kneecap movement and stress on surrounding tissues. One frequent diagnosis is Patellofemoral Pain Syndrome (PFPS), also known as “runner’s knee” or “jumper’s knee.” PFPS results from repetitive stress on the patellofemoral joint, common in activities involving running, jumping, squatting, or stair climbing. This repetitive loading can irritate soft tissues and bone around the kneecap, causing dull, aching pain that worsens with activity or after prolonged sitting with bent knees. Muscle imbalances, such as quadriceps weakness or hamstring tightness, can contribute to the kneecap not tracking properly, increasing pressure and irritation.
Chondromalacia Patellae involves the softening or breakdown of articular cartilage located on the underside of the kneecap. While cartilage lacks nerve endings, its deterioration can inflame the joint lining and cause pain in the underlying bone. This condition is associated with PFPS and can cause a cracking or grinding sensation when the knee moves.
Patellar Tendinitis, or “jumper’s knee,” is inflammation of the patellar tendon, which connects the kneecap to the shin bone. This condition arises from overuse and repetitive strain, particularly in sports involving jumping or rapid changes in direction. Pain is often felt directly below the kneecap, but can be perceived as internal or behind the kneecap during activities that load the tendon. The affected tendon may also feel tender to the touch, and swelling can occur.
Plica Syndrome involves irritation of a plica, a fold in the knee joint’s synovial lining. These folds can become inflamed or thickened due to injury or overuse. When irritated, a plica can catch or rub against the kneecap or thigh bone, causing pain, clicking, or a sensation of the knee “giving way.”
Osteoarthritis can affect the patellofemoral joint, especially in older individuals. This condition involves the gradual wearing away of protective cartilage, leading to increased friction between bones. Pain from osteoarthritis behind the kneecap can range from mild to severe, often worsening with activity and potentially causing swelling or stiffness.
When Professional Help is Needed
While many instances of kneecap pain can be managed with self-care, certain symptoms indicate that professional medical evaluation is advisable. If you experience severe pain that prevents you from bearing weight on your leg, or if there is noticeable deformity around the knee, seek immediate attention. Persistent swelling, warmth, or redness around the kneecap also warrant a medical assessment.
Additionally, if you hear or feel distinct clicking, catching, or locking sensations within the knee joint, or if your knee feels unstable and prone to “giving way,” a healthcare provider should evaluate it. Pain that does not improve with initial rest and self-care measures within a few days, or pain that significantly interferes with your daily activities, suggests the need for professional guidance.
First Steps for Relief
For immediate relief of pain behind the kneecap, several conservative, at-home measures can be beneficial. The RICE method — Rest, Ice, Compression, and Elevation — is a widely recommended initial approach. Resting the knee involves avoiding activities that aggravate the pain, allowing irritated tissues to recover. Applying ice to the affected area for 15-20 minutes several times a day can help reduce pain and swelling.
Light compression with an elastic bandage or sleeve can further manage swelling and provide support, while elevating the leg above heart level when resting can also help reduce fluid accumulation. Modifying activities to lessen stress on the knee, such as temporarily avoiding deep squats, prolonged kneeling, or steep stairs. Over-the-counter pain relievers, like nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, can help alleviate pain and inflammation. Stretching exercises for the quadriceps, hamstrings, and calf muscles can improve flexibility, and strengthening exercises for the muscles supporting the knee can enhance stability. However, it is advisable to consult a healthcare professional or physical therapist for guidance on appropriate exercise routines to ensure they are performed correctly and do not exacerbate the condition.