Is This Serious: Why Does My Kneecap Hurt?

pt Health Is this serious?, Knee pain


Are you a regular runner or have you just started training to run? Have you just started to experience knee pain? You are on a great path to get healthier and now all of a sudden your knee begins to hurt. What could be more frustrating than being stopped in your tracks because of runner’s knee? You don’t have to be a runner to get runner’s knee, but it is a very common disorder often seen in runners, so the term is used by many athletes or parents of athletes. The definition of a Runner’s knee is pain experienced at the front of the knee behind your kneecap [1]. It can also be called patellofemoral pain syndrome which quite simply translated from latin is pain where the kneecap (patello) meets the leg (femoral).  

What Causes Runner’s Knee?

Photograph of woman's knee showing the intersection of the fibula, tabula, and kneecap

So what exactly is happening? Well, the joining of 3 different bones creates your knee joint. The bone in your thigh and the bone in your lower leg meet and a third bone called the patella (kneecap) lays in front of that space. With overactivity or imbalances of strength in your muscles, this area can become inflamed or not be aligned optimally resulting in pain at the front of your knee, under or behind your kneecap. 

Who is at Risk of Getting Runner’s Knee?

Photograph of a mother and two children running in a park.

There are many different reasons that one may have knee pain at the front of the knee, behind the kneecap. However, 40% of adults and adolescents with knee pain have been diagnosed with patellofemoral pain syndrome (PFPS) or Runner’s knee [4]. So how at risk are you?

It has been shown that a Runner’s knee is more common in females and in young, active adolescents. Other causes or risk factors include:

  • Muscular imbalance, certain muscles pulling on the knee cap are stronger than others [4,2]
  • Overactivity, sudden and intense increases in training [4]
  • Excessive hill training or running steep descents [1]
  • Lower leg muscle tightness [4,2]
  • Flat feet, changes the alignment of the lower leg and therefore alignment of the knee [4]

How to Treat Runner’s Knee

If you feel pain at the front of your knees especially during running or standing after sitting for a long time, you may have runner’s knee or patellofemoral pain syndrome. Since there can be so many different causes resulting in the same type of pain it is important that you consult a professional to find what exactly is the root cause. Just stopping your physical activity or exercising is not the answer. Most times, the pain arises from the reasons listed above and should be addressed specifically so that the pain won’t continue or return.

We recommend booking an assessment with a qualified physiotherapist. Your physiotherapist will assess your strength, walking pattern, alignment and many other aspects to determine the root cause. Afterward, they will provide you with a set of exercises that will target the real problem and allow you to return to the sport that you or your child loves.



  1. P Varma, Stineman, T.R. Dillingham, William J. Erdman. Patellofemoral Pain, Physical Medicine and Rehabilitation Clinics of North America. 2016-02-01; 27(1): 31-52
  2. Dutton RA, Khadavi MJ, Fredericson M. Update on rehabilitation of patellofemoral pain. Curr Sports Med Rep 2014;13(3):173
  3. Marcus A. Rothermich, Neal R. Glaviano, Jiacheng Li et al. Patellofemoral pain: epidemiology, pathophysiology, and treatment options.Clinics in sports medicine. 2015;.34 (2):313 -327

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