Overview
what it is and why it mattersPatellofemoral pain — also called runner's knee — is a vague, achy pain in the front of your knee that comes from where the back of your kneecap rides against the groove on the end of your thigh bone. It's one of the most common knee complaints in active teens and young adults. When the kneecap doesn't glide cleanly through its groove — usually because of muscle imbalances, weak hip muscles, or the shape of the bones themselves — the cartilage on the back of the kneecap takes too much pressure and starts to hurt.
The pain typically gets worse going up and down stairs, after sitting still for a long time (the classic movie-theater sign), squatting, or running. It's not really a single problem with a single cause — more a pattern of pain with several drivers stacked on top of each other.
Symptoms
what you may noticeA vague ache in the front of your knee or behind the kneecap that gets worse going up and down stairs, squatting, kneeling, or sitting for a long time with your knee bent (the classic movie-theater sign). Running — especially downhill — tends to flare it.
You may hear a grinding or crunching sensation (crepitus) when you bend and straighten your knee. The knee can feel stiff after prolonged sitting, and the pain often starts gradually without a single injury to point to.
Diagnosis
exam first, imaging secondPain around or behind the kneecap, plus a positive Clarke's sign (pressing the kneecap into its groove reproduces the pain) and pain when you do a single-leg squat. Your provider also looks at how strong your hip muscles are and whether your feet roll inward when you walk — both can throw off how the kneecap tracks. An MRI is reserved for when we're worried about cartilage damage on the back of the kneecap (chondromalacia patella) or another structural problem.
Treatment Path
how care progresses at OSI1
Hip and quadriceps strengthening
The single most effective treatment is strengthening the hip muscles that control how your knee tracks (the side hip muscles and rotators) plus the inner thigh muscle near the knee (the VMO). Fixing those imbalances usually fixes the kneecap's tracking and the pain that comes with it.
2
Activity modification
Cut back on hill running, stair climbing, and deep squats during the painful stretch — the same activities that load the kneecap the most are what flare it.
3
Foot orthotics
If your feet roll inward when you walk or run, an arch-supporting insole can keep your knee from collapsing inward at each step — which takes pressure off the kneecap.
Patellar taping / bracing
A specific taping pattern (McConnell taping) or a brace with a built-in pad can pull the kneecap into better alignment, take the edge off the pain, and help you feel where the kneecap should sit while you do your rehab.
NSAIDs
An over-the-counter anti-inflammatory like ibuprofen can help calm a flare while you build strength.
Surgical Options at OSI
if non-operative care isn't enoughSurgery is rarely needed for kneecap pain. We only consider it when imaging shows real cartilage damage or a structural reason the kneecap can't track straight (like a shallow groove), and only after a thorough non-operative program hasn't worked. The goal of surgery is to change the anatomy so the kneecap rides where it's supposed to.
Providers Who Treat Patellofemoral Pain
sports-medicine team
Further Reading
authoritative sourcesExternal patient-education references and related OSI pages for additional background: