Why Does It Hurt Under My Kneecap? Understanding Patellofemoral Pain

Knee pain

You kneel down, stand back up, or take the stairs—and there's that pain again. A dull ache, right under the kneecap. It’s frustrating, and if you’re like many people, you’re not even sure where to start when it comes to fixing it. Let’s break down what’s going on behind this common kind of knee pain.

What Is Patellofemoral Pain Syndrome?

Most pain under the kneecap falls under a broad umbrella called Patellofemoral Pain Syndrome (PFPS). It's sometimes called “runner’s knee,” but you don’t have to be a runner to deal with it. PFPS refers to irritation where the back of your kneecap (patella) meets the thigh bone (femur).

That area is lined with cartilage that helps everything glide smoothly. But when tracking gets off, meaning the kneecap doesn't move properly with the leg, it can cause stress, inflammation, and pain.

Common Causes of Pain Under the Kneecap

You don’t have to experience a big injury to have chronic kneecap pain. Many causes are more subtle:

  • Muscle imbalances — Weak hips, quads, or glutes can cause poor tracking of the kneecap.

  • Overuse or sudden activity spikes — Like going from no workouts to daily squats or hill runs.

  • Poor biomechanics — Flat feet, collapsed arches, or knock-knees can change how forces move through the knee.

  • Previous injury — Even a small sprain or misstep years ago can set the stage for problems now.

Signs It’s Time to Get Help

Pain under the kneecap is often persistent and comes back during certain movements. Look out for:

  • Pain when sitting for long periods with bent knees

  • Discomfort when walking down stairs or hills

  • Grinding, clicking, or popping under the kneecap

  • Swelling around or behind the patella

If you're experiencing any of these symptoms regularly, it's worth getting evaluated. The good news? It's highly treatable.

How Chiropractic Can Help With Kneecap Pain

At Mountain Movement Chiropractic, we don’t just look at your knee—we look at how your whole body moves.

  • Joint Adjustments can improve mobility and reduce abnormal tension in the surrounding structures.

  • Soft Tissue Therapy targets the tight or overactive muscles that pull the kneecap off track.

  • Rehab Exercises rebuild strength and restore proper movement patterns from the ground up.

Our approach is personalized, so whether your pain stems from an old injury, your work routine, or your weekend activities, we’ll build a plan that fits you.

What You Can Do at Home Right Now

While professional care speeds up healing and helps prevent recurrence, there are simple things you can start doing today:

  • Stretch your quads and hip flexors daily

  • Strengthen your glutes with bridges or clamshells

  • Avoid high-impact movements like jumping or squatting deep until pain subsides

  • Use ice after activity if swelling or pain increases

And above all—listen to your body. Pain under the kneecap is your knee’s way of asking for help, not something to just push through.

Final Thoughts

Pain under your kneecap is common, but that doesn’t mean it should be ignored. With the right combination of care and smart movement, you can feel better—and stay active—without pain holding you back.

📍 Mountain Movement Chiropractic – Spearfish, SD
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