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Published on: 5/6/2025

What Could Cause Pain Below the Kneecap?

Pain below the kneecap can come from a few different problems, such as patellofemoral syndrome or issues with the cartilage under the kneecap. Other causes include overuse, misalignment of the kneecap, and sometimes inflammation of the tendons or bursae around the knee.

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Explanation

The area below the kneecap can hurt for several reasons. One common cause is patellofemoral syndrome, which happens when the joint where the kneecap meets the thigh bone does not move well, causing pain with activities like climbing stairs or sitting for a long time. Associated with this is chondromalacia patellae, where the cartilage under the kneecap softens or wears away. This can also be linked to patellofemoral malalignment, meaning the kneecap is not tracking properly over the knee joint. Overuse from running, cycling, or jumping can stress the tendons and create tendinopathy (inflammation of the tendon). In some cases, bursitis, an irritation of the small fluid-filled sacs near the knee, can also lead to pain. These conditions all make it hard for the knee to move smoothly and can cause discomfort when you are active. Remember, this information is educational and if you are experiencing pain, it is important to speak with a healthcare provider for proper diagnosis and care.

(References)

  • Bump JM, Lewis L. Patellofemoral Syndrome. [Updated 2023 Feb 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557657/

  • Aysin IK, Askin A, Mete BD, Guvendi E, Aysin M, Kocyigit H. Investigation of the Relationship between Anterior Knee Pain and Chondromalacia Patellae and Patellofemoral Malalignment. Eurasian J Med. 2018 Feb;50(1):28-33. doi: 10.5152/eurasianjmed.2018.17277. Epub 2018 Feb 1. PMID: 29531488; PMCID: PMC5843449.

  • Kuwabara A, Fredericson M. Narrative: Review of Anterior Knee Pain Differential Diagnosis (Other than Patellofemoral Pain). Curr Rev Musculoskelet Med. 2021 Jun;14(3):232-238. doi: 10.1007/s12178-021-09704-9. Epub 2021 Apr 5. PMID: 33818700; PMCID: PMC8137785.

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