Knee
Patellofemoral pain
Pain around the kneecap with stairs or squats
What it means
Patellofemoral pain is felt around or behind the kneecap with activities that load the joint while the knee is bent. Stairs, squats, and running often bring it on. A clinician also considers tendon symptoms and other possible sources of pain around the knee. [1, 2]
What I check in the clinic
I compare a step-down at a height you tolerate with a version that changes the height or adds hand support. If one feels better, it gives us a place to start building back to the stairs you need.
What the evidence says about care
Education and knee-targeted exercise, with hip exercise as appropriate, are the foundation in the best-practice guide. Taping or running changes may fit some people. Your goals help decide which additions are worth trying. [1, 3]
Common questions
Why does one step feel fine but a full flight bothers my kneecap?
I’d ask when the discomfort starts and where you feel it. We can compare a supported step at a height you tolerate and track what happens as you repeat it.
How do I tell whether my stairs are improving if I still hold the rail?
Keep using the rail as needed. Notice when you reach for it, how much support you want, and whether the first and last steps feel more alike.
Why does the kneecap feel sore after a movie when walking into the theater felt fine?
Tell me how it feels while seated and during the first few steps afterward. We can compare a sit-to-stand and use what you feel to guide the next check.
Why is running downhill harder than running on flat ground?
I’d ask which hill and when it starts. We can look at a tolerable task that resembles slowing or lowering yourself and see what changes with support or range.
Is pain around the kneecap always a cartilage problem?
Symptoms and the movement that reproduces them help guide the assessment. Your clinician can decide whether there is a reason for imaging. [1]
What should I bring to an evaluation?
Bring one example of a movement or activity you want back, along with any relevant imaging or treatment notes you already have.