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Pain below knee cap may be felt when something is amiss with the knee cap itself or the structures surrounding it. The soreness that borders the knee cap makes it difficult and painful to perform certain activities that involve the knees or the legs. Since the knee cap significantly increases the strength of the knee joint, a problematic knee cap will significantly affect simple, day-to-day motions such as sitting for long periods of time, going down the stairs and kneeling.

Treatment for pain below the knee cap is geared towards relieving the soreness. Since treatment is designed based on the underlying cause, a definitive diagnosis of the root cause should first be made. The treatment usually starts by resting the affected knee to prevent the condition from getting worse. The doctor may likewise prescribe medications to alleviate inflammation and design a physical therapy program that will restore the strength of the knee. However, surgery will be required if all other options fail.

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Causes of pain below knee cap

The knee cap or patella refers to the moveable bone in front of the knee joint which is enclosed in a tendon that connects the thigh and leg muscles to the knee joint. The patella works in protecting the knee joints as well as in providing knee joint leverage by allowing the legs to straighten up or bend at the knee joint. Beneath the patella is a layer of slippery cartilage that allows it to glide easily on the femoral groove.

Pain below the knee cap arises when:

  • The cartilage on the underside of the knee cap becomes irritated.
  • The knee cap rubs against the thigh or leg bone.
  • The small fluid-filled sacs on the joints become inflamed.
  • The knee cap is dislocated or fractured.

These conditions severely affect the ability of the knee cap to provide leverage to the knee joint.

Medical conditions closely associated with pain below knee cap

Pain under the knee cap could mean a lot of things, including:

  • Runner’s knee

Runner’s knee is a long-lasting injury associated with running which occurs because the kneecap constantly rubs against the thigh bone. The pain can also be felt on the sides. The affected knee is swollen and produces a cracking sound when running.

  • Chondromalacia

This condition crops up when the cartilage underneath the kneecap becomes irritated. Chondromalacia causes dull pain around and below the kneecap which intensifies when walking downwards or upwards as in the case of going up and down a staircase.

  • Patellar tendinosis

Patellar tendinosis develops when the tendon on the kneecap has been subjected to repeated stress causing tiny tears on the tendon to develop. These tears could cause the tendon to swell and become painful.

  • Pes anserinus bursitis

This is a condition in which the anserinus bursa – the small sacs on the knee joint become swollen. Pes anserinus bursitis causes uncomfortable pain below knee cap which aggravates when the knee is flexed repeatedly or when standing up after sitting.

  • Patellar dislocation or fracture

A dislocated knee cap causes intense pain because it is completely dislodged from its femoral groove – the area where the thigh and leg bones meet. The knee cap is susceptible to fracture following a hard blow or accidental fall. It can also break after a violent contraction of the thigh muscles.

  • Patellar subluxation

This is a condition in which the knee cap does not glide over its track or groove. Patellar subluxation causes severe kneecap pain.

Occurrence of pain below knee cap

Anyone can suffer from pain below the knee cap, even children. However, high incidence of knee cap pain is found among athletic individuals like runners, jumpers, cyclists, skiers, and soccer, basketball and tennis players.

Pain below knee cap is more common in women than in men, as well as those who are diabetics, obese and flat footed. People who have just recently joined an exercise program or lately intensified their exercise regimen may also complain about pain under the knee cap.


Pain below the knee cap is treated in a number of ways depending on its underlying cause. That is why it is very crucial to visit the doctor in order to get a proper diagnosis and start the appropriate treatment. More often than not, when pain below knee cap is felt, the first line of treatment is rest. Taking a break from physical activities helps in preventing the pain to aggravate. Treatment for pain under the knee cap may also involve:

  • Taking anti-inflammatory medications

This may come in the form of NSAIDs (non-steroidal anti-inflammatory drugs) or cortisone injections which help reduce the swelling and pain. Applying ice on the affected knee may also help decrease the inflammation and stimulate the flow of blood towards the area.

  • Physical therapy

Physical therapy will aid in bringing back the strength of the muscles surrounding the knee joint.

  • Surgery

Surgery is undertaken if pain below knee cap persists or gets worse even after conservative treatment.

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