Kneecap Pain and Pain on Stairs
Pain at the front of the knee that is worse going down stairs, squatting, or after sitting still for a long time usually comes from the joint between the kneecap and the thigh bone. Going downstairs and standing up after a long sit both load that joint heavily, which is why they are so often the moments people notice it. Most of these knees improve without an operation, but it is worth knowing which problem you are dealing with.
Also described as: front of knee pain, pain going down stairs, patellofemoral pain, runner’s knee, anterior knee pain.
Go to A&E now if
- •A hot, very painful, swollen knee when you also feel unwell or feverish - this can be an infected joint and is treated as an emergency
- •A leg that is cold, pale, numb or that you cannot feel properly below the knee
- •An obvious deformity after an injury, or a knee that gives way completely and cannot take any weight at all
What causes it
Patellofemoral pain
Pain from the kneecap joint without a structural tear, often related to how the kneecap tracks and to hip and thigh muscle strength. Typically aches after sitting and hurts most on descent rather than climbing.
More on knee pain assessment clinicKneecap instability
Where the kneecap does not simply hurt but moves - shifting or dislocating, often with a sense of the knee giving way and a reluctance to trust it on turns.
More on patella instability and MPFL reconstructionKneecap joint arthritis
Wear specifically behind the kneecap. Stairs, slopes and getting out of a low chair are the usual complaints, and it can be present while the rest of the knee is in good condition.
More on knee arthritis clinicCartilage injury behind the kneecap
Can follow a direct blow to the front of the knee or a dislocation, and may cause catching or grinding as well as pain.
More on knee arthroscopyWorth being seen within a week if
- •A kneecap that has dislocated, especially for the first time
- •Front-of-knee pain with the knee giving way
- •Being unable to straighten the knee against gravity or to lift the leg straight after an injury
- •Pain that is not improving after several months of good physiotherapy
How it is assessed
- •Examination of how the kneecap tracks, and of hip, thigh and calf strength - front-of-knee pain is frequently driven from above and below the joint.
- •Skyline X-ray views, which show the kneecap joint specifically and are part of the standard first-line series.
- •MRI where cartilage damage or instability is suspected.
- •A rehabilitation plan first in most cases, because the majority of these knees settle without surgery.
Mr Sam Nahas is a consultant knee surgeon in Reading, and sees new knee problems within a week at Circle Reading Hospital. No GP referral is needed for self-pay patients.
Book a consultationThis page is general information about knee symptoms and does not replace individual medical advice. If you are worried about your knee, please be assessed.