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By Jason R. Saleh, MD


Pain in or around the knee cap is common in younger and middle-aged athletes, especially in runners.  Pain in front of the knee can come from the knee cap itself, tendons, bursae (fluid-filled sacs) or the soft tissues within the knee.  Knee cap pain almost never results from a specific injury; instead it creeps up over time until it finally prevents you from doing what you want to do.

Knee cap pain often presents with tell-tall signs.  Pain while descending stairs is often present, more so than while going up stairs.  Many patients also have pain while sitting with their knee bent for a long time, such as on a plane or at a movie.

The good news is, this condition rarely requires surgery and can be treated at home.  I recommend a 5-part approach that works for most patients.

1) Quadriceps strength. Make sure your quads on both sides are toned and well developed as these muscles control the knee cap

2) Hip abductor and external rotator strength.  These are the muscles that move your hip out to the side.  Keeping them strong helps to keep your whole leg in alignment.

3) Hamstring flexibility. Flexible hamstrings reduce pressure on the knee cap and lessen the amount your quads have to work.

4) Address flat feet. Flat feet can contribute to bad alignment so wear orthotics if you need them.

5) Cross train. Especially if you do a sport that involves movement in a single direction (running, cycling).  Cross training will help balance your muscles and prevent injuries.