Patellofemoral Knee Pain – The Front of My Knee Hurts!

Patellofemoral Knee Pain

This is generalized pain around the front of the knee, and it is typically worse when you are walking down hills or stairs and after long periods of inactivity.  It is most commonly caused by abnormal tracking of the kneecap, where it usually moves too far to the outside of the joint, rather than straight up and down in the groove in which it sits.  This can’t be corrected through exercise or stretching.  However, if the kneecap tracks appropriately, there may be problems at the hip or ankle/foot  that are creating the knee pain.


Your glute (butt) muscles and a hip flexor muscle called the tensor fascia latae (TFL) insert into the illiotibial (IT) band, which is a thick connective tissue that inserts into the knee through the patellar tendon.  These muscles work together to pull your leg away from your body.  If this band is tight, or the muscles attached to it are tight, it pulls on the knee, creating pain.

Stretch your glutes, TFL and IT band. See the Stretch This! page for the appropriate stretches.

It also helps to strengthen your abductors, the muscles that pull your leg away from your body.  Guess what those are?  Yep, butt muscles – the glute medius and minimus, as well as the TFL and sartorius.  See the Activate Your Derby Booty! page for exercises.

Sometimes it just sucks to be a girl.  Women have what’s called a Q angle.  Basically, the top of our humerus (the large bone in the top of our leg) has a longer section of bone (the femoral neck) between the ball at the top and the shaft of the bone.  This section points out away from our hips. This angle helps us walk when we are pregnant.  So, if you have a large Q angle, your humerus sits on top of your tibia and fibula differently, creating stress on the knee joint.  This creates the same type of knee pain.  Nothing you can do about this!


Do you pronate, meaning that you roll your foot to the inside as you walk?  This changes the alignment of your knees, bringing them inward.  Overpronation forces the feet to turn out to compensate.  This can also create bunions!  Ouch!  Skaters with knee issues due to overpronation may also have plantar fasciitis, an inflammation of the connective tissue on the bottom of the foot.  Dancers strengthen the arch of their feet in the following way:

Sit on the floor with one end of the resistance band around the bottom of your foot (over the ball of your foot and your toes) and the other end in your hands. Slowly push your foot forward so it is fully extended, then flex your toes as much as possible.  Slowly return to the starting position, resisting as much as possible.  Do 20 repetitions every other day. Repeat on the other foot.


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