Causes of Back Kneecap Pain

Back of the kneecap pain can be caused by different reasons. Directory in the front part , the pain felt at the patella or patellofemoral pain syndrome may be due to chondromalacia patellae. Other possible causes include muscle tendon strain (patellar tendinitis), bursitis, joint membrane fold injury (plica syndrome), joint calcification (osteoarthritis), rheumatic diseases.

Anatomical structures that can cause pain behind and around the kneecap are the articular cartilage, the joint membrane, the ligament and tendon structures that hold the kneecap in place, and the fat pad under the kneecap.

What Causes Back Knee Cap Pain?

Pain behind the kneecap may occur due to trauma, overuse, arthritis (joint degeneration), or an inflammatory process. Except for pain that starts with an acute trauma, a physical therapy and rehabilitation doctor should be examined for pain below the kneecap. The doctor first listens to your complaints. It questions features such as how long the pain has existed, where is it felt, what are the factors that increase and decrease it, what is its relation with movement, whether there is swelling. Then he inspects. The shape of the knee, the location of the kneecap, the sign of edema are evaluated. Tenderness on or around the kneecap by touch, grinding/rubbing sensation when the kneecap is moved, the degree of bending and opening of the knee are examined.

How to Diagnose Pain Behind the Knee Cap?

Physical examination is key in understanding the pain felt behind the kneecap. Tenderness on the inner or outer edge of the kneecap may indicate inflammation in the synovium or damage to the folds called plica. Tenderness under the patellar tendon below the kneecap may be a sign of edema and inflammation in the retropatellar fat pad. The ligaments that connect the kneecap to the shinbone (tibia) can be damaged due to trauma or surgery. Problems in these ligaments, called the patellotibial ligament, can also be detected by examination. Problems of the quadriceps tendon connecting the kneecap to the quadriceps muscle above and the patellar tendon connecting it to the tibia bone below can also be diagnosed according to the location of the pain and tenderness. It is also important to change the intensity of pain when the knee is bent and straight.

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The softening and damage of the cartilage layer surrounding the lower face of the kneecap is called chondromalacia . Chondromalacia is one of the major causes of posterior kneecap pain. Pain and friction sensation are evaluated by sliding the kneecap to the right, left, up and down.

Abnormalities in the bones and thinning of the cartilage (osteoarthritis) can be seen with X-ray. Problems in structures such as cartilage, tendon, ligament, and bursa in the knee joint can also be detected with MRI imaging.


Treatment is based on the cause. There are various treatments available, such as reducing activities that cause pain, physical therapy, exercise, local injections (corticosteroid, PRP , hyaluronic acid injections, etc.), using a knee brace or surgery.

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