The Science of Knee Pain

Patellofemoral pain syndrome involves dysfunction at the interface where your kneecap (patella) meets your thigh bone (femur). The condition typically develops when your patella doesn't track properly in its groove during knee movement, creating abnormal pressure and stress on the joint cartilage. The patella normally glides smoothly in the trochlear groove of the femur, but when muscle imbalances or structural factors alter this tracking, certain areas of cartilage experience increased compression. This can lead to irritation of pain-sensitive structures including the joint capsule, synovium, and subchondral bone. Research shows that people with patellofemoral pain often have altered biomechanics during functional activities, with changes in how forces are distributed across the joint during weight-bearing movements like squatting, stair climbing, and landing from jumps.