Knee Pain 101: What’s Causing It and How to Get Relief

Is your knee aching for no clear reason?

You haven’t had a big injury. You didn’t fall. But now your knee aches when you climb stairs, go for a walk or sit with your knees bent for too long. Sound familiar?

You’re not alone. This kind of knee pain, often called patellofemoral pain syndrome (PFPS), affects up to 25% of people at some point. It’s especially common in teenagers, as their bones often grow faster than their soft tissues causing muscle tightness and imbalances, as well as athletes, and anyone whose sport or job involves squatting, running, jumping or climbing stairs.

So, what is patellofemoral pain?

Patellofemoral pain happens when your kneecap doesn’t track properly in the groove of your thigh bone. Over time, this leads to pain, irritation and sometimes swelling or grating.

The main cause? Usually poor alignment of the leg, often something you were born with. Think of it like the wheel alignment on a car. If the alignment is off, it wears unevenly.

You may be at risk if:

• Your kneecaps point inward when standing with feet together

• Your knees don’t touch when your feet are together or you can’t put your feet together because your knees overlap.

• You have flat feet 

• You have tight hamstrings

• Your knee wobbles or caves inward when you do a 1 leg squat

Pain is usually felt:

• Going up or down stairs

• Sitting too long with bent knees (known as movie goers knee)

• During squats, lunges, or after long walks

Where does the pain come from?

Surprisingly, it’s not from the cartilage or joint lining. These structures don’t have nerve endings. The pain is usually coming from a small structure called the infrapatellar fat pad (or Hoffa’s pad). It sits just below the kneecap and helps cushion the joint, but it has a great number of pain sensitive nerves.

When irritated, the fat pad causes sharp pain, swelling, and a sense that the knee might “give way,” because the quads (thigh) muscle is automatically inhibited (turned off) by the pain.  

Why does it keep getting worse?

Pain leads to weaker muscles, especially the inner thigh muscle (vastus medialis, “VMO” or “inside quad”). That causes the kneecap to track even more poorly, which causes more pain and more weakness.

It’s a cycle that looks like this:

1. Pain → 2. Weak muscle → 3. Poor tracking → 4. More pain

Even walking can become difficult. Other muscles (like hamstrings and calves) try to help, which can create even more tension and misalignment.

What can you do about it?

The good news is that most patellofemoral pain can be treated without surgery.

A physiotherapist can:

• Teach you exercises to strengthen the right muscles (especially your inside quad and glutes)

• Assess your foot posture, hip strength, and flexibility

• Show you how to use tape to guide your kneecap into the right position and reduce pain

Think of taping like training wheels on a bike. It helps you move pain-free while your muscles get stronger.

How long does it take to improve?

Recovery looks different for everyone, but a good sign is how well you feel when the tape is on. If you’re still in pain without the tape, it’s a sign that your muscles aren’t quite ready yet.

Your physiotherapist will monitor your progress, help you return to sport or exercise safely, and show you how to stay fit without making your knee worse.

And yes, you can often return to sport with tape on, as long as you’re pain-free.

Watch the video

To learn more about the common causes of knee pain, watch our Causes of Pain explainer video.

Final takeaway

Knee pain without an obvious injury is often a muscle control and alignment issue. With the right support, exercises, and taping strategy, it’s treatable.

The key is early diagnosis, consistent rehab, and working with a professional who understands how to retrain the knee safely.

At McConnell Therapeutics, our Rigid Tape and Under Tape are designed for this purpose. To support your rehab and help you move with confidence.

This blog is for educational purposes only and does not replace professional medical advice. Always consult a healthcare provider for diagnosis and treatment.