The key points

Pain at the front of the knee describes a symptom, not one diagnosis.

Patellofemoral pain is one common cause, but tendon problems, arthritis, injury, instability and other conditions can also cause pain in this area. Assessment looks at how the symptoms behave, movement and strength, and whether there are signs that another diagnosis or further investigation should be considered.

What is patellofemoral pain?

Patellofemoral pain (PFP) is a common cause of pain around or behind the kneecap, particularly when the knee is bent and bearing weight. It may be aggravated by stairs, squatting, lunging, running, jumping, getting up from a chair or sitting for a long time with the knee bent.

Symptoms can begin gradually, sometimes after a change in running distance, hills, gym training, sport or physically demanding work. These activities help describe the pattern, but they do not prove the diagnosis. Anterior knee pain does not automatically mean that the cartilage is damaged or that the kneecap is out of place.

Other possible causes of pain at the front of the knee

Pain from the patellar tendon is often more localised just below the kneecap and may be provoked by jumping. Osteoarthritis, irritation of a bursa or other tissues at the front of the knee, kneecap instability, or an injury involving a ligament or meniscus can also cause pain in this area. In younger people, growth-related conditions can be relevant. Hip problems may sometimes refer pain towards the knee.

A sudden injury, marked swelling, locking or repeated giving way may change which assessment or investigation is appropriate. The location of pain alone cannot reliably identify the structure involved.

How is anterior knee pain assessed?

A clinician will ask where the pain is, how it started, which activities bring it on, and whether there has been swelling, locking, giving way or a specific injury. Examination may include knee movement, strength and functional tasks, with the hip, ankle and work or training demands considered when relevant.

Typical patellofemoral pain is usually assessed from the history and examination; scans are not routinely required. Imaging may be considered after significant trauma, when the diagnosis is unclear, if recovery is unexpected or when the result could change management.

What management is supported by evidence?

Education and a gradual strengthening programme are central to managing patellofemoral pain. A 2024 best-practice guide recommends knee-targeted exercise, with hip-targeted exercise added when appropriate, supported by clear advice. The programme should reflect current symptoms, strength and the activities the person wants to regain; there is no single exercise or dose that suits everyone.

Temporarily reducing the most provocative activity may help symptoms settle while maintaining comfortable movement and fitness where possible. Strength and activity can then be built up progressively, adjusting the plan in response to symptoms during exercise and over the following day.

Taping, foot orthoses, manual therapy or running retraining may be considered if the assessment suggests a useful role. These options support a tailored plan; they are not necessary for every person and should not replace active rehabilitation.

When to seek advice

Seek urgent NHS 111 advice if your knee is very painful, you cannot move it or put weight through it, it is badly swollen or has changed shape, it locks, or it becomes hot and red alongside a high temperature or feeling shivery. After a significant injury, urgent assessment is also appropriate if you cannot bear weight or the knee looks deformed. Arrange a routine assessment if pain is not improving over a few weeks or is limiting normal activity.

Resolve MSK Clinic · Bond Street, Hull

Rehabilitation should match the cause and your goals.

At Resolve MSK Clinic, 44 Bond Street, Hull, assessment considers the possible source of pain, knee movement and strength, and the demands of work, walking, sport or exercise. Rehabilitation is progressed around your goals, with further investigation or referral discussed when clinically appropriate.

Read about knee pain assessment and treatment, private physiotherapy in Hull and our sports injury rehabilitation service.

Sources and further reading

Published 12 October 2026. Evidence checked 12 October 2026. General information for adults; it does not diagnose the cause of your symptoms or replace individual assessment. Review due October 2027, or sooner if relevant guidance changes.