Knee Pain Top of Kneecap

Knee pain at the top of the knee cap (knee pain top of kneecap) can be caused by an alignment problem, cartilage injury, patellar tendon issues, or trigger points in the quadriceps muscle. The knee cap fits into a groove in the end of the femur (thigh bone). When the muscle that controls the knee cap (quadriceps) pulls on one side of the knee cap more than the other, the knee cap can get out of alignment. This is discussed further in our book on new approaches to orthopedic problems and stem cells. As the knee cap travels through it’s groove, the cartilage on the back of the knee cap and on the femur help to make the knee cap glide smoothly. When this cartilage gets injured or has been worn away through arthritis, knee pain at the top of the knee cap can be the result. The knee cap lives in a tendon (the end of the quadriceps muscle) that anchors itself to the leg bone (tibia). This whole mechanism (muscle, knee cap, and tendon) move the leg bone forward when you kick, run, or walk. When the muscle has areas that are shut down due to nerve issues in the back, the tendon can be pulled on too much, leading to pain at the top of the knee cap. In addition, the tendon can become injured by trauma such as kicking into turf. Finally, the quadriceps muscle itself may be the problem. The muscle can develop trigger points (as discussed above) which can cause pain and weakness in the muscle. These trigger points can refer knee pain to the top of the knee cap. If you have any of the problems causing knee pain at the top of the kneecap, what can you do? If the knee cap isn’t well aligned, there are many types of physical therapy that can help that alignment (see our book on new biologic orthopedic techniques). Taping the knee cap may help in addition to these special exercises. If you have a cartilage injury or arthritis causing this knee pain, investigate whether stem cell injection options may help your pain. If the tendon is the problem we’ve had excellent results with platelet rich plasma or stem cell plasma injections into the tendon under imaging guidance. Also consider what biomechanical problems might be causing too much pressure on the knee cap tendon. Finally, if the quadriceps muscle is the cause, IMS trigger point needling works well. In summary, knee pain at the top of the knee cap has a few causes, all of which are treatable.