Kneecap Pain (Patellofemoral Pain) Exercises
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- 1Kneecap mobility
- 2Straight leg raise
- 3Side-lying hip abduction
- 4Side-lying hip adduction
- 5Hip hike
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About This Exercise
Patellofemoral pain is an ache around or behind the kneecap. It’s common in runners, teenagers and active adults, and it tends to flare with stairs, squatting, kneeling, or sitting for a long time with the knees bent.
Clinical guidelines recommend exercise for the hip and thigh muscles as a core part of treatment. Strength in these muscles helps control how the kneecap tracks as the knee bends.
The video starts with gentle kneecap mobility and then works through leg raises and hip exercises, finishing with hip hikes as a standing progression.
How to Use This Page
- Watch the video through once before trying the exercises.
- Start each exercise with about 10 slow repetitions.
- Add repetitions gradually over a few weeks as the exercises get easier.
- Do the routine 3–4 days a week. Mild discomfort that settles by the next day is usually OK; pain that builds or lingers means ease back.
What you’ll need Paid links
What this exercise uses, with household swaps where they work.
- Exercise mat · Non-slip, about 6 mm (1/4 in) thick, for floor exercises. A rug or folded blanket works.
- Exercise step · Optional, with a non-slip top. The bottom stair with a handrail works well.
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Exercises in the Video
- Kneecap mobility — With your leg straight and relaxed, gently move the kneecap up, down and side to side.
- Straight leg raise — Lying on your back, tighten the front of your thigh and lift the straight leg to the height of the other knee. Start with 10 reps. (See Supported Leg Raise.)
- Straight leg raise, toes turned out — The same lift with your foot turned slightly outward.
- Side-lying hip abduction — Lying on your side, lift the top leg up and slightly back.
- Side-lying hip adduction — Lying on your side with the top leg bent in front, lift the bottom leg.
- Hip hikes — Standing on a step with one leg hanging off the side, lift and lower that hip while keeping both knees straight.
Key Form Cues
- Tighten your thigh muscle before you lift, and keep the knee straight.
- Lower slowly; the lowering part counts as much as the lift.
- In side-lying exercises, keep your hips stacked and don’t roll backward.
- For hip hikes, hold a rail or wall for balance.
Progression & Regression
Regression (Make It Easier)
- Do fewer repetitions, or lift the leg a shorter distance.
- Skip hip hikes until the lying exercises feel easy.
- Rest between sets for as long as you need.
Progression (Make It Harder)
- Work up to 2–3 sets of 15–20 reps.
- Add a light ankle weight to the leg raises.
- Try the strength exercises in Wall Squats, keeping the squat shallow and pain-free.
Precautions
Get it checked if your knee pain started with an injury or isn’t improving.
- See a clinician if your knee swells, locks, catches, or gives way.
- Children and teenagers with knee pain, especially with a limp, should be checked by a clinician; knee pain can come from the hip.
- Stop any exercise that causes sharp pain.
- Seek care promptly if: your knee is hot, red and swollen, you have a fever, or you can’t put weight on the leg.
Kneecap pain: a three-stage plan
Patellofemoral pain, also called runner’s knee, is pain around or behind the kneecap. About 1 in 4 people get it at some point.1 It is usually worse on stairs (especially going down), downhill, and when squatting, kneeling or sitting with the knees bent.1
International experts and US physical therapy guidelines recommend exercise therapy as the main treatment, and prefer programs that strengthen the hip and the knee together over knee exercises alone.2,3
| Stage | Goal | What it usually includes |
|---|---|---|
| 1. Settle | Lower the load on the kneecap without stopping activity | Cut back on the activities that flare it. Swap running or jumping for cycling or swimming for a while.1 Start quad sets, straight leg raises and clamshells. |
| 2. Strengthen | Build the thigh and hip muscles | The exercises in the video, plus bridges, leg extensions and shallow wall squats. NHS physiotherapy uses about 3 sets of 10, 3 times a week.1 |
| 3. Return | Get back to stairs, sport and running | Step-ups, lateral step-downs and split squats, with gradual return to activity.1 Runners can follow return to running after a knee injury. |
Other things that can help
- Foot orthoses (insoles) may help in the short term for some people. They are best used alongside exercise.2,3
- Kneecap taping may give short-term relief when combined with exercise.2,3
- Treatments used on their own, such as manual therapy or electrical machines without exercise, are not recommended.2
- Stay active. Return to normal activity gradually once the pain has eased and the knee is stronger.1
Pain just above the kneecap? See pain above the kneecap. Not sure what kind of knee pain you have? Start with knee pain exercises.
Frequently asked questions
Is it OK to squat with patellofemoral pain?
Usually yes, within a comfortable depth. Start with shallow squats or wall squats and go deeper as the knee tolerates it. If your knee is sorer the next day, reduce the depth or the reps.
Should I stop running with kneecap pain?
You may need to cut back for a while. Reduce distance, speed or hills, or swap some runs for cycling or swimming, then build back up gradually as the pain settles and the knee gets stronger.
Does taping or a knee brace help kneecap pain?
Taping may give short-term relief alongside exercise. Exercise is the main treatment, and taping or insoles are add-ons.
Is grinding or clicking under my kneecap a bad sign?
Usually not. NHS physiotherapy advice says the grating feeling is common, is not linked to osteoarthritis, and is not a reason to stop exercising.
Why does my kneecap hurt going downstairs?
Going downstairs loads the muscles at the front of the thigh as they lengthen, and the pressure behind the kneecap rises as the knee bends. Hip and thigh strengthening usually makes stairs easier over time.
Sources for this section
- Royal United Hospitals Bath NHS Foundation Trust: Patellofemoral pain (PHY027)
- Crossley KM, van Middelkoop M, Callaghan MJ, et al. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions. Br J Sports Med. 2016;50(14):844–852.
- Willy RW, Hoglund LT, Barton CJ, et al. Patellofemoral pain: clinical practice guidelines. J Orthop Sports Phys Ther. 2019;49(9):CPG1–CPG95.
- NHS: Knee pain
Last checked October 2026. Found something out of date? Email hello@protocolarchive.com.
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Willy RW, Hoglund LT, Barton CJ, et al. Patellofemoral pain: clinical practice guidelines linked to the International Classification of Functioning, Disability and Health from the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2019;49(9):CPG1-CPG95.
Crossley KM, van Middelkoop M, Callaghan MJ, et al. 2016 Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat, Manchester. Part 2: recommended physical interventions. Br J Sports Med. 2016;50(14):844-852.
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