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Why is my kneecap grinding?

Why Do I Have Patella Pain

Why is there Pain under the kneecap

Why do I have Pain behind the kneecap

Why is my kneecap grinding?



Sally is a client of mine and she was frustrated. She had a grinding under her kneecap that crunched, cracked and was painful every time she moved.


She felt like she couldn’t kneel. How was she going to scrub the floors?


She felt like she couldn’t go up and down stairs. How was she going to get to bed?


She felt like she couldn’t squat. How was she going to sit down and stand up from the toilet?


Does this sound familiar?

This grinding at the kneecap is common. 

Some people describe it as grinding under the kneecap, and others say grinding behind the knee cap. I call it grinding behind the kneecap.


Knee cap grinding or clicking is also called crepitus.



So what is causing the grinding behind the kneecap?

The grinding from the kneecap can be caused by 1 or 2 main things and they aren’t necessarily separate.

  1. Arthritis of the kneecap

  2. Tightness of the quad muscle



How does arthritis of the kneecap cause grinding?

Arthritis is degeneration of the cartilage in an area of the body. In osteoarthritis this tends to happen more in weight bearing joints. Because of how the kneecap moves when you bend and straighten your knee it can be prone to wear and tear of the cartilage behind the kneecap. As the cartilage wears away there are parts of the cartilage that are thin enough that the femur (thigh bone) and the kneecap rub against each other instead of the cartilage pieces rubbing together.



How does tightness of the quad muscle cause grinding at the knee?

The way the knee is anatomically set up it involves the kneecap sitting within the quad muscle tendon itself. This tendon is sometimes called the quad tendon and sometimes called the patellar tendon, either way it’s the same tendon. The kneecap sits in this tendon to make the quad muscle more efficient for strength. If the quad muscle is tight the quad tendon will be tight (because they are a part of the whole), and then it almost suctions the kneecap down and presses it into the groove of the femur. This creates pressure and friction and overtime leads to degeneration of the cartilage on the knee cap.



How can I get rid of grinding at my kneecap?

One of my favorite ways to get rid of grinding at the knee cap is to release pressure at the knee cap. Let’s think about it, if the cartilage is gone or worn away you could get that replaced, but in the meantime let’s just create more space in the area.

I love to do cupping at the knee cap. When I first learned how to do this in the physical therapy clinic I was in my final internship rotation. My clinical instructor had a kitchen sink plunger on the treatment table and said that was part of the treatment that day. I thought she was kidding. The patient was in on it, too. They both got a good laugh when I completely did not get it.



Then my instructor put some Ultrasound gel on the plunger, wrapped it over the patient’s knee cap and sunctioned it down. Then she plunged and wiggled the plunger around.



The patient said the treatment was so amazing! She said the tension was immediately released and she could feel her kneecap move more freely. And for the next few days after she could kneel, squat and go up and down stairs with less pain and less grinding.



This plunger or if you use a cupping set is not a single use treatment. It does need to be done a few times a week, and concurrently with strengthening treatment as well. 



This is a great option for patients who can’t have surgery, don’t want to have surgery or just overall need some help with the grinding now.



To recap: Grinding behind the kneecap, also called crepitus, is common due to arthritis wear and tear behind the kneecap. Tight quad muscles can contribute to kneecap grinding because of the pressure and tension that’s created. My favorite treatment for this grinding is cupping or a plunger to the kneecap to relieve pressure. For more tips and tricks follow along my page!


If you’re looking for knee pain relief check out this free guide I created just for you