Knee Pain Location Guide: What Each Area Means

The location of knee pain is one of the most useful clues to its source. While a thorough assessment is always needed for diagnosis, knowing what structures live where gives you a framework for understanding what might be going on.

Front of the knee

Pain at the front of the knee is the most common presentation. At the inferior pole of the kneecap, it's usually patellar tendinopathy. Diffuse pain across the kneecap, especially on stairs and after sitting, often points to patellofemoral pain syndrome - a condition involving poor tracking of the kneecap rather than structural damage. Pain just below the kneecap in adolescents is commonly Osgood-Schlatter disease.

Inside of the knee (medial)

Medial knee pain is usually one of three things: medial collateral ligament (MCL) sprain, typically from a valgus force; medial meniscus pathology, which often presents with joint line tenderness and clicking; or pes anserine bursitis, more common in older patients and runners, sitting about 3-4cm below the joint line.

Outside of the knee (lateral)

Lateral knee pain in runners is most often iliotibial band syndrome - a friction-related pain that classically occurs at a specific distance into a run (around 15-20 minutes) and eases when stopping. Lateral meniscus tears cause joint line tenderness and loading pain. Lateral collateral ligament injuries are less common but occur in contact sport.

Back of the knee

Posterior knee pain often comes from a Baker's cyst - a fluid-filled sac behind the knee that is usually secondary to an intraarticular problem such as a meniscus tear or osteoarthritis. Hamstring tendon pain at the attachment behind the knee is also possible. Posterior cruciate ligament involvement is rare outside of significant trauma.

Deep knee pain

Deep, diffuse pain with swelling is more likely to be intraarticular - ACL, meniscus, or articular cartilage. Any significant swelling after a twisting or pivoting injury should be assessed promptly.