How to Fix a Clicking Knee (Patellofemoral Pain Syndrome): Strengthening and Stretching Exercises
Simple, effective exercises that may help fix a clicking or painful knee caused by patellofemoral pain syndrome, demonstrated by a chiropractor with over 24 years of clinical experience — all doable at home.
If your knee clicks or hurts when you kneel, squat, climb stairs, or get up from a chair, you may have patellofemoral pain syndrome — an irritation at the back of the kneecap. It happens when the kneecap stops tracking smoothly through its groove in the thigh bone, usually because of muscle imbalances around the knee, so it sits slightly off to the side of the groove rather than in it.
Our chiropractor Jasper Hulscher explains the anatomy, then works through the fix: strengthening the vastus medialis oblique (VMO) — the key muscle that pulls the kneecap into correct alignment — with several progressions (foam roller, resistance band, ankle weight, standing, seated, and wall slides), followed by three stretches (quadriceps, hamstrings, and the iliotibial band) to take pressure off the kneecap. Restoring the muscle balance lets the kneecap track properly again, reducing the clicking and pain.
Related Reading
Is chiropractic safe? What patients in Bury St Edmunds should know
Questions
How do I fix a clicking knee (patellofemoral pain syndrome)?
What causes a clicking or painful kneecap?
What is the VMO and why does it matter for knee pain?
How do I strengthen the VMO at home?
Which stretches help patellofemoral knee pain?
Why does my knee click when I squat or climb stairs?
Key Takeaways (timestamped)
[00:00] The signs — clicking or pain in the knee when kneeling, squatting, climbing stairs, or standing up from a chair may indicate patellofemoral pain syndrome, an irritation at the back of the kneecap.
[00:46] The cause — the kneecap normally tracks smoothly through a groove in the thigh bone; with this syndrome it tracks off to the side, usually due to muscle imbalances. The fix is to restore that balance.
[01:29] Strengthening the VMO — the vastus medialis oblique (the teardrop muscle on the inner front of the knee) pulls the kneecap into alignment. Strengthen it by straightening the knee through the last five degrees while turning the toes outward; progressions add a resistance band, an ankle weight, and standing/seated versions. ~15 reps, three sets.
[05:30] Wall slide — slide down a wall to a comfortable depth (45–90°), keeping the knees tracking straight over the feet (never letting them fall inward, which hurts the kneecaps more). Hold ~5 seconds.
[06:41] Quadriceps stretch — lying face down, pull the ankle towards you until you feel the front-thigh stretch (raise the thigh to progress).
[07:45] Hamstring stretch (2 variations) — targeting different parts of the hamstring, since tight hamstrings add pressure to the knee.
[08:56] ITB band stretch (2 variations) — seated and standing versions to loosen the iliotibial band running down the outside of the knee.
Transcript
Introduction
Do you get a clicking sensation or pain in your knee when you kneel or squat? What about climbing stairs, or getting up from a chair? If so, you might have patellofemoral pain syndrome — an irritation at the back of your kneecap. The good news is you can do something about it, with simple, effective exercises you can do at home to reduce the clicking.
Quick Knee Anatomy
On a model of the right knee: the upper leg, lower leg, and the kneecap at the front. There’s a groove in the upper leg, and the kneecap sits in it and tracks smoothly. With a clicking knee, the kneecap no longer tracks that groove — often due to muscle imbalances — so it sits next to the groove rather than in it. We’ll use strengthening and stretching exercises to restore the muscle balance so the kneecap tracks properly again.
Strengthening the VMO
The most important muscle to exercise is the vastus medialis oblique (VMO), the teardrop-shaped muscle on the inner front of the knee, which tracks the kneecap in the right direction. With your knee resting on a foam roller or towel, straighten it through the last five degrees while pushing your toes outward, hold one to two seconds, and lower. Do about 15 repetitions, three sets. Progress it with a resistance band around the foot, or an ankle weight. There’s also a standing version (band behind the knee, extend and hold three to four seconds) and a seated version (extend the leg, turn the toes out, hold a few seconds), both 10–15 reps, three sets.
Wall Slide
The final strengthening exercise: lean against a wall, feet 15–20 cm away and about 30 cm apart, and slide down as far as is comfortable (45° if 90° hurts), holding about five seconds. Crucially, keep your knees tracking straight over your feet — don’t let them fall inward, which hurts the kneecaps more. You should feel all these in the VMO.
Quadriceps Stretch
Lie face down, bend the affected knee, hold the ankle, and pull forward until you feel the stretch in the front of the thigh. Hold 10–15 seconds, five reps. Progress by raising the thigh off the floor as you pull.
Hamstring Stretch (2 variations)
Tight hamstrings add pressure to the knee. Version one: lying on your back, hip at 90°, knee as straight as you can, hands behind the knee, pull the leg gently towards you, hold 10 seconds. Version two: with a towel around the foot, keep the leg straight from the start and pull it towards you. The two target different parts of the hamstring.
ITB Band Stretch (2 variations)
Seated: left leg straight, right foot over to the outside of the left knee, pull the knee across and rotate the body to the right, hand behind you, feeling it on the outer hip. Standing: place the affected leg behind the other, push that hip out to the side, and lean over with the hand on the head, keeping the body straight. Hold each 10–15 seconds, five reps, daily.
Closing
I hope you found value in this video. Take care of yourself, take care of someone else if you can, and bye for now.
Summary
Patellofemoral pain syndrome is a common cause of a clicking or painful knee, felt when kneeling, squatting, climbing stairs, or standing up after sitting. It’s an irritation at the back of the kneecap that occurs when the kneecap stops tracking smoothly through its groove in the thigh bone — usually because of muscle imbalances that pull it slightly off to one side. The fix is to restore that balance. This video focuses on strengthening the vastus medialis oblique (VMO), the teardrop-shaped muscle on the inner front of the knee that pulls the kneecap into correct alignment, using a specific technique — straightening the knee through the last few degrees while turning the toes outward — with progressions using a resistance band, ankle weight, and standing, seated, and wall-slide variations. It then adds three stretches — quadriceps, hamstrings, and the iliotibial band — to reduce pressure on the kneecap and restore mobility. Together, strengthening and stretching let the kneecap track properly again, reducing the clicking and pain. Persistent or worsening knee pain should be professionally assessed.
Frequently Asked Questions
What causes a clicking or painful kneecap?
Usually patellofemoral pain syndrome. The kneecap normally glides smoothly through a groove in the thigh bone. When muscle imbalances around the knee pull it slightly off to the side of that groove, it no longer tracks properly, which irritates the back of the kneecap and produces clicking and pain — especially when the knee is loaded, as in squatting or stairs.
What is the VMO and why does it matter?
The VMO — vastus medialis oblique — is a small, teardrop-shaped muscle on the inner front of the knee. It plays a key role in pulling the kneecap into correct alignment as the knee moves. If it’s weak relative to the other thigh muscles, the kneecap gets pulled off-track, which is why strengthening the VMO is the central part of fixing patellofemoral pain.
How do I strengthen the VMO at home?
The specific technique: with the knee bent over a foam roller or towel, straighten it through the last five degrees while turning your toes outward, hold a second or two, and lower. That last few degrees is where the VMO works hardest. Do around 15 repetitions for three sets. You can progress it with a resistance band, an ankle weight, or standing and seated versions, and finish with wall slides — keeping the knees tracking straight over the feet.
Which stretches help patellofemoral knee pain?
Three muscle groups, to take pressure off the kneecap: the quadriceps at the front of the thigh (lying face down, pulling the ankle towards you), the hamstrings at the back of the thigh (two variations targeting different parts), and the iliotibial band down the outside of the knee (seated and standing variations). Each is held around 10–15 seconds and repeated five times, daily.
Why does my knee click when I squat or climb stairs?
Those movements load the kneecap, so if it’s tracking slightly off its groove, you feel and hear it click as it moves under load. It’s typically a sign of the muscle imbalance behind patellofemoral pain syndrome rather than anything structurally broken — which is why rebalancing the muscles with these exercises tends to reduce it.
Is a clicking knee serious?
A painless click on its own is often harmless. But clicking combined with pain when squatting, kneeling, or on stairs points to patellofemoral irritation worth addressing. If the knee also locks, gives way, swells, or the pain is severe or persistent, it’s worth a professional assessment to rule out other causes (such as a meniscus problem).
GET IN TOUCH
Let’s Talk
If you would like to find out how we can help you or any other questions, please message, call or use our form to get in touch.
Monday - Friday 7:30 - 19:30
Fornham Chiropractic Clinic
Unit 10
Fornham Business Court
The Drift
Fornham St Martin
Bury St Edmunds
IP31 1SL
