Why do my kneecaps hurt now that I'm pregnant?

Why pregnancy affects the front of the knee

As pregnancy progresses, body weight rises and the centre of gravity moves forward. Many women stand with the knees slightly locked back or turned in, and walk with a wider gait. Each of these increases pressure behind the kneecap.

The hormone relaxin also softens ligaments throughout the body. That helps the pelvis prepare for birth, but it can make the kneecap feel less settled in its groove, particularly in women who already had kneecap pain before pregnancy.

What it usually is

• Patellofemoral pain: an ache around the kneecap on stairs, squatting, getting up from the floor or after sitting
• Fluid retention around the knees and ankles, especially in the third trimester and in hot weather
• Irritation of the bursa over the kneecap from more time kneeling, for example on the floor with older children
• Less commonly, pain felt in the knee from the hip or lower back as the pelvis changes

Safe ways to ease it

Keep active with walking on flat ground, swimming, aqua classes or a stationary bike, which are generally safe in an uncomplicated pregnancy. Gentle strengthening of the hips and thighs, such as side-lying leg raises and partial squats holding a support, helps the kneecap. Check any new programme with your obstetrician.

Supportive, flat shoes, a rail on stairs, and sitting on a higher chair reduce strain. Avoid long spells with the knees fully bent. A cold pack wrapped in a cloth can ease aching. Paracetamol is the usual pain reliever in pregnancy; anti-inflammatory tablets are generally avoided, so ask your doctor before taking any medicine.

Warning signs and specialist review

Get urgent medical help for swelling, pain or redness in one calf or thigh, which can be a blood clot, and for sudden swelling of the face and hands with headache or visual change, which can signal pre-eclampsia. A hot, red, very swollen knee also needs prompt care.

Book a knee assessment if pain follows a fall or twist, the kneecap slips, the knee locks, or pain persists for more than a few months after delivery. Dr. Gelber at Aman Hospital in Doha can assess the knee during pregnancy and uses ultrasound or MRI, not X-rays, when imaging is genuinely needed.