Why does my kneecap hurt when I kneel for prayer or get up from sujood?

What happens to the kneecap during prayer

The kneecap joint is under the greatest pressure in deep bending. Going down to sujood, sitting on the heels or in the tashahhud position, and rising again several times in each prayer combine deep flexion with body weight. Repeated across five daily prayers, and more during Ramadan with taraweeh, that is a significant load for a sensitised kneecap.

Pressure directly on the front of the knee from a hard floor can add a separate soreness, especially if the tissues in front of the kneecap are irritated.

Making prayer more comfortable

• Use a thicker prayer mat or a folded cushion under the knees
• Lower yourself slowly with a hand on the floor or a nearby support, and use your hands to help push up
• Shift weight towards the less painful knee while the sore one settles
• In tashahhud, adjust your sitting position within what is permitted, for example with one leg extended or using a small cushion
• During a bad flare-up, praying seated on a chair for a period is an accepted option for people with genuine pain; ask your imam if unsure
• Keep strengthening exercises going so that the deep positions become easier over time

Floor sitting at home and in the majlis

Long periods sitting cross-legged or on the heels at family gatherings put the same sustained pressure on the kneecap. Change position often, stretch the legs out when you can, and use firm floor cushions that keep the knees less sharply bent.

When to see a specialist

If kneeling remains painful despite these measures for several weeks, or the knee is swollen, warm, or you cannot fully bend it, an examination is worthwhile. Swelling directly in front of the kneecap can indicate bursitis, and older adults may have kneecap arthritis. At Aman Hospital in Doha, Dr. Pablo Gelber assesses the cause and helps you build back towards full, comfortable prayer positions.