Why do I get pain just below my kneecap when I squat at the gym?

Where exactly does it hurt?

Press gently with one finger. Tenderness on the tendon right at the lower tip of the kneecap, sore at the start of a session, easing as you warm up and returning later or the next morning, is the typical pattern of patellar tendinopathy (jumper's knee).

If the pain is diffuse, around or behind the kneecap, and also bothers you on stairs or after sitting, patellofemoral pain is more likely. The two can overlap, and the treatment approach is similar: adjust the load, then build it back.

Common training triggers

• A sudden jump in volume or weight, a new programme, or adding plyometrics, box jumps or skipping
• Deep, fast squats with heavy load before the tendon is conditioned for it
• Returning to training after Ramadan, travel or a long break at the old intensity
• Combining heavy leg days with football, basketball or padel in the same week

How to keep training without making it worse

Do not stop all leg training. Tendons respond to load, and complete rest makes them weaker. Instead, cut the painful exercises back to a level where pain stays around 3 out of 10 or less during and the next day.

Holding a wall sit or a leg extension at a fixed angle for 30 to 45 seconds often eases tendon pain and is a common starting point. Over several weeks, progress to slow, heavy squats and leg presses, then reintroduce speed and jumping last. Box squats to a set depth, or a slightly higher bar position, may reduce symptoms in the meantime. Tendon problems typically take two to three months or more to settle.

When to get it assessed in Doha

See a specialist if the pain has not improved after six to eight weeks of sensible load changes, if it is getting worse, or if it limits normal walking and stairs. A sudden pop below the kneecap with inability to straighten the leg needs urgent assessment, as it can mean a tendon rupture.

At Aman Hospital, Dr. Gelber confirms which structure is involved, and an ultrasound or MRI is used when the picture is unclear. Injections are not a first-line treatment for tendon pain.