Pain Under the Kneecap – How I Went From Frustration to Excitement When Treating This

For years, pain under the kneecap was one of the most frustrating complaints I dealt with.

Why? Because there was no clear body language or consistent gesture that pointed to the real cause. In the Fascial Distortion Model (FDM), body language is often the biggest key to accurate diagnosis. But for this specific issue? Nothing obvious. No consistent pattern.

So, like most providers, I was left guessing.
Treating fascial dysfunction in the quad, and around the patella.
Sometimes it helped. Often it didn’t. Results were hit or miss - and I'm not a fan of “miss.”

Then One Case Changed Everything.

A soccer goalie came in. Chronic pain under the kneecap - 15 years of it.
But he didn’t just complain about the knee.
He also mentioned some discomfort in his calf - casually, almost as an afterthought.

That changed everything.

I checked his calf and found something that was not uncommon in patients with calf pain:
deep fascial herniations.

I treated several of them - and then something surprising happened:

He stood up, moved around, and told me the pain under his kneecap was gone.

That moment flipped a switch in my brain.
I didn’t know exactly why it worked, but I remembered it.

Then Came the Sisters.

About a month later, two teenage sisters, ages 14 and 16, came in - both volleyball players.
They had each been dealing with knee pain since age 12.
And both had already undergone knee surgeries, yet still had pain directly under the kneecap.

I started with the older sister.

After reviewing her history and running a few orthopedic tests, I decided to check her calves.
Sure enough, just like the soccer goalie, she had deep fascial herniations.

I treated them.
And her kneecap pain was gone.

No knee work.

So I moved on to her younger sister.
Same assessments. Similar findings.
Same treatment - and the same result:

No more under the kneecap pain.

That’s when I knew this wasn’t random.
This was a pattern.
And one I had to pay attention to.

Since Then? I’ve Seen It Over 50 Times.

Same presentation: pain directly under the kneecap, usually resistant to conventional treatment.
Same hidden culprit: deep fascial herniations in the calf.
Same result: almost immediate relief - even in chronic cases.

Every single patient I’ve treated with this pattern has dramatically improved.

So... Why Is This Happening?

Here’s the honest answer:

I don’t really know.

My best guess is that these deep fascial distortions create abnormal tension through the fascial chains that extend into the back of the knee. That tension may alter knee tracking or overload structures that aren’t built to carry it. That’s my theory and I may be totally wrong.

What I do know, with certainty - is this:

When pain under the kneecap is present AND deep fascial herniations are found in the calf, treating those herniations works.

Not sometimes.
Every. Single. Time.

The Takeaway

If you’ve been dealing with stubborn pain under the kneecap and nothing’s worked, there’s a strong chance the root cause isn’t even in your knee.

Scans won’t show it.
Most providers don’t know it exists so they can't look for it.
But it’s there. And it can be fixed.

📍 If you're in Palo Alto, Los Altos, Sunnyvale, or Mountain View and dealing with chronic knee pain - especially under the kneecap, don’t settle for guesswork.

There’s a reason this keeps getting missed.
And there’s a reason it keeps working when we treat it right.

👉 Book Your Fascial Evaluation and let’s get to the root.