These articles have quotations from film adaptations of J.R.R. Tolkien's novel The Lord of the Rings and related works: 1  The Lord of the Rings.  J.R.R. Tolkien's The Lord of the Rings (1978)
This causes a twisting on the tibia and changes its relationship to your kneecap. This can cause tracking problems as well. If your quadriceps or hamstring muscles are too tight, they also will affect the mechanics of the knee and lead to compensation patterns that cause pain.
It is common in runners, hence the term runners knee, but also occurs in inactive people. Runners Knee is a condition characterized by pain behind or around the kneecap. Poor kneecap tracking is believed to be the main cause this condition. The kneecap (patella) slides over a groove on the thighbone (femur) as your knee bends and straightens.