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When the front of the knee hurts in yoga Patellofemoral pain syndrome (PFPS) is the most common overuse injury of the lower extremity1, 2. PFPS is a condition characterized by pain surrounding the kneecap associated with activities involving lower limb loading (eg, walking, running, jumping, stair climbing, and prolonged sitting and kneeling (yoga!)). There are many factors that can lead to PFPS3.  These include: 1. ) Alignment: the angle your thigh bone (femur) connects to the shin bone (tibia), the way the knee cap (patella) fits onto your femur, and the way your ankle and foot line up with the shin bone. 2.) Muscle strength: The muscles that influence the hips, knees and ankle all influence your alignment and knee function. 3.) Muscle tightness: If the muscles that cross the knee and attach to the patella are tight, it will cause increased compressive forces and may also influence how the patella moves. There is not always an obvious reason why someone has anterior knee pain.  PFPS is often associated with higher impact activities, but may occur in yoga.   Regardless of whether practicing yoga aggravates your knees, learning more about the patellofemoral joint may help you improve your alignment and avoid unnecessary strain and pain. The knee bone’s connected to… The knee is made up of three bones: the thighbone (femur), the shinbone (tibia), and the kneecap (patella). The patella is a large sesamoid bone (a bone embedded within a tendon) and protects the knee from direct trauma.  It also acts as…