The kneecap moves up and down, tilts, and rotates. Patellofemoral pain syndrome is pain in and around the kneecap caused by changes in the kneecap joint. There may be one or both knees. High-impact sports such as football, basketball, soccer, tennis, and running can make scapula problems worse. running on uneven surfaces (hills or paths) or playing on different surfaces Hard grass and tennis courts may cause this syndrome. Even sitting for a long time can hurt.