Pain a little below the knee is likely to be tibial tubercle. Generally tibial tubercle is a chronic, localized, fixed-point pain that develops at the point of the tibial tuberosity. This is when the patient has no other symptoms and is most likely an inflammation of the ligaments or pivot points that have rubbed together as a result of the patient’s prolonged knee flexion. This inflammation is aseptic and requires only limiting knee motion and not moving the knee too much, and the pivot point pain will slowly resolve. If the pivot point pain does not resolve or continues to worsen, local closure therapy may be used to provide pain relief. If closure is still ineffective, surgical treatment options can be used to remove the tibial tuberosity to re-establish the muscle fulcrum and achieve a radical cure.