ADVICE

Anterior Knee Pain (that’s pain at the front of the knee!)

Ouch! Knee pain is something we’ve probably all experienced at one point or other, and if you haven’t knowingly injured the knee in a specific incident, it can be difficult to know what’s causing it.

Some basic knowledge about the knee is useful. The knee is the largest joint in the body and comprises the femur (thigh bone), tibia (shin bone) and the patella (knee cap). Several ligaments connect the femur to the tibia and fibula, giving the knee stability. Two tendons (extensions of muscles that connect the muscle to bone) hold the patella in place: the tendon of the quadriceps (thigh muscles) attaching the femur with the patella, and the patella tendon, which is continuous with the quadriceps tendon and attaches the patella to the tibia). When we bend our knee, the patella glides back and forth in an indentation on top of the femur, called the trochlear groove. The knee is a complex and effective mechanism but there are numerous factors that can upset its delicate balance and cause knee pain.

Patellofemoral pain is a dull ache felt at the front of the knee, which usually comes on gradually and might be felt when climbing stairs, after sitting for a long time, or after exercise. There may be tenderness along the upper, inside border of the patella and a crunching or grinding sound (crepitus) when squatting or kneeling. This knee pain is frequently caused by the patella “mal-tracking” in the trochlear groove.

Possible cause: Overuse or overload of the knee in repeated weight bearing impact in your chosen sport, particularly after a sudden increase in intensity of training.

Treatment: Stop all activities that cause pain, opting for low impact alternatives.

Possible Cause: Tightness in the lateral quadriceps muscle can pull the patella out of alignment.

Treatment: Stretching and foam-rolling the quadriceps regularly helps relieve tension.

Possible Cause: Weakness in the medial quadriceps can cause the patella to be pulled out of alignment by the stronger lateral quadriceps.

Treatment: Strengthening programme focussed on the medial quadriceps.

Possible Cause: Weak hip muscles, particularly the gluteus medius, can cause the leg to rotate inwards and increase pressure on the patellofemoral joint.

Treatment: Strengthening programme focussed on the gluteus medius.

Other causes of anterior knee pain are patellar tendinitis (pain and inflammation below the patella) and quadriceps tendinitis (pain and inflammation just above the patella). These are usually overuse injuries which can be treated by icing with regular icing for up to 20 minutes and avoiding activities that cause pain.

If the knee doesn’t recover after a couple of weeks of rest, give me a call. I’ll assess you thoroughly to get a clearer picture of the possible causes of the pain, treat the effected areas and then recommend a rehabilitation plan which may include a programme of stretching / strengthening and massage, which plays an important part in addressing problems caused by muscle imbalance.

Whatever the cause, don’t put up with pain, seek help and resolve the problem.