Pain at the front of the knee
Pain located at the front of the knee – anterior knee pain – can have multiple causes, especially if the pain has been brought on suddenly by an accident or injury. However, whether the pain started slowly, or due to a specific incident, the two most common causes of anterior knee pain are Patellofemoral pain and Patellar tendinopathy.
Patellofemoral pain may be caused by a variety of structures in the knee joint. Because of this, the pain is usually quite vague in its location. It may be felt on either side of or below the knee cap. It is mostly felt with weight-bearing activities that also include bending the knee such as running or using stairs, and is especially aggravated by downhill activities.
The patellar tendon or ligament is a fibrous tissue that connects the kneecap to the top of the shin bone. In patellar tendinopathy the fibres become disorganised and weakened. The pain is usually felt below the knee cap and can be sensitive to finger pressure. Activities that involve jumping or sudden changes in direction and / or deceleration often aggravate the pain. The pain may also be felt at the beginning of a squat, or on climbing stairs.
Pain at the front of the knee is often associated with a sudden increase in load on the structures supporting our knee joint. If the load on the knee is greater than what it is able to handle, pain or injury can result. More obvious factors that can have an effect on this are, for example, the frequency and type of our activity, speed, surfaces, shoes, or how often we rest. Other factors can be harder to identify such as the correct alignment and biomechanics of our hip, knee and ankle joints. Correct alignment and biomechanics of the knee, in part, depends on the strength, length and control of the muscles in our glutes, thigh and calf.
How can physiotherapy help with these conditions – in person or remotely?
Because pain at the front of the knee is mostly associated with our daily activity and exercise, if you can’t visit your physiotherapist in person, knee pain like this can successfully be treated without hands-on treatment. The trick is to strengthen the knee and improve its mobility so that it is able to handle more load. From there, the load placed on the knee can be slowly increased.
Depending on the situation it may be important to first decrease and better understand the pain. In addition to being uncomfortable, pain also changes the way our muscles function and the way we move. During this time, it may be necessary to temporarily decrease or avoid certain activities.
Once the pain is under control, we can look at managing and slowly progressing the load placed on the knee joint with daily activity. Working with you, your physiotherapist may alter some of your daily habits or activities, or change your training program to accomplish this.
Throughout the treatment period, your physiotherapist may incorporate certain exercises or stretches to improve body alignment with the movement of the knee during daily activities.
If you are currently struggling with knee pain, get in touch with a physiotherapist here at Ponsonby Physiotherapy to get the right support for your specific situation.
Article by Caroline Richards, Physiotherapist