Anterior Knee Pain

Anatomy of the Knee

The knee joint is a large, complex joint in the body that comprises of three bones, i.e. the lower end of the thighbone (femur), the upper end of the shinbone (tibia), and the kneecap (patella). The patella moves over the joint and allows bending of the knee and straightening of the leg. There are a few major ligaments situated around the knee joint that hold the joint firmly in position and contribute to the stability of the knee.

What is Anterior Knee Pain?

Anterior knee pain is characterized by chronic pain over the front and centre of the knee joint. It is common in athletes, active adolescents (especially girls) and overweight individuals. Anterior knee pain may be caused by various conditions, which include runner's knee or patellar tendinitis, and chondromalacia of the patella. There is an great variation in the duration and presentation of pain. 

Causes of Anterior Knee Pain

Anterior knee pain usually develops due to improper movement of the kneecap, causing it to rub against the lower end of the femur bone. This may occur secondary to an imbalance or poor flexibility of the thigh muscles that stabilize the knee joint, problems with alignment of the knee joint, flatfoot, tightness or weakness of the front and back muscles of the thigh, excessive sports activities, improper sports training techniques or improper use of equipment. Other possible causes for anterior knee pain include arthritis, cartilage injury and dislocation or fracture of the patella. 

Symptoms of Anterior Knee Pain

Pain is the predominant symptom and is usually gradual in onset. Patients may experience a dull aching pain around the sides, below or behind the kneecap. Sometimes, climbing stairs and standing up or walking after prolonged sitting may produce a popping or cracking sound in the knee. The pain may also present at night and be exaggerated by any repetitive knee bending activity such as jumping, squatting, running or weight lifting. Any changes in the activity level, playing surface or equipment may also result in pain. 

Diagnosis of Anterior Knee Pain

The diagnosis of anterior knee pain includes a medical history and a physical examination along with imaging tests such as X-ray and MRI scan. Physical examination determines the cause of pain and other related problems while X-rays and MRI scan aid in confirming the condition by providing visualization of the internal structures.

Treatment of Anterior Knee Pain

Patients usually respond to conservative treatment which includes application of ice, rest and well-programmed rehabilitation exercises. Ice helps to relieve the swelling and inflammation, rest protects the joint from repetitive injury, while stretching and mobilization exercises improve muscle strength, flexibility, and range of motion. Sometimes, if needed, pain relieving medication and anti-inflammatory drugs may be prescribed. Surgical treatment is rarely indicated.

Prevention of Anterior Knee Pain

Chronic persistent pain needs to be reported to your doctor immediately. Once the pain has been treated, a recurrence can be prevented by following a few simple measures which include:

  • Wearing appropriate shoes for your sporting activities
  • Performing warm-up exercises before any physical activity
  • Discontinuing any activity causing pain in your knees
  • Modulating the intensity of activity depending on your condition
  • The General Medical Council
  • The British Medical Association (BMA)
  • NHS website
  • The Royal College of Surgeons of England
  • British Orthopaedic Association
  • British Association for Surgery of the Knee
  • European Society for Sports Traumatology, Knee Surgery and Arthroscopy
  • American Academy of Orthopaedic Surgeons
  • Top Doctors
  • Percival Pott Club
  • Magellan Orthopaedic Society