Anterior knee pain, aka pain towards the front of the knee, is extremely common.
Pain in the front of the knee may vary from a specific sharp pain to more of a general ache as well as feelings of warmth, swelling and instability.
Each common cause will present with different symptoms, so it is important to note these symptoms such as what brings on your pain, what type of pain it is, how long your pain last for, and where exactly is your pain located. These are just to name a few and will help you manage your knee pain effectively.
Common types of anterior knee pain include patella femoral pain syndrome, patella tendinopathy, Osgood Schlatter’s and Sinding Larsen Johansson (common in juveniles), fat pad irritation, Quadriceps Tendonitis, and Knee Bursitis.
Today we will look at two common types of anterior knee pain; runner’s knee and jumper’s knee, and how you can specifically treat and manage these.
- Patella femoral pain syndrome aka runner’s knee
PFPS is one of the most common knee conditions treated by sports medicine clinicians and physiotherapists. Usually, this condition is secondary to repetitive mechanical loading of the patella-femoral joint (PFJ) and the surrounding soft tissues. Basically, the kneecap doesn’t track or move optimally in the trochlear groove due to an imbalance of forces acting on the knee cap.
These imbalances may be caused by weak thigh or buttock muscles, tight muscles on the outside of the thigh, calf or hamstring, or due to poor hip and foot control. All of these factors can affect how the load is distributed in the PFJ.
Often there is a gradual onset of symptoms and it may be difficult to pinpoint one specific incident when symptoms started. Pain is often described as a vague ache across the front or inner side of the knee, but can also be sharp in nature. Aggravating factors may include weight-bearing activities involving repetitive knee bending such as walking up/downstairs, cycling, running, squatting, or jumping.
Successful treatment of PFPS may involve manual therapy to address muscle tightness and joint restrictions, temporary behavior modification, such as reducing running distance and avoiding prolonged periods of sitting, and incorporating exercises that target hip, knee and foot control. These exercises help the person in pain learn how to control their lower limb better and trains new movement patterns which help alter the way stress is applied to the PJF.
- Patella tendinopathy aka jumper’s knee
Patella tendinopathy is characterised by pain at the front of the knee, often localised to the patella tendon just below the kneecap.
It is generally an overloading injury, where the demands place on the quadriceps exceeds the capacity of the patella tendon to keep up resulting in the tendon degrading and becoming sore.
Patella Tendonopathy is often more common in males. Onset of symptoms is often gradual, and there is frequently a history of participation in jumping sports such as basketball, volleyball, football, and tennis. As the patella tendon repetitively stores and releases energy, it results in a break down in the tendon.
Rehabilitation of patellar tendinopathy can be frustrating as often it involves a period of rest or modification from sports, although a progressive resistance-based training program has been shown to be effective in restoring tendon health.
With patella tendon issues it is important to pay attention to your symptoms and make sure you are giving yourself enough rest in between training days. It is okay to have mild to moderate knee symptoms during training days as long as they are settling by the next morning and not increasing.
If you are experiencing knee pain symptoms, please seek the assistance of a healthcare professional such as your physiotherapist for advice.
See you soon!
Written by Haydn Matthews Physiotherapist at 4 Life Physiotherapy Mandurah.