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Anterior Knee Pain

What is Anterior Knee Pain?

Pain around the knee cap (patella) is also known as Anterior Knee Pain or Patellofemoral Pain Syndrome and may have many causes.  It is frequently caused by altered alignment of the knee cap due to a combination of muscle weakness and tightness of soft tissue, resulting in pain or discomfort.

How does it happen?

This can be caused by repeated bending of the knee in activities where there is a lot of pressure put on the knee cap such as sport, climbing stairs and hill walking; especially on uneven ground.  Usually there is no history of injury, but it can follow an accident such as falling directly and heavily onto your kneecap.  It is sometimes a type of wear and tear on the cartilage on the underneath surface of the patella, which becomes soft and occasionally inflamed.

Who gets Anterior Knee Pain?

It is a very common condition.  It may affect people at any age.

What are the symptoms?

The main symptom is pain or an ache over the front of your knee.  The pain may come on for no apparent reason and can gradually get worse with activity.  The pain can be especially worse with the following:

  • Walking up or down stairs
  • Running (especially downhill)
  • Walking on rough ground
  • Squatting
  • Kneeling
  • Prolonged sitting or driving

What is the long term future?

Your outlook is very good and a steady recovery can be expected with attention to very simple guidelines.  X-rays of the knee are normally not necessary.

How do I manage it?

The application of ice packs can help to relieve your pain.  Wrap an ice pack (a bag of frozen peas or ice cubes can be used) in a damp towel.  Place on your knee for up to 20 minutes.  You can repeat this every 2 to 4 waking hours.  The key approach is for you to modify or rest from the activities which make the pain worse and to retrain your muscles, especially the quadriceps (on the front of your thigh).  Referral to a Chartered Physiotherapist may be necessary to supervise rehabilitation.  Sometimes a short course of pain medication may help.  Please see your GP or Pharmacist for advice on this.

Early exercises

Repeat each exercise 10 times, 3 times a day.  If you get pain with the exercises reduce the number of repetitions, but stop if the pain persists and ask for advice.

Lying on your back with legs straight.  Bend your ankles and push your knees down firmly against the bed.  Hold for 5 to 10 seconds and relax. Repeat at least 10 times.

Lying on your back with one leg straight and the other leg bent.  (You can vary the exercise by having your foot outwards).  Exercise your straight leg by pulling the toes up, straightening the knee and lifting the leg 20 cm off the bed.  Hold approximately for 5 to 10 seconds then slowly relax.  Repeat at least 10 times.  The exercise can also be altered by sitting up with legs out in front.

Reproduced with kind permission of NHS Fife Physiotherapy Services.