Front Knee Pain – Causes, Treatment & Prevention
The knee is the largest joint in the body and is often the common site of trauma and overuse injuries, therefore front knee pain or anterior knee pain is a very common symptom.
There are a number of factors that may cause anterior knee pain, and these include poor alignment of the joint between the patella and the femur, tightness or weakness of the thigh muscles, improper warm-ups before exercises, overuse from activities which place a lot of stress on the kneecap such as running, skiing, and playing soccer, wearing bad shoes, and chronic inflammatory conditions of the knee joint.
Anterior knee pain most commonly occurs among people who are overweight, athletes, teenagers, and people with a previous injury to the kneecap.
The following details the top causes of anterior knee pain, their associated symptoms, and treatment.
Front Knee Pain Causes
Runner's knee is the commonest cause of front knee pain. It is caused by repetitive movement of the patella in the trochlear groove.
It affects runners most commonly, but it also affects people whose daily activities require prolonged walking or running.
The front knee pain in runner’s knee is gradual in onset, worse with activities, and resolves with rest. Runner’s knee also presents with a grinding sensation on flexing the knee.
Treatment of runner’s knee is essentially conservative and includes physical therapy, wearing knee braces, orthotics, and use of analgesics. In severe cases, surgery may be necessary.
Housemaid’s knee is an inflammation of the prepatellar bursa.
Prepatellar bursa is a fluid-filled sac at the front of the knee which serves as a shock absorber against the heavy impact on the knee.
Housemaid's knee is often caused by prolonged periods of impact on the knee as occurs from frequent kneeling by housemaids, plumbers, and carpet layers.
Housemaid’s knee presents with anterior knee pain, swelling, and redness in the front of the knee. These symptoms are aggravated by activity especially kneeling, bending, and running.
Treatment of housemaid’s knee is conservative and includes rest, protection of the knee with knee braces, application of ice packs, compression, elevation, and use of analgesics. Surgery is rarely necessary unless conservative treatment does not resolve the symptoms.
Chondromalacia patella is a condition in which the cartilage behind the kneecap is damaged.
It presents with dull achy pain in the front of the knee, clicking sounds as you move, grinding sensation, and swelling of the knee.
The pain that comes with chondromalacia patella is gradual in onset and worse on standing up from a sitting position, moving downhill, and on applying pressure to the kneecap. Chondromalacia patella usually affects young adults.
Treatment of chondromalacia patella is also conservative and includes physical therapy, application of ice packs, use of orthotics, intake of analgesics, and wearing knee braces. In severe cases, surgery may be necessary
Jumper’s knee is also called patellar tendonitis. It is an inflammation of the patella tendon located just under the kneecap.
It is caused by injury to the tendon caused by overuse from activities such as jumping and kicking, both of which tense the tendon.
Patellar tendonitis presents with front knee pain below the patella, associated with stiffness of the knee.
The pain is gradual in onset and becomes progressively worse with repetitive activities.
Patellar tendonitis can be treated effectively with conservative measures such as rest, ice therapy, use of knee braces or knee straps, physical therapy, analgesics, and elevation of the knee. In unresponsive cases, surgery becomes necessary.
Osgood Schlatter’s Disease
Osgood Schlatter’s disease is a chronic disease characterized by irritation of the bone below the kneecap.
It is the commonest cause of front knee pain in teenagers, especially boys between the ages of 9 and 16.
Osgood Schlatter’s disease presents with a bony lump below the kneecap causing pain as you walk and engage in activities such as kicking, running, and jumping.
Treatment of Osgood Schlatter disease mainly involves conservative measures including protection of the knee with braces, rest, ice therapy, elevation, compression, physical therapy, and analgesics.
Cartilage and meniscus tears often result from acute injuries to the knee and weakness from overuse activities.
These tears present with swelling of the knee, knee locking, and pain on flexing or extending the knee.
The pain is worse with weight-bearing activities such as standing, squatting, and walking.
Treatment for cartilage and meniscus tears is also conservative and includes protection of the knee with knee braces, rest, ice therapy, physical therapy, elevation, compression of the knee, and use of analgesics. Some cases may require surgical repair.
Arthritis is an inflammation of the knee joint.
There are many types of arthritis, but the commonest types are rheumatoid arthritis, osteoarthritis, and gouty arthritis.
These types of arthritis typically present with morning stiffness and pain in the knee, loss of the knee’s range of motion, and swelling of the knee.
The pain in knee arthritis is usually of gradual onset, worse with activities, and relieved with rest.
Treatment of knee arthritis is mainly conservative and includes ice therapy, wearing knee braces, compression, elevation, physical therapy, analgesics, and use of assistive devices such as walking aids.
In cases where conservative measures do not resolve the symptoms, surgery may be considered.
Knee sprain occurs when one of the ligaments in the knee is overstretched or torn.
It usually occurs after trauma to the knee, or sudden stretch or twisting movement of the knee.
Knee sprains usually present with knee swelling, redness, pain around the knee, and reduced range of motion of the knee.
The pain of knee sprain is worse with any weight-bearing activity as well as sudden twisting movements of the knee.
Treatment of knee sprain is mainly conservative and includes rest, ice therapy, compression and elevation of the knee, use of knee braces, and physical therapy.
Osteochondritis dissecans is a chronic condition of joints caused by the insufficient blood supply to the joints causing the bones and cartilages to break into small fragments.
It is most prevalent in adolescents aged 10-20, but it could occur at any age. It is, however, a rare cause of anterior knee pain.
Common symptoms of osteochondritis dissecans include sharp pain over the knee, knee locking, reduced range of motion of the knee, and knee swelling.
The knee pain in osteochondritis dissecans is gradual in onset and worse with sporting activities, climbing up stairs, and twisting movements of the knee.
Treatment of osteochondritis dissecans includes rest, physical therapy, use of knee braces, and in sever case, surgery.
Patella injuries are traumatic injuries to the kneecap which may be characterized by fracture or dislocation of the kneecap.
Common causes of patella injuries are falls, road traffic accidents, and sudden twisting movement of the knee.
Patella injuries present with knee pain, a reduced range of knee motion, knee swelling, and deformation of the knee.
Patella injuries are treated with conservative measures such as rest, use of knee braces, exercises, ice therapy, and use of analgesics. In unresponsive cases and in cases with severe injuries, surgery is considered.
How to Prevent Front Knee Pain?
The following tips are essential for preventing anterior knee pain.
Strength training is very important with or without knee pain. These exercises keep the calf and thigh muscles strong and flexible enough to protect the knee.
In addition, if one has knee pain, building these muscles help lower the pain and protect the knee from further damage.
Examples of such stretch exercises which build muscle strength and flexibility include step-ups, hamstring curls, butterfly stretch of the feet, standing hip flexor stretch, and straight-leg lifts.
The best forms of aerobic exercise for people with knee diseases include low impact aerobic exercises such as swimming, cycling, and walking on a level surface.
However, it is advisable to know your limits and avoid strenuous exercise which may be counter-productive. Activities which worsen knee pain such as kneeling and running downhill should also be avoided.
Healthy Weight Loss
Body weight is borne by the spine and the joints of the lower limbs particularly the knee joints.
With every step one takes, two to four times the body weight is transmitted through the knee joint, therefore, overweight people place a lot of burden on their knees.
Weight loss reduces both the stress on the knee and one’s susceptibility to certain chronic knee diseases such as osteoarthritis.
Wearing proper footwear
Wearing comfortable and supportive footwear takes pressure off the knee joint by ensuring proper alignment of the knee and hip joints while also maintaining balance. This is why wearing high heels cause knee pain in the long run.
Standing up straight
Standing in an awkward posture, such as leaning forward or walking with the waist bent over, causes the body to move off-center.
This causes the muscles of the thigh and calf to work extra hard to compensate for the abnormal posture. This would eventually strain the knee joints.
Front knee pain is a common symptom as the knee bears much of the body’s weight and is heavily involved in our day-to-day activities.
Front knee pain is often caused by factors including poor posture, bad footwear, improper warm-ups before exercise, obesity, acute knee injuries, and certain chronic diseases of the joints.
Treatment of most of the causes of front knee pain is conservative, including rest, ice therapy, knee braces, and analgesics. There are some cases, however, where surgery may be necessary.