Anterior Knee Pain

What is it?

Also referred to as “patello-femoral” pain, anterior knee pain is a growth abnormality that is commonly experienced in adolescence.

How is it diagnosed

Anterior knee pain is a diagnosis of exclusion and requires a thorough examination of the knee and the hip as pain may be referred from that joint.

There are a number of conditions that can cause pain at the front of the knee and each should be examined for and if clinically indicated a radiological examination of the knee is made. Sometimes either CT scanning or MRI is required. The majority of patients with anterior knee pain do not have a specific diagnosis and it appears to be mainly due to changes that occur with growth and development leading to minor alterations in alignment of the quadriceps mechanism.

How does it present?

Anterior knee pain often presents without any clear cause, although it can be made worse by any activity requiring the knee to bend, for example kneeling, squatting, sitting and climbing up stairs. A generalized ache around behind or around the kneecap (patella) may be felt and slight swelling during painful episodes may occur.

How is it treated?

Particular attention is paid to the quadriceps, a group of muscles located on the front of the thigh and attached to the kneecap, joining the four quadriceps to one common tendon and allowing straightening of the knee.

This area will be checked for optimal function which requires that the kneecap is correctly aligned in the groove of the thigh bone. Weakness in the one active stabilizer – the vastus medialis oblique or VMO – can result in the kneecap moving slightly out of the groove which in turn produces pain and occasionally, softening of the cartilage.

How is the condition managed?

After analysis by an Orthopaedic Surgeon, a specific physiotherapy programme will need to be developed and any other problems excluded

The physiotherapist will concentrate on strengthening the VMO, ensuring the tight structures are stretched. This may be combined with other treatments including taping, topical anti-inflammatory gel and warm packs.

Utilising an appropriate physiotherapy programme, a gradual return to full physical strength and normal sporting activities can be achieved.