Common Mistakes When Treating Anterior Knee Pain
If you suffer from anterior knee pain, there are some things you should avoid doing.
1. Try avoiding heat therapy products recently after the pain arises and hold off using this as a pain-relief treatment until later. Heat will only worsen matters by causing swelling and inflammation which your body is already doing naturally.
Its also important to remember that cold therapy or ice packs shouldnt be used too much because they are anti-inflammatory and actually slow down the healing process.
2. Avoid stretching out the affected area for the first few weeks. Stretching can actually cause more damage than good, especially if you dont know what the cause of your Anterior Knee pain is.
Similarly, try not to massage the painful part of your knee until the pain and swelling have subsided a bit because itll probably cause more pain than pain relief.
3. Try your best to avoid exercising through the pain. Instead, rest as much as possible until the pain subsides because rest is one of the most important things for recovery
4. Do not take any medications unless prescribed by a doctor/sports medicine professional or it is over-the-counter medicine such as ibuprofen gels
5. Seek medical guidance if you have severe pain in the front part of your knee or your knee cap
Causes Of Outer Knee Pain
Like the inside of your knee, the outside or lateral portion of the joint is a crossroads of many different anatomical structures. This can make getting to the bottom of pain in this area equally frustrating. If you have soreness near the lateral part of your knee, the most frequently seen causes are listed below.
When The Front Of The Knee Hurts
Normally, the kneecap moves up and down the thigh bone during running. People may feel pain in the kneecap because thigh muscles are weak or the feet roll in too much . As a result, the kneecap rubs abnormally against the thigh bone, causing increased wear and tear.
Pain in the front of the knee may be caused by
A kneecap located too high or too low in the front of the knee joint
Off-center insertion of the muscles around the knee cap
Tight, shortened hamstring muscles
Weak thigh muscleswhich normally help stabilize the knee
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When Will My Kneecap Start To Feel Better
One broad caveat to keep in the back of your mind. Many of you are thinking that a few weeks are enough time to start to see improvements with treatments such as exercise or physical therapy. Sadly thats not going to happen. It is not unusual for it to take 3-4 months before you start to see significant improvement in your pain. Furthermore, it is not uncommon for it to take 8-12 months for a complete resolution of your symptoms. This is important I wouldnt want to seek a surgeons consultation because 4-6 weeks of therapy and exercise left you with persistent pain.
Down below.. under coping strategies, we list a few things to try that can calm down your pain while we give the exercise time to work.
How Is Knee Pain Diagnosed
Your healthcare provider will begin with a health history and ask about your other health problems as well as your current symptoms. Describe any activities that make your knee pain worse.
Youll have a thorough knee exam. This will include tests of your range of motion, strength, and areas of soreness of your knee. Your provider will also assess your knee alignment. Your provider will need to rule out other possible causes of your knee pain, such as arthritis or instability.
Often, you won’t need any more tests. If your diagnosis is unclear, you might need additional imaging tests to rule out other possible causes. These tests may include an X-ray or MRI.
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A Pain Behind The Knee
- Bakers Cyst: Most common cause of pain and swelling behind the knee. Inflammation of the popliteal bursa. LEARN MORE>
- Arthritis: Degeneration of the knee cartilage and bones causing pain and stiffness, especially in the morning. LEARN MORE>
- ACL Tear: Injury to the anterior cruciate ligament from twisting or force through the knee. Usually associated with knee instability. LEARN MORE>
- PCL Tear: Injury to the posterior cruciate ligament – less common than ACL Injury. Typically injured in RTA, fall or sports. LEARN MORE>
- Hyperextension Injury: Where the knee bends too far backwards causing pain, swelling and restricted movement. LEARN MORE>
Knee Pain From Front To Back
Anterior knee pain is experienced by many people in all walks of life, from adolescents to senior citizens. It is the most common knee pain diagnosis we make. The pain occurs at the front and center of the knee and can refer to the back of the knee. This means a patient can feel pain in the back of the knee, but the pain is actually generated from the structures in the front of the knee.
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What Are The Critical Structures For Front Of Knee Pain
The knee is a complex structure consisting of three bones: the thigh bone or femur, the leg bone or tibia, and the kneecap. The knee joint consists of three compartments medial, lateral, and patellofemoral. Strong tendons and ligaments hold the bones together. Other important structures include the fat pads and bursa.
During the movement of the knee, the kneecap slides on the front of the knee. The kneecap or patella provides an important lever to gain more power from your knee joint.
Rarer Causes Of Anterior Knee Pain
CLASSIC SYMPTOMS: Front knee pain just above the patella that gets worse with activity, weakness, stiffness, knee swelling.
What Is It: Small tears in the quadriceps tendon above the knee resulting in inflammation and degeneration
Onset: Tends to come on gradually over time, affecting people who do lots of jumping and sprinting activities
Treatment: Rest, ice, strengthening & stretching exercises, knee straps, physical therapy and sometimes surgery
Find Out More: Learn more about the causes, symptoms and treatment in the Quadriceps Tendonitis section
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Conditions Associated With Pain At The Front Of The Knee
There are several medical conditions linked to pain at the front of the knee. They include the following.
Patellofemoral pain syndrome is one of the most common reasons for pain at the front of the knee. When you bend and straighten your leg, your kneecap slides up and down a groove at the end of your thigh bone . Patellofemoral pain syndrome describes pain related to this joint. It can happen if theres repeated stress on your knee for example, from jogging, squatting or jumping. It can also result from problems with the alignment between your kneecap and thigh bone. Doctors sometimes call it runners knee. It often happens in people who are very active particularly teenagers and young adults.
Patella tendinopathy means the patellar tendon in your knee becomes worn down. This tendon attaches your kneecap to your shin bone, and it can become inflamed and tear. This can be due to overuse and stress over time, particularly in sports that involve jumping like basketball and volleyball. Because of this, its often called jumpers knee. Quadriceps tendonitis is a similar condition but is less common. It causes pain and tenderness where the tendon from your thigh muscle attaches to your kneecap.
Infrapatellar fat pad syndrome is a condition where the fat pad below your kneecap gets pinched between your kneecap and thigh bone. Its usually due to repeated stress on your knee. Its sometimes called Hoffas syndrome.
Anterior Knee Pain Causes In Young Athletes:
Before you read this, it is worth repeating the majority of you will not have the issues that I outline below. The majority of you will have pain due to a gait abnormality or muscle imbalance. We all feel the need to have a specific label for why our knee hurts. Anterior knee pain due to muscle imbalance just doesnt cut if for some of you you want something more specific. I understand that.
The point I am trying to make is, if you assign the cause of your pain to a specific structural finding or something that your MRI report mentioned, then you may have difficulty getting past that and buying into the PT or exercise strategies that have been shown to work.
- Chondromalacia: Chondromalacia is likely a very early sign of arthritis. It involves the softening of the cartilage under your patella . As the cartilage softens, it is thought that it irritates other tissue in the knee with certain activities. Im not convinced that this is a common cause of anterior knee pain. Chondromalacia is very common, even in people with no pain.
We find chondromalacia in so many people at the time of surgery for other things, such as an ACL tear. And those people rarely have pain in the front of their knee. So it is not entirely clear why some people might have pain due to chondromalacia, and others do not. Surgery is rarely needed.
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When Will My Knee Feel Better
People heal at different rates. Your recovery time depends on your body and your injury.
While you get better, you need to take it easy on your knee. That doesnât mean you have to give up exercise. Just try something new that won’t hurt your joint. If you’re a jogger, swim laps in a pool instead.
Whatever you do, don’t rush things. If you try to get back to your workouts before youâre healed, you could damage the joint for good. Don’t return to your old level of physical activity until:
- You can fully bend and straighten your knee without pain.
- You feel no pain in your knee when you walk, jog, sprint, or jump.
- Your knee is as strong as your uninjured knee.
Exercises For Front Of Knee Pain
One of the most effective treatments for all forms of front of knee pain is to strengthen your surrounding muscles. This relieves pressure from your knee and will help keep the pain from returning.
You may want to consult a physical therapist so they can design an exercise routine thats specific to the cause of your knee pain. But, in general, there are many helpful exercises you can try at home.
Your at-home exercise routine should focus on both stretching and strengthening your muscles particularly your quadriceps at the front of your thighs.
An example exercise for stretching quadriceps:
- Stand with your feet flat and shoulder-width apart possibly with a chair back in front of you to hold onto
- Begin to lift one leg back toward your buttocks, bending at the knee
- Grab your foot with one hand and move your leg further back until you feel a stretch at the front of your thigh
- Hold for 15 seconds and repeat three times for each leg
An example exercise for strengthening quadriceps:
- Lay on your back with one knee bent and one leg straight
- Raise your straight leg by tightening your quadriceps until its level with your bent knee keep your toes pointed upwards
- Lower the leg back down and relax your muscles
- Repeat 25 times on each side
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Upper Iliotibial Band Stretch
Standing upright, cross your bad leg behind your good one, making sure you keep it locked straight.
Then, without bending forwards, gently lean sideways from the waist over to the good side.
You can support yourself against a wall by leaning away from it. You should feel this stretch over the outside of the hip and upper thigh.
Knee Pain Diagnosis Chart
Reviewed by: KPE Medical Review Board
A knee pain diagnosis chart can be a really useful tool to help you work out why you have pain in your knee. There are lots of different structures in and around the knee that can cause pain.
Knowing what typicallycauses pain in each area of the knee makesit easier to reach an accurate knee pain self diagnosis.
We have therefore devised these two knee pain location charts so that you can see what causes pain in the parts of the knee.
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Other Forms Of Tendonitis
Other inflamed tendons around the knee may also lead to pain in the front of the knee. The quadriceps and hamstring tendons, if involved, may also result in knee pain.
The quadriceps tendon connects the muscles on the front of the thigh to the top of the kneecap, whereas the hamstring tendons connect the muscles of the back of the thigh to the top of the tibia.
Damage to and inflammation of any of these tendons can also cause pain in the front of the knee.
Common Causes Of Front Knee Pain
If you suffer from front knee pain in Huntsville Alabama, you understand the frustration as you search for relief. Professional athletes, weekend warriors, and those who just love outdoor sports can all attest to how this directly affects daily activities.
To help grow your knowledge and seek comfort, here are 6 common causes of front knee pain, also known as anterior knee pain.
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Complementary And Alternative Therapies
A number of mind-body therapies may be used to treat knee pain. These include:
- Tai chi
These are especially common for knee osteoarthritis.
The once-popular supplements glucosamine and chondroitin have fallen out of favor for knee osteoarthritis due to a lack of scientific proof. Always talk to your healthcare provider before taking any supplements or medications.
When To Seek Medical Help
If your injury is mild, you may be able to manage your symptoms yourself, without seeking medical advice. But you should see a doctor if:
- you cant put weight on the affected leg
- you have severe pain, even when youre not putting weight on it
- your knee gives way, clicks or locks
- you cant move your knee
- your knee is hot, red or very swollen or you have a fever
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How Is Knee Pain Treated
Your healthcare provider might suggest several different treatment strategies to help ease your symptoms. These might include:
- Not doing activities that make your pain worse for a while, returning to activity only gradually.
- Icing the outside of your knee when it causes you pain.
- Taking over-the-counter pain medicines.
- Wearing a knee brace or taping your knee to support it.
- Wearing special shoe inserts to help keep your feet in the correct alignment.
- Practicing special exercises to stretch and strengthen the muscles around your hip and your knee. Your provider or physical therapist can show you how.
These steps help most people manage knee pain. Your healthcare provider might advise surgery if you still have significant symptoms after 6 months of trying these other therapies. Depending on the underlying cause of your knee pain, your provider might suggest one of several surgical options, such as surgically realigning your kneecap. You can discuss all of your surgical options with your orthopedic surgeon.
Gradual Onset Medial Knee Pain
Gradual onset or chronic knee pain develops over time. You will probably not be able to pinpoint the exact time your injury occured. Overuse is a likely cause, resulting in wear and tear or degeneration.
Chronic medial knee pain can also develop following an acute injury which is not treated properly. As a result, it fails to heal properly.
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What Are The Symptoms Of Knee Pain
This type of knee pain is marked by a dull, aching pain in the front of the knee in the area under and around the kneecap. This pain may start quickly or slowly. Your pain might be worse when you squat, run, or sit for a long time. You might also sometimes feel like your knee is giving out. You might have symptoms in one or both of your knees.
Common Causes Of Inner Knee Pain
There are a variety of causes of inner knee pain. Many of them can be linked to an injury. Some of the most common incidents that cause knee injury and pain include falls, sports injuries, or increased activity.
Adults particularly those older than 60 are most likely to experience knee pain. However, inner knee pain can also occur in children and adolescents.
According to the American Academy of Family Physicians, the most common causes of inner knee pain in children are:
- patellar subluxation
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There Is No Easy Surgical Solution For Anterior Knee Pain
The mere fact that there are likely to be ten or more described surgical techniques to try and treat pain in the front of your knee should give you pause. That usually means that none have been very successful, so we keep trying new ones. Surgery for anterior knee pain has not been proven to be more effective than a proper exercise program.
Some procedures have drilled holes into the patella, thinking that excess pressure may have been the cause of pain. Did it work for some people? Maybe but with that pesky placebo thing, we always hear about, we dont know because this procedure was never tested against control or sham. Besides having holes drilled through your patella might cause it to break if you fall on it or if you are hit in front of your knee.
One prolific Spanish author wrote about burning the tissues around the patella. We call that a denervation procedure. Thats because when you heat the tissues, you will fry the nerves to that region. The thought behind this procedure was that the patella is fed by nerves that could easily be burned using an arthroscopic approach. This procedure was also never evaluated against a control group or a sham group- so we just dont know if it works.