Are you having trouble completing everyday activities such as walking, climbing stairs or prolonged sitting? Has your knee given way or feels unstable? If you're suffering these symptoms or pain in the knee then this article looks at the main causes of knee pain along with what to do about it to help get you back on your feet.
What causes pain in the front of the knee (anterior knee pain)?
The two most common causes of anterior knee pain are:
Patello-Femoral Syndrome
Patellar Tendinopathy
Patello-Femoral Syndrome: The patello-femoral joint is formed by the knee cap (patella) sitting on the front of the thigh bone (femur). As the knee bends, the patella moves in a groove found at the end of the femur. The patella is a floating bone. Therefore, the patella’s position and function depend intimately on the structures that attach to the patella such are the quadriceps muscles and the connective tissue on the outside of the thigh.
Patello-femoral syndrome occurs when the under surface of the patella (knee cap) is pain sensitive, due to damage and irritation to any of the pain sensitive structures between the patella and femur. This can be caused by incorrect tracking, or movement of the patella, as the knee bends and straightens. The patella rubs against the femur, instead of gliding correctly in the groove.
Patella Tendinopathy: refers to a painful overuse injury of the patella tendon, which connects the kneecap (patella) to the shin (tibia). This occurs as a result of degeneration (either acute or chronic) and a 'weakening' within the patella tendon itself, without the presence of inflammation. Many cases of patella tendinopathy also co-exist with patella-femoral syndrome.
What are the symptoms?
Pain that gradually worsens with activity
Pain going up or down stairs
Pain with squatting
Pain with prolonged sitting
Pain deep in the front of the knee
Giving way or a feeling of instability
Swelling
Recurrent clicking
Bottom of the knee is tender to touch
What leads to these problems?
Patello-femoral syndrome is usually caused by a muscle imbalance in the thigh. The patella is a floating bone and therefore structures that are too tight will pull the patella into the wrong position. Usually the tightness occurs in the lateral thigh structures (tensor fascia latae, gluteals, quadriceps, hamstrings and calf) and a loss of muscular control and strength of the inner quadriceps muscle, the vastus medialis oblique (VMO).
Typically, the ‘tug-of-war’ between the outside and inside structures is won by the outside, pulling the patella laterally. Eventually, too much incorrect rubbing leads to inflammation, pain, swelling and dysfunction. Patella tendinopathy is caused by excessive loads on the patella tendon, particularly if there are insufficient rest periods. This problem is commonly a result of an untreated patella-femoral dysfunction.
What can a Physiotherapist do to help fix the problem?
A trained physiotherapist can provide an accurate diagnosis of the problem and identify the underlying problems that have led to your anterior knee pain. Your physiotherapist will then design a structured rehabilitation program that will first aim at relieving the pain you a currently experiencing and then use a combination of manual therapy and exercise to resolve the underlying factors, resulting in a pain free and non-recurring problem.
Our physiotherapists work closely with our Podiatrists and Massage Therapists to provide a total solution to your keen pain.
Book your appointment online with one of our physiotherapists here.