Anterior knee pain
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Anterior knee pain is pain that occurs at the front and center of the knee. It can be caused by many different problems, including:
Chondromalacia of the patella -- the softening and breakdown of the tissue (cartilage) on the underside of the kneecap (patella)
Runner's knee (sometimes called patellar tendinitis)
Lateral compression syndrome - the patella tracks more to the outside part of the knee
Quadriceps tendinitis - pain and tenderness at the quadriceps tendon attachment to the patella
Patella maltracking - instability of the patella on the knee
Causes
Your kneecap (patella) sits over the front of your knee joint. As you bend or straighten your knee, the underside of the patella glides over the bones that make up the knee.
Strong tendons help attach the kneecap to the bones and muscles that surround the knee. These tendons are called:
The patellar tendon (where the kneecap attaches to the shin bone)
The quadriceps tendon (where the thigh muscles attach to the top of the kneecap)
Anterior knee pain begins when the kneecap does not move properly and rubs against the lower part of the thigh bone. This may occur because:
The kneecap is in an abnormal position (also called poor alignment of the patellofemoral joint).
There is tightness or weakness of the muscles on the front and back of your thigh.
You are doing too much activity that places extra stress on the kneecap (such as running, jumping or twisting, skiing, or playing soccer).
You have flat feet.
Anterior knee pain is more common in:
People who are overweight
People who have had a dislocation, fracture, or other injury to the kneecap
Runners, jumpers, skiers, bicyclists, and soccer players who exercise often
Teenagers and healthy young adults, more often girls
Other possible causes of anterior knee pain include:
Arthritis
Pinching of the inner lining of the knee during movement (called synovial impingement or plica syndrome)
Symptoms
Anterior knee pain is a dull, aching pain that is most often felt:
Behind the kneecap (patella)
Below the kneecap
On the sides of the kneecap
One common symptom is a grating or grinding feeling when the knee is flexed (when the ankle is brought closer to the back of the thigh).
Symptoms may be more noticeable with:
Deep knee bends
Going down stairs
Running downhill
Standing up after sitting for awhile
Exams and Tests
The health care provider will perform a physical exam. The knee may be tender and mildly swollen. Also, the kneecap may not be perfectly lined up with the thigh bone (femur).
When you flex your knee, you may feel a grinding feeling below the kneecap. Pressing the kneecap when the knee is straightening out may be painful.
Your provider may want you to do a single leg squat to look at muscle imbalance and your core stability
X-rays are very often normal. However, a special x-ray view of the kneecap may show signs of arthritis or tilting.
MRI scans are rarely needed.
Treatment
Resting the knee for a short period of time and taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or aspirin may help relieve pain.
Other things you can do to relieve anterior knee pain include:
Change the way you exercise
Learn exercises to both strengthen and stretch the quadriceps and hamstring muscles
Learn exercises to strengthen your core
Lose weight (if you are overweight)
Use special shoe inserts and support devices (orthotics) if you have flat feet
Tape your knee to realign the kneecap
Wear the correct running or sports shoes
Rarely, surgery for pain behind the kneecap is needed. During the surgery:
Kneecap cartilage that has been damaged may be removed
Changes may be made to the tendons to help the kneecap move more evenly
Outlook (Prognosis)
Anterior knee pain often improves with a change in activity, exercise therapy, and the use of NSAIDs.
Possible Complications
When to Contact a Medical Professional
Call your health care provider if you have symptoms of this disorder.
Alternative Names
Patellofemoral syndrome; Chondromalacia patella; Runner's knee; Patellar tendinitis; Jumper's knee
References
Collado H, Fredericson M. Patellofemoral pain syndrome. Clin Sports Med
De Carlo M, Armstrong B. Rehabilitation of the knee following sports injury. Clin Sports Med
Tan EW, Cosgarea AJ. In: Miller MD, Thompson SR eds. Patellar instability.DeLee and Drez's Orthopaedic Sports Medicine
Silverstein JA, Moeller JL, Hutchinson MR. Common issues in orthopedics. In: Rakel RE, ed.Textbook of Family Medicin
Anterior knee painEmail this page to a friend Print Facebook Twitter Bookmark & ShareAnterior knee pain is pain that occurs at the front and center of the knee. It can be caused by many different problems, including:Chondromalacia of the patella -- the softening and breakdown of the tissue (cartilage) on the underside of the kneecap (patella)Runner's knee (sometimes called patellar tendinitis)Lateral compression syndrome - the patella tracks more to the outside part of the kneeQuadriceps tendinitis - pain and tenderness at the quadriceps tendon attachment to the patellaPatella maltracking - instability of the patella on the kneeCausesYour kneecap (patella) sits over the front of your knee joint. As you bend or straighten your knee, the underside of the patella glides over the bones that make up the knee.Strong tendons help attach the kneecap to the bones and muscles that surround the knee. These tendons are called:The patellar tendon (where the kneecap attaches to the shin bone)The quadriceps tendon (where the thigh muscles attach to the top of the kneecap)Anterior knee pain begins when the kneecap does not move properly and rubs against the lower part of the thigh bone. This may occur because:The kneecap is in an abnormal position (also called poor alignment of the patellofemoral joint).There is tightness or weakness of the muscles on the front and back of your thigh.You are doing too much activity that places extra stress on the kneecap (such as running, jumping or twisting, skiing, or playing soccer).You have flat feet.Anterior knee pain is more common in:People who are overweightPeople who have had a dislocation, fracture, or other injury to the kneecapRunners, jumpers, skiers, bicyclists, and soccer players who exercise oftenTeenagers and healthy young adults, more often girlsOther possible causes of anterior knee pain include:ArthritisPinching of the inner lining of the knee during movement (called synovial impingement or plica syndrome)SymptomsAnterior knee pain is a dull, aching pain that is most often felt:Behind the kneecap (patella)Below the kneecapOn the sides of the kneecapOne common symptom is a grating or grinding feeling when the knee is flexed (when the ankle is brought closer to the back of the thigh).Symptoms may be more noticeable with:Deep knee bendsGoing down stairsRunning downhillStanding up after sitting for awhileExams and TestsThe health care provider will perform a physical exam. The knee may be tender and mildly swollen. Also, the kneecap may not be perfectly lined up with the thigh bone (femur).When you flex your knee, you may feel a grinding feeling below the kneecap. Pressing the kneecap when the knee is straightening out may be painful.Your provider may want you to do a single leg squat to look at muscle imbalance and your core stabilityX-rays are very often normal. However, a special x-ray view of the kneecap may show signs of arthritis or tilting.MRI scans are rarely needed.TreatmentResting the knee for a short period of time and taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or aspirin may help relieve pain.Other things you can do to relieve anterior knee pain include:Change the way you exerciseLearn exercises to both strengthen and stretch the quadriceps and hamstring musclesLearn exercises to strengthen your coreLose weight (if you are overweight)Use special shoe inserts and support devices (orthotics) if you have flat feetTape your knee to realign the kneecapWear the correct running or sports shoesRarely, surgery for pain behind the kneecap is needed. During the surgery:Kneecap cartilage that has been damaged may be removedChanges may be made to the tendons to help the kneecap move more evenlyOutlook (Prognosis)Anterior knee pain often improves with a change in activity, exercise therapy, and the use of NSAIDs.Possible Complications When to Contact a Medical ProfessionalCall your health care provider if you have symptoms of this disorder.Alternative NamesPatellofemoral syndrome; Chondromalacia patella; Runner's knee; Patellar tendinitis; Jumper's kneeReferencesCollado H, Fredericson M. Patellofemoral pain syndrome. Clin Sports MedDe Carlo M, Armstrong B. Rehabilitation of the knee following sports injury. Clin Sports MedTan EW, Cosgarea AJ. In: Miller MD, Thompson SR eds. Patellar instability.DeLee and Drez's Orthopaedic Sports MedicineSilverstein JA, Moeller JL, Hutchinson MR. Common issues in orthopedics. In: Rakel RE, ed.Textbook of Family Medicin
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