The three most common problems that cause pain at the front of the knee
1. Patellofemoral pain
The patella or knee-cap sits on top of the femur and forms the patellofemoral joints of the knee. Pain can result from the patella not tracking in its groove as you bend the knee forwards and backwards. This is common in activities that cause higher loads on the knee such as running, squatting and jumping. Although it can become very painful it has been shown there is unlikely any damage to the knee.
What to do next?
- In an acute situation it’s important to address any biomechanical factors that may be inhibiting the knee to function well. This could be due to a variety of factors such as gluteal and quadricep strength, tightness in the lateral structures of the hips and knee, internally rotating at the hips with running, or finally the biomechanics of the feet such as over-pronating.
- If this problem becomes frequent it’s important to get an x-ray as this can establish where your patella sits on the femur. A patella that sits too high is subject to higher stresses and therefore requires a lot of strengthening and tracking exercises. Although you can’t change the morphology of your bones, it may point to the reason as to why rolling your ITB 10X/day has not worked.
2. Patellar Tendinopathy or patella tendonitis
The patella tendon is the continuation of the quadricep muscles and where they attach at the tibia (shin bone). The tendon can become sore and is often due to over-use of the quadricep muscle group such as a long-distance runner.
What to do next?
It’s important to NOT rest but rather load the tendon appropriately and SLOWLY. The physiotherapist will likely ask you to pull back on the activity that is aggravating the tendon and complete daily exercises. The painful tendon often takes 3-4 months to improve.
3. Osteoarthritis of the knee
Osteoarthritis is a degenerative inflammatory condition that affects a lot of the population. When the cartilage thins it causes the bones to rub on one another over time. This results in osteophytes (bit of bone) forming, cystic changes and much more. The knee deteriorates over-time, however the process can be slowed through exercise, bracing, and taking turmeric.
What to do next?
See your Physiotherapist so they can prescribe the correct exercises and advise you what you should avoid.
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