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Knee Pain Series: Why Does the Front of my Knee Hurt?




Also known as anterior knee pain, the pain in the front of your knee can come from multiple causes. It is also a common area of complaint for ages young and old. The most common reason for anterior knee pain is patellar tendon dysfunction, but can also come from meniscus involvement or arthritis. Let’s take a look at the causes for these common diagnoses.


Patellar Tendonitis - Inflammation of the Patellar Tendon


The quadricep muscle, or commonly referred to as the quad, is the big muscle at the front of our thigh and it travels to our knee and forms a tendon that inserts just below our kneecap. This part of the tendon is called the patellar tendon. The patellar tendon can become angry when an unusual strain is placed on it, repetitive strain happens without support, or even when the quad is weak or attempting to be strengthened.


An unusual strain could be simply changing your training program for example, you typically walk and now you start running or you typically walk/run on level surfaces and now you are trying inclines. When we change our normal routine to include activities that challenge the quad, we can strain the patellar tendon because either the quad isn’t strong enough or it doesn’t have the muscular endurance to withstand the new load.


A repetitive strain happens when we utilize stairs every day several times a day and don’t know a technique to use that would assist the quad. For example, when we go up and down stairs we should be thinking of pushing up towards the ceiling to go from one step to the next. Most of the time people tend to pull themselves up the stairs with our knees taking most of the strain. One way to think of this is using your buttock muscles to power you up to the next step, not pulling with your knee.


When we are attempting to strengthen the quad after surgery or an injury we can put extra strain on the patellar tendon simply due to the weakness of the muscle and the new repetitive exercises to get it stronger. The best way to avoid irritating the patellar tendon is to gradually work up in weight and repetitions as well as utilize eccentric exercises to allow for lengthening of the muscle while strengthening.


Meniscus Tears - Degenerative or Torn Cartilage


The meniscus is padding between the bones of the knee that protect the bones from cramming on one another. This padding can become inflamed or even torn. A commonly referred area to feel pain from the meniscus is the anterior knee, especially for the medial meniscus.


Tears occur when the foot is planted and you twist your body/knee. Degeneration occurs naturally as well as when repetitive pounding occurs at the knee joint without support or control by the muscles and ligaments.


Depending on the severity of the meniscus involvement, surgery may be recommended. However, many times the meniscus can be rehabbed with physical therapy including strengthening and stabilizing the joint and learning protection strategies to not put increased pressure on them.


Osteoarthritis - Inflammation of a Joint


As scary as an arthritis diagnosis can be, it simply means the joint is inflamed. This inflammation can be due to degeneration of the joint or meniscus, which to a degree is normal as we age.


Advanced degeneration happens when the joint is unsupported, meaning the muscles and ligaments around the joint aren’t able to control the pounding that occurs as we move. Over time, if we don’t learn how to utilize our muscles and decrease the strain to the knee joint, then the cartilage begins to break down quicker than it should.


Getting ahead of the pain and avoiding compensations are the most important initial steps to treating arthritis. Sometimes this includes anti-inflammatory medication and/or a brace to decrease the pain and give the joint a break. Arthritis can be well controlled with a good strengthening program and learning joint protection strategies taught by a physical therapist.



Are you Ready to Start Treating your Knee Pain?


Working with a physical therapist is your best bet at getting ahead of the pain quickly and learning the best techniques to avoid the return of pain. If you are having knee pain with your sport or training program then you really need to work with a physical therapist that is knowledgeable in sports and the movements that are involved, like myself! I offer free phone consultations to talk about what you are experiencing and discuss your goals to make sure we are a good fit to work together before we get started. All you have to do is click here to schedule!

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