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Anatomy of the knee

Anterior Knee Pain

Knee cap pain (Patella Femoral joint pain) is pain in the joint at the front of your knee, which consists of your knee cap and thigh bone.

Symptoms:

Pain that feels deep in the knee cap, grinding or clicking and there may be a very small amount of swelling.

Aggravating Factors:

Ascending and descending the stairs, squats, lunges, running, jumping, prolonged sitting and walking on steep terrain.

Easing Factors:

Holding the knee in a straight (extended) position and avoiding the aggravating factors.

Onset:

Usually gradual and often occurs in people who do a lot of exercise (If your injury was traumatic, please seek medical advice ASAP).

Management:

Exercises and advice regarding joint loading under the guidance of a Physiotherapist. Taping and bracing can be used if required. Exercises should be your key focus and often include: Closed kinetic chain leg strengthening exercises (where your foot stays in contact with the floor or a footplate), specific exercises for strengthening the quadriceps and flexibility exercises for the leg.

Often, runners who run with bent knees and a low cadence (cadence is the number of steps you take per minute) have this problem. A gradual increase in running cadence under the guidance of a physiotherapist may be beneficial in reducing anterior knee pain in runners. There has been some evidence suggesting that a 5-10% increase in running cadence can significantly reduce loading of the patellofemoral joint. Other evidence however, has shown that simple advice and exercise has had a similar effect on anterior knee pain as increasing cadence.

References:

Barton CJ, Crossley KM, Macri EM. Should we consider changing traditional physiotherapy treatment of patellofemoral pain based on recent insights from the literature? Br J Sports Med. 2018.

Barton C, Balachandar V, Lack S, Morrissey D. Patellar taping for patellofemoral pain: a systematic review and meta-analysis to evaluate clinical outcomes and biomechanical mechanisms. Br J Sports Med. 2014;48(6):417-24

Collins NJ, Barton CJ, van Middelkoop M, Callaghan MJ, Rathleff MS, Vicenzino BT, et al. 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017. Br J Sports Med. 2018

Roper JL, Harding EM, Doerfler D, Dexter JG, Kravitz L, Dufek JS, et al. The effects of gait retraining in runners with patellofemoral pain: A randomized trial. Clin Biomech (Bristol, Avon). 2016;35:14-22



Knee Injuries