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Anterior Knee Pain

Anterior Knee Pain - Why does this happen?
The knee cap, patella, is a small bone on the front of the knee joint.   To help reduce friction between the patella and the knee joint during movement, the back of the patella is covered with cartilage. 

Anterior Knee Pain is a condition where the cartilage on the back of the patella becomes softened and degenerates as a result of poor alignment of the patella.  This causes the normally smooth surface of the cartilage to become roughened which results in irritation to the patella and pain in the front of the knee.


Whilst this condition is most common in people over 40 years old it is also seen in teenage girls as the stress changes on the cartilage due to growth spurts and the width of the pelvis.  Anterior Knee Pain often occurs due to repeated stress or a change in stress on the knee.  A change in activity, increase in frequency or intensity of activity, muscle imbalance, a poor foot position, poor warm up, tight muscles and excess weight may be contributing factors.

What are the symptoms?
  • Pain and tenderness on the front of the knee.
  • Pain is worse on walking, sporting activity, walking up stairs or after sitting for prolonged periods.
  • Grating sensation on the knee during movement.
  • Pain is relieved after a period of rest. 
Diagnosing Anterior Knee Pain

Your GP or Physiotherapist can usually diagnose an Anterior Knee Pain by simply examining your knee and hearing where the pain is and how it started.


X-rays and other tests are not usually necessary.
What is the treatment?

Anterior Knee Pain can usually recover with some simple changes to activity and exercise.  By trying to avoid or reduce the activity which causes the pain, to allow the damaged cartilage time to recover and heal. 


To help reduce the symptoms an 'ice pack' can be placed on the painful area for 15 - 20 minutes, twice a day.  Do not place the 'ice pack' directly on the skin.  Wrap the 'ice pack' in a damp towel before placing on the painful area to ensure you do not burn the skin.


When possible elevate the leg during the first 48 hours.


During the initial painful stages it is important to manage the pain. 

Painkillers and anti-inflammatory medications  -  These may be prescribed by your GP if the pain is costant.  This is a temporary measure to break the pain cycle, but can continue as required.
Exercise  -  Exercise is important to help realign the position of the patella in relation to the knee joint.  It is important to stretch and strengthen the surrounding muscles and work on your balance to help prevent reoccurrence.    Click here for a list of exercises suitable for Anterior Knee Pain.
Biomechanical Analysis  -   If there are significant mechanical problems insoles or specific trainers may improve your leg position and help avoid further injuries.  A biomechanical assessment by a Podiatrist or Physiotherapist will determine whether insoles or specific trainers would be of benefit.
Physiotherapy  -  If exercise alone does not improve symptoms then physiotherapy treatment may be required.  A physiotherapist can use specific treatments including, ultrasound, deep friction, massage, interferential, acupuncture or taping to help relieve pain and aid recovery. Click here for more information about Physiotherapy.
Injections  -  In some cases your GP or Consultant may recommend an injection.  These can be used to reduce inflammation and pain when the symptoms are severe and constant.  This is not a 'cure' and it is important to follow the exercises and modify activities.  
Surgery  -  This is not common for Anterior Knee Pain.  In some cases when symptoms are persistent surgery may be considered.    
Remember an important part of treatment for Anterior Knee Pain your home exercises and modifying activities.