Anterior knee pain-
Pain that occurs in the anterior and central aspect of the knee joint is called as anterior knee pain. Conditions contributing to anterior knee pain can be many. These can be patellofemoral pain syndrome, chondromalacia patellae, knee bursitis, patellofemoral instability, patellar fracture, tendinitis, etc.
Anterior knee pain is not a diagnosis, rather a symptom.
Cause of pain-
The causes can be multifactorial. Therefore, Patients present with a variety of symptoms, pain location and pain level. Patella abnormalities, muscle imbalances or weakness leading to patella malalignment can also be few causes for pain. Overuse injuries can lead to tendinopathy, patellar instability and osteochondral damage.
Symptoms commonly seen-
- Pain on anterior aspect of knee joint, which aggravates on walking, squatting, sitting with knees flexed, stair climbing.
- functional deficit
- knee instability
- muscle weakness
- restricted range due to pain
Correctly diagnosing the cause-
Diagnosing an accurate condition is however sometimes difficult. Factors such as type of pain, location of pain, onset, duration, change with activity or rest, aggravating and relieving factors, postural and diurnal variations help in ruling out causes. Other symptoms such as presence of night pain, history of trauma, or presence of any inflammatory symptoms such as morning stiffness, swelling; should be evaluated carefully.
Common conditions associated with anterior knee pain-
Patellofemoral Pain Syndrome (PFPS)-
In this condition, pain arises from the patellofemoral joint or also the adjacent soft tissues. Pain aggravates with squatting, sitting, climbing stairs, and running. Sometimes however pain can be felt in all aspects of the knee, and not just anterior. Causes can be trauma, overuse, presence of anatomical abnormalities, muscle weakness, imbalance or dysfunction.
Chondromalacia patellae (CMP)- presence of anterior knee pain due to the physical and biomechanical changes.The articular cartilage of the posterior surface of the patella undergoes degenerative changes. These manifest as softening, swelling, fraying, and erosion of the hyaline cartilage underlying the patella and sclerosis of the underlying bone. Moreover, It is more common in young people.
Causes include injury, patellofemoral contact, trauma , instability or maltracking of the patella. Chondromalacia patella is usually described as an overload injury.
Other causes are muscular tightness of rectus femoris,TFL, hamstrings and calf muscles. Muscle imbalances between vastus muscles are also a significant contributor.
It is the dislocation of patellar bone commonly due to lateral shift of patella. It is common in athletes. Causes can be Ligament laxity, Biomechanical issues such as femoral and tibial rotation, and pes planus, hyperextended knee.
The bottom line-
Anterior knee pain can be due to a number of factors or condtions. It is important that you consult your doctor for an accurate diagnosis. Patient history, clinical examination along with imaging procedures help to make the correct diagnosis. Depending on the diagnosis, every person has an individualised rehab, thus making it crucial for recovery.