Causes & Treatments For Knee Pain

Causes and Treatments for Pain in Front of Knee

knee model patella labeled

When thinking of knee pain, it almost always is all-inclusive. Most of the time, that is not the case; the pain is localized to one area. A common area in which knee pain occurs is the anterior side of the knee, or the front. Pain normally occurs just behind the kneecap, below the kneecap, and on either side of the kneecap.

The knee is an incredibly complex joint that goes through a tremendous range of motion. It has many muscles that cross the knee joint to help control its movement while walking, running, squatting, or going up and down stairs. All of this movement occurs while supporting your body weight. Anterior knee pain is often most felt while hinging at the knee in daily activities such as going up or down the stairs, squatting, jumping, or standing up after a long period of sitting. Damage to the muscles, tendons, and ligaments surrounding the front of the knee is the main cause of front of the knee pain.

Causes of Anterior Knee Pain

The kneecap, or patella, sits over the knee joint and every time the knee is extended, the patella glides over the tibia and femur. Knee pain is caused when the patella doesn't move properly and grinds against the femur. This grinding can be caused by many different factors. The patellofemoral joint could not be aligned properly, meaning the kneecap would be in an abnormal position. Tightness of the muscles surrounding the knee would cause the patella to be less fluid in its gliding motion across the femur and cause the grinding.

knee model lateral view labeled

Excessive strain can be caused to the knee during high-volume activities such as running, jumping, or twisting. Athletes often feel knee pain and anterior knee pain is a common injury among soccer players who both run and twist their knee. Anterior knee pain is most common in athletes, people who are overweight, people who have flat feet, and people who have had previous knee injuries. Anterior knee pain is felt among teenagers, mostly female.

There are four common injuries which result in anterior knee pain: chondromalacia of the patella, lateral compression syndrome, quadriceps tendonitis, and patella maltracking. Chondromalacia is the deterioration of the soft tissues under the patella and is often referred to as "runner's knee." Lateral compression syndrome is the misalignment of the kneecap. Quadriceps tendonitis is the inflammation and soft tissue damage of the quadriceps muscles. It mainly occurs at the attachment site to the kneecap, which causes the anterior knee pain. Patella maltracking is an imbalance of the muscles surrounding the knee. The vastus medialis is the muscle on the inside of the knee and the vastus lateralis is on the outside of the knee. If one of these muscles doesn't function properly, the patella gets pulled to the side of whichever muscle is working properly, causing an imbalance and pain in the front of the knee.

Home Treatments

At home the first step is always PRICE: protect, rest, ice, compress, and elevate. Reduce the stress and strain to the knee. Over the counter nonsteroidal anti inflammatory drugs (NSAIDs) as recommended by your doctor can help reduce pain and inflammation. Ice helps block the knee pain and reduce inflammation.

Medical Treatments

NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options, as well. Pain management is not usually required unless stronger medications or joint injections are involved in treatment.

MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries. Severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. Nerve conduction velocity (NCV) testing may be utilized in cases that also involve muscle, sensory or reflex loss.

Conservative Treatments

GT therapy

Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, trigger point therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair.

Iliotibial band Syndrome is common in runners who develop the injury because of weakness and poor stabilization of the leg and hip muscles. Specific knee exercises are given to increase strength and endurance. Proprioception exercises help teach the muscles how to work together again to stabilize the knee during walking or running.

When these treatments are incorporated into a treatment plan, patients heal faster and are less likely to have long-term pain, soft tissue fibrosis, or scar tissue in the injured muscle. These soft tissue treatments are incorporated with therapeutic exercise and flexibility programs.

tissue progression sm

Improve Movements to Eliminate Hip & Knee Pain

The back, hip, and lower extremity work as a comprehensive unit allowing for many of the repetitive tasks you complete at home, work, and during recreational activities. Injuries to one area of the musculature often indicates that additional damage has been incurred by adjacent muscles.

Many therapeutic exercises can help restore proper strength and endurance to the leg muscles. Isometric exercises are often the initial treatment exercises, followed by single plane rubber band exercises for the hip, knee, and ankle: flexion, extension, adduction, abduction, circumduction, inversion, and eversion. Dynamic exercises involving stability foam, rubber discs, exercise ball, and BOSU balls can be performed on the floor. The more unstable the surface, the more effort and stabilization is required of all the lower extremity muscles.

Vibration 2

Vibration plates enhance neuromuscular learning throughout the ankle, knee, foot, hip, and back muscles. Additional strength exercises can be found on the hip, knee, and foot strengthening pages. More information for injuries and treatments for knee pain and foot pain.

Our Chandler Chiropractic & Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.