Anterior Knee Pain explained
Of all the joints in the body, it is arguably the simplest anatomically, yet to diagnose is one of the most difficult to get right. The knee. But get it right we must! Get the diagnosis wrong, you will give the wrong advice and exercise and potentially make the problem worse. I have heard so many times in social gatherings:
My knee hurts, what is it? What do I need to do?
If only it was that simple! The opening image highlights just 3 pathologies that could affect you, around the anterior (front) aspect of your knee. This does not even consider any ligament or meniscal pathologies! Let's look at them all, one at a time:
1.
"Achy pain in and around the knee cap"
You may present with this problem which is most likely to be patella-femoral joint mal-tracking. In other words: your knee cap may not be tracking in it's groove correctly and certain exercises will help to resolve this in a matter of weeks
2.
"Sharp pain around the outside of the knee, particularly after running or cycling"
You may find this is your problem, which is likely to be ioliotibial (ITB) band syndrome.
The protocol for this is completely different to patella-femoral joint maltracking.
There is currently minimal evidence for the efficacy for exercise intervention in this this pathology directly. It can only be effected indirectly. More on this later!
3.
"Sometimes sharp, sometimes achy, can be below the kneecap"
This is the pain pattern for quadriceps and / or patella tendinopathy.
These are two separate pathologies again. Get this wrong, give the wrong advice and exercise, you'll potentially make yourself worse!
Treat a quadriceps tendinopathy like it is a patella tendinopathy and you will make your pain worse.
Any patterns?
You are twice as likely to have patella-femoral pain than you are to have patella tendinopathy and Iliotibial band combined!!
40% of runners are likely to suffer from knee pain. Compare that to 25% of footballers and 5% of cyclists. It is noteworthy that there is no data available for swimmers. It is highly known that breaststroke will give you knee pain!
As I have said before and as I assess in all of my clients:
Anterior knee pain usually stems from excess hip adduction, or weak gluteals!
Why do people get knee pain?
People try to climb the mountain too fast too soon! As opposed to climbing the mountain up the steady slope. All exercise should be graded and gradual! It's a marathon you're training for, not a sprint There you have it. Knee pain isn't simple. There are patterns, there are similarities. But it isn't as simple as giving out quadriceps strengthening exercises. Always get an assessment from your local, friendly experienced physiotherapist to accurately diagnose your knee pain and rehabilitate you correctly and expediently.
