Anterior knee pain or patellofemoral pain syndrome (PFPS) is simply the name given when pain is felt in and around the front of the knee. Many different parts of the knee cause anterior knee pain which are referred to with different terms. Some of which are listed below:
- Patella tendinitis
- Patella tendinopathy
- Knee arthritis
- Pre-patella Bursitis
- Chondromalacia Patella
- Osgood-Schlatter's disease
- Patella instability
Anterior knee / patellofemoral pain often develops when the area is overloaded or overworked beyond its ability to cope, such as starting or increasing a sport or activity. Often your symptoms can be caused from areas other than your knee, and can include your feet up to your hips.
The most common symptoms of anterior knee pain / patellofemoral are:
- Pain in and around the front of the knee
- Pain felt behind the knee cap
- Pain increased on squatting activities
- Pain increased when going up and down stairs or hills
- Pain increased when getting up after sitting for a while
- Pain increase on or after impact activities such a jumping / running
- Pain on kneeling
Diagnosis is usually made from a consultation with your Health Care Professional, involving a detailed history of the onset of symptoms, current pattern of symptoms and your current functional ability.
Images/scans are generally not needed to confirm anterior knee pain. One may be performed if the Health Care Professional needs further information to finalise the diagnosis or if surgery is being considered.
The primary aim of treatment is to help manage your pain. This allows you to move more and help you return to normal activities sooner. Initial treatment therefore is aimed at pain control. This might involve pain medication, or the use of heat or cold treatments.
Once your pain is under control, working on the movement, strength and stability of your knee is what will help long term return to normal activities.
You can help to reduce pain, ease stiffness, strengthen your muscles and improve overall general fitness by keeping active. Below are some basic exercises specific to your knee to get you started.
It is normal to experience some discomfort when doing exercises, and individuals may start at different points. Pain should not increase excessively during or immediately after the activity. Discomfort should return to pre-activity levels 24-48 hours after the activity has finished.
The number (reps) and frequency (sets) of exercises suggested here are a guide, and should be performed to your personal tolerable pain levels. This means repetitions will vary between individuals and you should only go as far as is reasonably comfortable for you.
Seated knee extension
Sit upright on a chair. Slowly straighten your affected knee, pointing your toes towards the ceiling. Control the movement as you slowly lower the leg back down.
Knee flexion & extension in sitting
Sit on a chair and slide your affected foot along the floor by bending the knee. Bring your foot under the chair and then extend it out as far as you can comfortably and return to the starting position and repeat as directed. You can place a towel under your foot to assist in performing this exercise if desired.
Inner range quadriceps
Sit upright with your legs out in front of you. Place a yoga block under your affected knee. Slowly lift your heel up off the floor, straightening your knee while keeping the back of your leg on the towel. Hold this position, then control the movement as you lower the foot back down again.
Unless you have a serious injury or have sudden continuous severe pain, you can usually treat your knee pain without having to see your doctor. If after 2 weeks of treating yourself you feel the pain isn’t any better or is worsening, you should see a Health Care Professional
You should also see a Health Care Professional if you:
- Have pain that doesn’t show any signs of improvement, within a couple of weeks of self help
- Have pain that has rapidly deteriorated or suddenly worsened despite self help
- Have pain, tingling, numbness or weakness in your legs and feet
- Develop sudden stiffness in the knee resulting in a complete loss of movement (also known as locking)
- Are noticing changes to your balance or walking pattern
- Are feeling clumsy or are falling more often
- Have a history of inflammatory arthritis, immuno-suppression, cancer, Tuberculosis (TB), drug abuse, AIDS or other infection
- Feel unwell, have a fever, or unexplained weight loss
- Are experiencing significant and regular changes to your usual sleeping pattern
- Have a history of recent injury (e.g. from a road traffic accident or a fall) or a history of knee surgery
- Have a new and visible deformed or misshapen knee
- Your knee is giving way
If you do not have any of the above, you may be able to effectively self manage your condition.