april2 - Richmond Physical Therapy

Anterior Knee Pain
Matt Pulisic, PT, DPT, OCS
Anterior knee pain is the most common
complaint of knee pain in individuals’
seeking medical treatment. Anterior
knee pain, or pain in front of the knee, is
often called patellofemoral pain
syndrome. The patella (kneecap) forms
a joint with the lower end of your thigh
bone, the femur. Motion at this joint
occurs when the patella glides upward
and downward during straightening and
bending of the knee. Injuries to the
patellofemoral joint are often not
traumatic, but are due to an increase in
physical activity over time, known as
overuse. The pain is often a very
uncomfortable ache over the front of the
knee that can limit ones activity level
significantly. The pain is worse during
activities such as bending, squatting, and
going up/down stairs. These positions
put increased pressure on the
patellofemoral joint.
In order to prevent anterior knee pain
one must identify known risk factors that
may lead to these symptoms. A study in
the February 2012 issue of the Journal
of Orthopedic and Sports Physical
Therapy identified specific areas that
may put one at greater risk for
developing anterior knee pain. The
authors did a systematic review of the
literature identifying over 3845 possible
studies, however, after evaluating these
studies based on specific inclusion
criteria, they selected 7 high quality
articles for review. These 7 articles
assessed 243 patients who had anterior
knee pain and found the most common
risk factor for developing anterior knee
pain to be weakness of the quadriceps
muscle. In addition to quadriceps
weakness, they also found that females
were at greater risk.
Being able to predict who may develop
anterior knee pain is the first step in
preventing this from occurring.
Individuals identified as having weak
quadriceps can be placed on an exercise
program to prevent the occurrence of
anterior knee pain. This would be of
even more importance in active females
with weak quadriceps. Regularly doing
exercises to strengthen your quadriceps
muscle is easy to do and can be done
simply at home.
In addition to quadriceps weakness,
other factors that have been reported to
contribute to anterior knee pain are
flexibility, foot-ankle posture, and
training errors. Your physical therapist
would be an appropriate health
professional to perform a complete
lower extremity biomechanical
evaluation to identify any underlying
risk factors, and discuss your individual
exercise program. Physical therapy care
is a common and effective conservative
means of identifying and treating
anterior knee pain. Feel free to contact
us at your convenience if you have
anterior knee pain or quadriceps
weakness that may predispose you to
developing this during your activities.