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.