Pain at the front of the knee can come from many different things:
1. The knee cap or patellofemoral pain. This is the joint when the knee cap meets the thigh bone. The knee cap is supposed to sit in a small groove. However sometimes this alignment can be affected, known as patella maltracking. Pain is usually behind the knee cap and felt with tasks such as going down stairs, squatting, walking or running.
The cause may be due to poor hip stability and strength as it is the hip muscles that keep the leg straight. Careful assessment is needed to decide which muscles are not doing there job. Specific exercises can then be given to the problem area. Control of the foot and also be a big contributing factor. If you roll too much in or out in the foot then the whole of the leg above rolls aswell. This excessive rolling can result in the kneecap then being placed in the wrong position. Taping of the foot can mimic an orthotic. If this helps considerably to relieve pain then a basic orthotic (either a simple one bought from a sports shop or chemist, or a more specifically designed one from your physio or podiatrist) is worth investing in as a temporary support. This is until you are able to strengthen up the foot and ankle muscles that should be doing the job of controlling your foot.
2. Patella Tendinopathy. The patella tendon is what attaches the front of thigh muscle frm the knee cap to the shin bone. It is unually injured where it attaches to the knee cap. This usually happens after increasing your exercise too quickly or by too much. Pain is often with jumping or squatting activities, that is, when the quadricpes (thigh muscle) is contracting. A huge amount of research has gone into patella tendinopathy here is Australia at the Institute of sport. Squatting on a downward sloping surface was shown to particularly help in recovery and should be a hug must do exercise in rehab.
3. Fat pad Impingement. There is a small fat pad that sits just below the knee cap. It acts as a space filler between the patella tendon and the shin bone underneath. Sometimes the bottom of the knee cap can dig into the fat pad. This is usually felt as the knee straightens, for example as you push off as you run or walk, swimming as you kick the leg straight, or standing if you lock your legs too straight. A simple taping technique can be used, which once you are taught what to do, is very easy for you to do yourself. This works to tilt the knee cap in the opposite direction taking the pressure off the fa pad allowing it too heel.
4. The knee joint. The meniscus is the shock absorbing cartilage in between the thigh and shin bone. This can become injured, usually in a twisting incident. Pain from the structure can refer to the front of the knee. Likewise wear and tear in the knee joint can also refer. The joint is usually generally sore through the whole front of the knee, but with a deeper pain. There is usually a general swelling of the knee.
5. Never forget to check the hip. Yes - the hip joint can also send pain down to the knee so if you have full movment of your knee and it seems you can't manage to reproduce the pain in your knee, you must check out your hip. This is so often missed but a good sports physiotherapist will always check your hip out as well as assessing you knee.
Correct diagnosis is essential. At Physiologix, our Sports Physiotherapists will help you figure out exactly where you pain is coming from and then give you a bunch of things you can do to start getting you back on track: from advice on what you can and cant do, to taping, to exercises. Call us on (07) 3511 1112 or email us from the contact page of this website.