Anterior Knee Pain
Anterior knee pain is one of the most common types of knee pain that we, as physiotherapists and osteopaths, come across. Not only is it common but it is also difficult to treat as the condition is complex. Rehabilitation of the anterior knee compartment syndrome often lasts for weeks and below is a brief outline of what anterior knee pain is and what causes it and some simple self-help exercises to help with the rehabilitation.
Pain in most cases (but not all) is due to degenerative changes happening at the knee. There are many reasons for these changes but the 2 most common ones are:
Not all knees are the same, and in most of us our left knee is not the same as the right knee. The shape of the knee determines how loads are transferred through the joint. Common factors affecting the shape of our bones/joints are: genetic, working environment, fractures, age, nutrition and diseases like arthritis, gout, rheumatism etc.
Traumatic injuries usually occur suddenly and are often associated with injuries to other knee structures. Examples of traumatic injuries vary from a simple stumble on the pavement to skiing or road accidents.
How is an anterior knee pain diagnosed?
The most effective way of assessment is through a comprehensive history taking of the pain and any other symptoms. This is then followed by examining the affected joint and how it behaves under strain/load etc.
It is also very important to be aware that diagnostic imaging (X-ray, MRI, ultrasound) usually does not show structural changes that could cause the reported symptoms.
Treatment of anterior knee pain syndrome:
During the acute phase – resting and if inflamed, icing the knee are important. Avoid any painful movements in the first 24-48 hours. Then gradually start moving the joint and get back to normal weight bearing movement as soon as possible.
During the chronic phase – it is important to keep the knee moving and exercising to keep the muscles in good tone.
The recovering knee requires a gradual progression of the load, which gives it the ability to adapt to future work in more difficult conditions.
It is worth noting that rehabilitation only in the pain-free range and giving up exercise when experiencing slight pain does not lead to an improvement in the condition.
My top exercise for anterior knee pain?
Squatting is a fundamental human movement pattern that involves nearly every muscle in the body. Squats are one of the best functional exercises out there, promoting mobility and balance to help complete day-to-day activities, while also helping to burn fat and build muscle. If there was one exercise that should be included in everyone’s workout routine, it should be the squat. Bodyweight squats can be performed virtually anywhere with no equipment required, and is a movement that can be carried over into everyday life. It’s important for the bodyweight squat technique to be good before progressing to weighted squats.
- Stand with feet hip-width apart and feet slightly pointed outwards
- Place hands in front of the body or on hips for balance
- Place body weight back on the heel of both the feet and lower butt to the ground as though sitting back on a chair
- Maintain neutral spine, keep chest up and feet flat on floor
- Lower to a 90° position at the knee or full range of movement
- Pushing weight through the heels, return to starting position
A good start would be to do 30 repetitions a day. These can be spread out through the day for example a set of 10 repetitions 3 times during the day.
- Start seated in a sturdy chair, feet planted on the floor about hip-distance apart.
- Using as little assistance from hands or arms as possible, engage your core, and tip forward from the hips.
- Press your weight through all four corners of your feet and push yourself to stand, extending your knees and hips fully.
- Reverse the movement, pressing your hips back and bending your knees to carefully lower yourself to the seated position.
A good start would be to do 20 repetitions a day. These can be spread out through the day for example a set of 5 repetitions 4 times during the day.