Ask the physio … knee pain

What Is Anterior Knee Pain And How Do I Manage It?

Why do I have knee pain?
Anterior knee pain is an umbrella term for pain felt at the front of the knee. It is usually linked to the knee cap (patella) region,either directly underneath or to either side.
Mechanism of Injury- how does it occur?
The knee is often referred to as the ‘slave to the foot and hip’. What this refers to is that it is rarely the knee itself that is the cause of the problem, but it takes the ‘brunt of it’ if the hip above or foot below are not moving effectively. Having said this, there are times when knee pain is as a result of direct trauma, such as a fall onto the knee or a direct knock .

SYMPTOMS
Typical symptoms of anterior knee pain include:

• Pain: Felt underneath or at either side of the knee cap. Pain is felt on movement. These areas may be sore to touch also.  It is common to feel pain when bending the knee under load such as up/down the stairs, squats, lunges and jumps.
• Swelling: May be present around the patella.
• Clicking/instability:There may be a sense of instability in the knee often as a result of pain. If the knee has been under strain for a long period there may be a clicking sound that can be heard. This can be due to a small degree of wear and tear or chronic swelling.

DIAGNOSIS
Diagnosis can normally be made by your Physio in clinic without the need for X-ray /MRI (Magnetic Resonance Imaging) or CT (computer tomography) scans. A solid assessment of the knee, foot and pelvis/hip will be required however to determine the best line of rehab based treatment.  Although in most cases pain is related to ‘patella’anterior knee pain can be due to the ‘fat pad’ or ‘patella tendon’. Treatment will be slightly different for each case which is why a thorough assessment is needed.


TREATMENT
Below are the main aims of treatment:

• Reduce inflammation-rest/ ice / compression / elevation / inflammatory medication (after 48hrs)
• Off load the knee area with dynamic taping (directed by your Physio)
• Regain strength at the inside of the knee (VMO) and back of hip as required
• Train proprioceptive/balance feedback to provide stability throughout the leg
• Soft tissue release and home stretches for the calf and/or quads and hips.
• Standing exercises to integrate the foot with the knee, pelvis and trunk.
• Jump and 3D lunge training to prepare for class

RECOVERY
Recovery time is dependent on the severity and chronicity of the injury. If pain has only been present for a short while, return to full dancing can be within the space of a week. For more chronic problems or those conditions where there may be some damage to the patella, recovery will be slower. Dancing will have to be modified as you recover and get stronger.


PREVENTION

Anterior knee pain / patella femoral pain often occurs over time without a singular event. An assessment/screening at your local Physio clinic, especially one versed in the requirements for dance, can assist in picking up any areas of weakness before they become problematic however.If you have felt twinges in the knee, or have had knee pain in the past it would be advisable to have a dance screening assessment to pin point any areas of weakness and iron them out before it becomes a problem.