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Anterior Knee Pain

What is Anterior Knee Pain?

Anterior Knee Pain is a general term used to describe pain originating from the structures at the front of your knee.

The most common structures that cause pain in this area are the patellofemoral joint (between your knee cap and your thigh bone), and the patella tendon (which attaches your thigh muscles to the bone, just below the knee cap).

Symptoms are localised to the front of the knee and are typically aggravated with activities such as squats, going up and down stairs, or high impact exercises such as running and jumping.

What causes Anterior Knee Pain?

Research shows that the biggest risk factor for developing patellofemoral joint pain is weakness of your quadriceps (the muscles at the front of the thigh which help to extend the knee). Because these muscles help to support the knee and are important in controlling how the kneecap moves, weakness of these muscles can lead to dysfunction of the joint.

However, weakness is unlikely to be the only contributing factor in developing pain, and it is likely that lifestyle and activity levels are also important considerations.

This is certainly true for the patella tendon, which typically becomes painful when it is overloaded through high impact or repetitive activities. This is called a “Patella Tendinopathy.” For more information on this, visit our page on Patella Tendinopathy.


How is this problem treated?

Research shows that the most effective treatment for anterior knee pain is a combination of activity modification and exercise therapy.

Activity modification aims to reduce further overloading of the structures at the front of the knee. This often means taking a period of “relative rest” during which you should refrain from activities which cause significant discomfort such as running and jumping, whilst continuing comfortable, lower impact exercise to maintain fitness and tissue health.

Please note, this will be different for everyone and you should be guided by your own symptoms. Any activity which causes significant discomfort which does not settle quickly once you stop, should be temporarily reduced or avoided.

Once symptoms begin to settle (usually after a few weeks of relative rest), exercise therapy should be commenced. This aims to strengthen the muscles that support the knee and gradually increase the amount of load that the knee can tolerate. Research shows that the most effective exercises are those which target the quadriceps muscles, as well as the muscles around the hips.

Below are a selection of exercises which are safe and appropriate to try in the early stages of your treatment.

These exercises should not cause significant or prolonged discomfort. If this is the case, reduce the number of repetitions to a comfortable level. You should build the number of repetitions up gradually, being guided by your symptoms.

It is important to remember that these problems take time to resolve. It often takes several months for symptoms to fully settle and for you to return fully to your previous activities, therefore it is important for you to persist with exercises.

If your pain is not settling and you feel you require further help or advice, you can self-refer here.