The Self-Rehab Guide to Anterior Knee Pain

The Self-Rehab Guide to Anterior Knee Pain

About 1 in 4 people will experience some bout of pain around the front part of their knee in their life, and it's even more likely among athletes.  This type of pain is commonly called patellofemoral pain, but that's quite frankly, a garbage can term. Not in a bad way, but as an easy catch-all collection of medical phrases for anterior knee pain.  

We could get specific and talk about fat pad impingement, patella alta and baja, patellar mal-tracking disorder, or chondromalacia. Yet, there's no need to untangle all those words since they have the common underlying issues of too much pressure or not enough stability.

Why Does The Front of Your Knee Hurt?

To start, let's review the knee for a better understanding of how and why it hurts.

(For a more in-depth review, check back to our knee anatomy guide.)

The fundamentals are that the knee plays a middle man between the ankle and hip. It helps to disperse loads from the ground up (like jumping) and from the body back down (like landing.) Because it is the middle man, if there are issues above or below (at the hip or ankle,) the knee gets the brunt of it.

Specifically, at the front of the knee, the kneecap is the critical structure that gets tied with anterior knee pain issues.  But again, the problem isn't usually the knee cap, but it's purely the messenger that something is not right.

If we look at a list of common impairments for knee pain, the major ones don’t involve the knee, but are related to strength and mobility above and below the joint. 

Common Impairments for Knee Pain

  • Quadricep and hamstring flexibility
  • Pronation of your foot (how far can you turn it inwards)
  • Hip Strength 
  • Hip Mobility 
  • Ankle Range of Motion 

Yet, even with those impairments, you would likely never notice pain if you never put your knees to work. But since you do fun things—like bike, hike, and run—those impairments result in magnified loads across the knee. These extra forces become a problem for the pulley system provided by the kneecap, and after enough time or reps, pain ensues in the area.

How do You Fix Anterior Knee Pain

The great news about anterior knee pain, in any form, is that it responds very well to relative rest, mobility, and strength work. 

Step one with rehabilitating the knee is nearly the same as any other and that is relative rest.  That means to keep up with everything you love to do, but if squats are particularly aggravating, take two weeks away from the painful stimulus and let your body recover. 

This downtime provides a window to correct things that may be going wrong. Here are a few easy tests that can help isolate if you need to work on strength or flexibility at the hip and ankle joint:

Modified Thomas Test

Hip Drop Test

Ankle Mobility Assessment

Next, address the strength of the hips and leg muscles to better handle the demands of your activity.

The Crossover Symmetry Hip and Core system encompasses some of the most effective exercises to improve motor control of the hip and strength. These exercises have the highest level of EMG activity of the rotators and abductors of the hip and challenge your hip and core muscles in several different positions. They are also easy on the knee and can be started early in the rehab process.

Then lastly, the key to returning to your sport or activity is not too much too quickly—plan for a period of "rebuilding" where you slowly introduce load. An easy rule of thumb is a 10% increase in volume or intensity without regression in pain. 

Don't Fret.

If the front of your knee hurts, it's usually a good prognosis.

Despite all those ominous words, it comes down to giving your body time to rest and finding the strength and mobility that you're lacking.

There's a good chance you can tackle this on your own, but of course, see a medical professional to assess and give you personal direction to solving your knee pain issue.

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