Anterior knee pain is a common complaint, affecting people of all ages and activity levels. Whether you're an athlete, a weekend warrior, or someone simply going about your daily activities, pain at the front of the knee can significantly interfere with movement and quality of life. One of the challenges in diagnosing and treating anterior knee pain is that it can originate from various structures around the knee, each contributing in different ways.

In this blog, we’ll break down five key structures that can be the source of anterior knee pain, helping you better understand the potential causes and how they might relate to your symptoms.

1. Patellofemoral Joint (PFJ)

The patellofemoral joint, where the patella (kneecap) moves over the femur (thigh bone), is often the main culprit in anterior knee pain. This joint is crucial for knee movement, but it’s also prone to stress and dysfunction, particularly with repetitive activities or poor movement mechanics.

Common causes of pain:

• Patellofemoral pain syndrome (PFPS): This is often caused by overuse, improper alignment, or weakness in the muscles around the knee, especially the quadriceps. It results in pain around or behind the kneecap, particularly with activities like climbing stairs, squatting, or sitting for prolonged periods.
• Patellar tracking issues: When the patella doesn’t move smoothly in its groove on the femur, it can cause friction and pain. This misalignment can occur due to muscle imbalances, tightness in the IT band, or even an imbalance in the hip or ankle.

2. Patellar Tendon‍

The patellar tendon connects the bottom of the patella to the tibia (shinbone), and it's an essential structure for transferring force during activities like running, jumping, and squatting. Overuse or excessive load on the tendon can lead to pain and inflammation.Common causes of pain:

• Patellar tendinopathy (Jumper’s Knee): This condition occurs when the tendon becomes irritated or degenerated due to repetitive stress, especially in sports that involve jumping or running. Symptoms include pain just below the kneecap, especially during physical activities.
• Tendinitis: Inflammation of the tendon, often resulting from acute injury or overuse, can also cause pain that may worsen with activity.

3. Quadriceps Muscle and Tendon

‍The quadriceps is the large muscle group at the front of the thigh, and its tendon attaches to the top of the patella. This muscle group plays a crucial role in knee extension and stabilisation. Tightness, weakness, or imbalances in the quadriceps can contribute to anterior knee pain.Common causes of pain:

• Quadriceps tendinopathy: Overuse or excessive load on the quadriceps tendon can lead to pain and tenderness at the top of the patella.
• Muscle imbalances: Weakness or poor activation of the quadriceps can lead to abnormal movement patterns at the knee, placing stress on the patellofemoral joint and leading to pain.
• Tight quadriceps: Shortened or tight quadriceps muscles can alter knee mechanics and increase stress on the knee joint, leading to discomfort.

4. Iliotibial (IT) Band

‍While the IT band is often associated with lateral knee pain, it can also contribute to anterior knee discomfort. The IT band is a long, thick band of connective tissue that runs down the outside of the thigh and attaches to the tibia. If it's tight or irritated, it can influence knee mechanics and lead to anterior knee pain.Common causes of pain:

• IT band tightness: Tightness in the IT band can affect the position and tracking of the patella, leading to patellofemoral pain. It can also increase friction between the patella and femur.
• IT band syndrome: Although more commonly associated with lateral knee pain, tightness in the IT band can cause symptoms that radiate to the front of the knee, contributing to anterior knee pain.

5. Bursa and Synovial Fluid

‍Bursae are small, fluid-filled sacs that reduce friction between tissues like muscles, tendons, and bones. In the knee, there are several bursae that help cushion and reduce friction. However, these bursae can become inflamed (bursitis), leading to pain and discomfort around the knee.

‍Common causes of pain:

• Prepatellar bursitis: This occurs when the bursa in front of the kneecap becomes inflamed, often due to repeated kneeling or direct trauma to the knee.
• Infrapatellar bursitis: Inflammation of the bursa just below the kneecap can cause pain that may worsen with activity or prolonged kneeling.

At Movement Therapy, we understand that anterior knee pain can stem from a variety of sources, and effective treatment requires a holistic approach. Our tailored treatment plans are designed to address the underlying causes of pain, whether it’s muscular imbalances, poor joint alignment, or overuse injuries.We take a comprehensive approach, combining techniques like:

• Manual therapy to release tight muscles and improve joint mobility.
• Movement retraining to address faulty movement patterns and improve overall mechanics.
• Strengthening exercises to address muscle weaknesses and provide better support for the knee joint.
• Education on proper posture, movement techniques, and injury prevention strategies.

By addressing all aspects of knee function, we can help reduce pain, restore normal movement patterns, and get you back to your active lifestyle without limitations. Anterior knee pain can be frustrating, but understanding its potential causes is the first step toward effective treatment and recovery. If you’re experiencing knee pain and haven’t been able to find relief, it’s worth considering all the structures that might be involved. At Movement Therapy, we’re committed to helping you identify the root cause and develop a personalized treatment plan to get you back to full function.