Front Knee Pain (Anterior): Causes, Symptoms & Treatments

Anterior knee pain is a common problem in the US, affecting over 78 million people. It’s when you feel pain in the front of your knee. Different injuries to your bones and muscles can cause it. But don’t worry, there are ways to deal with it.

In this article, we’ll explain what anterior knee pain is, look at what might be causing it, talk about the symptoms you might experience, and suggest treatments to help you understand and manage this condition.

What Is Anterior Knee Pain?

Anterior knee pain means pain in the front and middle of the knee. It can happen due to different problems like:

1. Chondromalacia of the patella: Softening and wearing out of the cartilage under the kneecap.
2. Runner’s knee (Patellar tendinitis): Common in runners, causing pain around the kneecap.
3. Lateral compression syndrome: The kneecap moves more towards the outer side of the knee.
4. Quadriceps tendinitis: Pain and tenderness where the quadriceps tendon connects to the kneecap.
5. Patella maltracking: When the kneecap isn’t stable within the knee joint.
6. Patella arthritis: Cartilage breakdown beneath the kneecap.

Front Knee Pain Symptoms

Front knee pain can vary from person to person and depends on its root cause. The discomfort can be felt below the kneecap, around it, on the sides, or behind it. The feeling can range from a dull ache to a sudden, sharp pain.

In most cases, you’ll feel pain in both knees at the same time, unless it’s due to a specific injury. Front knee pain tends to get worse when:

1. Standing up after sitting for a while.
2. Squatting or kneeling.
3. Using stairs.
4. Running downhill.

Jumper’s knee may only hurt during physical activity, but if it gets worse, it can become a constant source of discomfort.

On the other hand, an anterior cruciate ligament injury usually causes sudden pain, often with a distinct ‘pop’ sound. The knee can swell quickly, and it might feel unstable.

Osteoarthritis in the knee typically hurts when you put weight on the affected leg, and it often improves with rest. You might also feel stiffness and reduced mobility, especially in the morning or after sitting for a long time.

Conditions like Osgood–Schlatter disease and Sinding-Larsen–Johansson disease cause pain, tenderness, and swelling just below the kneecap, near the top of your shin bone. These symptoms are usually triggered by activities like running or jumping.

What Causes Anterior Knee Pain?

Anterior knee pain can be caused by various factors, some common and others less so. Let’s explore these causes:

1. Runner’s Knee (Patellofemoral Pain Syndrome)

Runner’s knee is a widespread issue that affects not only runners but also people with sedentary jobs. It stems from problems with the movement of the kneecap, making it one of the most commonly observed knee injuries. Symptoms include:

• A persistent ache in the front of the knee.
• A grinding sensation during knee movement.
• Mild swelling at the front of the knee.

Runner’s knee symptoms tend to develop gradually, rather than from a specific injury. They worsen with activities like running, jumping, climbing stairs, and even prolonged inactivity.

2. Chondromalacia Patella

Chondromalacia patella primarily affects young, healthy individuals. It occurs due to inflammation and tearing of the cartilage behind the kneecap, leading to patellofemoral pain. Symptoms include:

• Dull pain in the front of the knee.
• Swelling.
• Clicking and grinding sensations during knee movement.

Chondromalacia symptoms worsen when standing up, engaging in sports, descending stairs, or putting pressure on the kneecap.

3. Knee Bursitis

Knee bursitis arises when one of the small fluid-filled sacs around the knee becomes inflamed. This condition can develop gradually over time and is often seen in individuals who kneel frequently, such as carpet layers, plumbers, and gardeners, but it can also result from a direct blow to the front of the knee. Common symptoms encompass:

• Front knee pain.
• Redness and swelling at the front of the knee, resembling a squashy orange.

Knee bursitis pain intensifies during activities like kneeling, walking, or bending the knee. There are four types of bursitis that can cause swelling in front of the knee.

4. Osgood Schlatter’s Disease

Osgood Schlatter’s Disease is a leading cause of front knee pain in children and adolescents, typically following a growth spurt. The hallmark feature is a tender bony lump in front of the knee, just below the kneecap, leading to front knee pain. Symptoms worsen during sports activities like kicking, jumping, and running but can be effectively managed with stretching programs.

5. Patellar Tendonitis (Jumper’s Knee)

Patellar tendonitis results from damage to the tendon just below the kneecap, often associated with sports involving jumping or kicking. Symptoms include:

• Front knee pain below the patella.
• Aching.
• Stiffness after activity.

In some cases, the patellar tendon may thicken, resulting in a lump in front of the knee. The tendon is typically tender to the touch.

6. Meniscus Tear (Torn Knee Cartilage)

A common cause of anterior knee pain following an injury is a meniscus tear, also known as torn knee cartilage. The meniscus is a thick layer of cartilage in the knee. Symptoms of a meniscus tear include:

• Knee swelling.
• Locking (where the knee gets stuck).
• Instability.
• Difficulty straightening the knee.
• Pain with knee movements.

Front knee pain from a meniscus tear worsens when bearing weight, such as walking or running, using stairs, or squatting.

7. Knee Arthritis

The leading cause of front knee pain in individuals over 50 is knee arthritis. This condition can result from wear and tear, known as osteoarthritis, or joint inflammation, referred to as rheumatoid arthritis. Symptoms of knee arthritis include:

• Morning stiffness in the knee.
• Generalized swelling.
• Knee clicking or grinding.
• Joint stiffness.

These symptoms tend to worsen after periods of rest, in cold weather, and following activities.

8. Plica Syndrome

Often underdiagnosed, plica syndrome occurs when there is inflammation in the folds of the synovial membrane lining the knee joint. Common symptoms encompass:

• Dull, achy front knee pain.
• Knee instability.
• Locking.
• Clicking.
• Stiffness.

Anterior knee pain from plica syndrome typically worsens after activity or knee flexion.

Diagnosing Front Knee Pain

When you see a doctor for knee pain, they will:

1. Ask when the pain started and what makes it worse.
2. Inquire about any injuries or incidents related to the pain.
3. Check for additional symptoms like knee instability, clicking sounds, or pain in other joints.

They might suggest an X-ray or MRI, but often, they can diagnose through an examination and talking about your symptoms.

If cartilage or ligament damage is suspected, they might recommend arthroscopy (keyhole surgery). This involves a small knee incision with a camera to diagnose and potentially repair damaged tissues.

What are the Risk Factors of Anterior Knee Pain?

Here are the things that can make you more likely to have anterior knee pain, also called runner’s knee:

1. Excess Weight: Being overweight adds more strain to your knee joint.

2. Intensive Knee Exercises: Doing activities like football, running, or cycling can lead to knee pain.

3. Previous Knee Injury: If you’ve had knee cap injuries before, you’re at a higher risk of experiencing anterior knee pain.

Front Knee Pain Treatment

Treatment for front knee pain can vary based on the cause. Here are some common options:

1. Rest: Avoid activities that worsen the pain at the beginning of treatment.

2. Ice or Heat Therapy: Apply ice or heat to the knee to reduce swelling and ease pain.

3. Physical Therapy: Strengthening knee muscles can reduce stress and pain. A physical therapist can create a personalized exercise plan for you.

4. Anti-inflammatory Medications: Over-the-counter or prescription drugs can help with swelling and pain if necessary, but try other treatments first.

5. Kneecap Realignment Taping: A therapist or doctor may use taping to realign the kneecap, often along with physical therapy.

6. Surgery: In severe cases, surgery may be needed to fix bone misalignment or other underlying issues causing knee pain.

Depending on your condition and treatment, you may feel better in a few days or weeks. Always consult a doctor before starting any treatment.

Tips To Prevent Knee Pain

1. Choose supportive shoes: Wear shoes with good support and cushioning to ease knee strain.

2. Stay active: Regular exercise strengthens knee muscles, reducing joint pressure and preventing pain.

3. Use knee protection: For activities like running or jumping, use foam padding, knee braces, or gel inserts to protect your knees.

4. Stretch regularly: Improve muscle flexibility around your knees with stretches to avoid pain.

5. Maintain a healthy weight: Extra weight stresses knee joints, so aim for a healthy weight to prevent knee pain.

6. Avoid prolonged knee bending: Don’t sit with bent knees for too long; stand up and move around every 30 minutes to prevent stiffness.

When Should You Contact a Doctor for Front Knee Pain?

You should reach out to a doctor if:

1. Over-the-counter treatments don’t help.
2. The pain lasts for more than a few days.
3. You notice swelling or a change in your knee’s shape.
4. Your knee is red and warm to the touch, which could suggest an infection.
5. The pain is affecting your daily activities.

For more guidance, you may make an appointment with our online pain management consultation.