The Battle with Anterior Knee Pain
It is finally here, the start of athletic events post quarantine. While you may be focusing on keeping your immune system strong and taking all the necessary COVID precautions, you may be unaware about the potential for increased lower body pain or injury due to a prolonged break from working out or sporting activities. Whether you are an elite soccer player or weekend warrior, you probably have or know someone that has experienced anterior knee pain.
What is Anterior Knee Pain
Anterior knee pain is any form of knee pain that occurs at the front center area of the knee. This common condition that occurs in both athletes and non-athletes and is a frequent reason for patients to experience knee pain and come into my clinic for an evaluation.
Although the term is broad, there are 2 main conditions that encompass anterior knee pain around the patella (i.e., kneecap). The first diagnosis is peri-patellar pain associated with the soft tissues around the patella (runner’s knee) with or without patella chondromalacia, and the second diagnosis is patella femoral mal-tracking where the kneecap tends to not move centrally in its groove (aka femoral trochlea) which can sometimes become most pronounced by a dislocation event. Both conditions are related to the patella and how it moves within the groove which can cause subsequent pain secondary to the associated cartilage and soft tissue pathology.
Why am I at higher risk?
Let`s face it, training is not the same as competition. Despite your best effort, it is hard to replicate the stresses of competition during training especially without access to gyms, specialized equipment, and obstacles.
Specifically, both aforementioned conditions are typically caused by long-standing pain or acute injury producing biomechanical imbalances that result in movement and neuromuscular deficiencies, including gluteal, quadriceps, and hamstring dominance or weakness. Often the patella can become disproportionally overloaded through these biomechanical deficiencies, especially in the setting of quadriceps dominance or imbalance.
How do I treat it?
The best treatment is always prevention; however, once pain or an injury occurs, we must spend time analyzing the entire source of the problem.
Whenever I talk to my patients about resolving musculoskeletal pain, in fact, I spend significant time analyzing the cause-and-effect issues associated with their problem. If we always treat the effect, then the patient will always be susceptible to recurrent pain as the causal factors are never appropriately addressed. Therefore, we must always take a more holistic approach to managing musculoskeletal pain or injury through modification of imbalances through extensive physical therapy, recovery, and the possible utilization of assistive devices rather than just treating the problem with rest, ice, and ibuprofen. In terms of physical therapy, we must assess and treat muscle atrophy and imbalance through rehabilitative programs designed to obtain proper strength, neuromuscular control, and enhanced movement patterns. These programs can even be augmented and enhanced through the utilization of certain types of knee braces that have been designed to specifically optimize knee biomechanics, including those causing patellafemoral issues, through evidence-based research.If you have any serious issues you should follow up with your doctor or orthopedic surgeon.