What Is Anterior Knee Pain?

Knee pain has can be dressed up in many differenttests the leg should be relaxed.
guises. Whatever someone decides to call it, all weOne of the main culprits behind the altered positioning
need to know is that it usually occurs on the front ofof the patella is a weakness in vastus medialis obliqus
the knee and it hurts!(VMO). This muscle attaches medially (to the inside)
The pain is normally associated with running, walkingon the patella with weakness here allowing the patella
down hills/stairs, or sitting with a bent knee for longto drift laterally (outwards). This muscle is the first of
periods of time. This is due to an alteration in thethe muscles to waste following injury and lack of use
biomechanics of the knee which is usually caused byof the quadriceps muscles. The quadriceps muscles
an imbalance in the soft tissue structures.can start wasting within 24 hours of non-use!
The pain within the knee joint usually increases whenTreatment may therefore consist of strengthening
the quadriceps muscles work eccentrically (meaningof the VMO muscle to alter the pull of the quadriceps
the muscles working as they get lengthened). Thison the patella thus correcting its position.
exerts a large force through the patella (knee cap)Likewise shortening of vastus lateralis which attached
when the muscles are used this way. The large forceto the lateral aspect of the patella may also result in
presses the patella against the femoral groove, whichan outward pull on the patella again affecting the
if not located correctly causes pain.Q-angle. Treatment here would consist of heat,
Mal-tracking of the patella within the femoral groovestretching and massage to normalise the length of
is the most common cause of anterior knee pain.the muscle. In extreme cases surgery may be
This is like a train being driven off its rails which willrequired to 'release' the muscle to allow the patella to
lead to a bumpy and uncomfortable ride! Anre-position itself correctly.
imbalance in the pull of the quadriceps musclesOther causes of anterior knee pain from the
(vastus medialis, vastus lateralis, vastus intermediuspatella-femoral joint include
and rectus femoris) which attach to the patella can" Tightness in certain structures (e.g. calf and
alter its position.hamstring muscles).
The angle of pull of the quadriceps muscle through" Altered hip, knee or foot posture.
the patella is known as the Q-angle. The Q-angle is" Anatomic variations such as a shallow
determined by drawing a line from the ASIS (bonypatella-femoral groove.
point on the front of the pelvis) to the midpoint ofIf knee pain is left untreated the articular surfaces of
the patella with a second line being drawn from thethe patella-femoral joint may, in some cases, become
centre of the tibial tubercle (flat piece of bone belowaffected and worn, exacerbating the problem.
the knee cap) to the middle of the patella. The pointThese are just a couple of examples of causes of
where these two lines cross is known as the Q-angleanterior knee pain. To have your specific condition
which should be 13Ú in males and 18Ú indiagnosed correctly it is advised that you seek
females. Anything outside these ranges could be themedical advice from a professionally qualified
cause behind knee pain. Note when performing thesepractitioner.