Anterior Knee Pain: Why?

Anterior knee pain can be quite painful if left untreated. In our anti-inflammatory crazed society, it is common to pop a few pain killers and go on your way without actually addressing the problem itself. What many people don’t realize about anterior knee pain is that it may not be caused from a knee-related issue. The lower body needs to be evaluated as a whole to determine what is the actual cause of this type of pain. In cases of pain surrounding the patella or along the patella tendon itself, function of the ankle and hip joints will dictate how much stress is placed on the knee. Here are a few examples of why this is:

Ankle Plantar and Dorsiflexion

When the ankle lacks dorsiflexion (pulling your toes and ankle up towards the shin), it causes the knee to rely on a greater range of motion to accommodate. This is a common fault easily seen in people who perform a squat and their knees come over the toes, or immediately their heels lift off the ground. Hmm, interesting! Doesn’t the heels lifting off the ground sound familiar? Think about much of the footwear we wear on a daily basis, such as high heeled shoes in women. Could your anterior knee pain be a result of ankle range of motion lost from wearing improper footwear?
Hip Internal Rotation

The hip is another joint which greatly affects the function of the knee. The squat and lunge are great patterns to detect whether the hip is properly stabilizing during movement. When you see the knee collapse inward (valgus collapse) this could reveal an issue with the core not stabilizing the pelvis, the hip stabilizers not controlling the femur, or the lack of hip internal rotation. All or one of these issues will cause the knee to default to an alignment that increases stress on the joint

The first step to is figure out what exactly the issue is and that calls for an evaluation from a medical professional. We know the knee hurts and need to first rule out there isn’t any deeper knee pathology, such as chondromalacia patella, or meniscal injury. If other knee issues are ruled out and structurally the knee proves to be stable, we must evaluate the joints above and below. Here is a previous article I wrote about self-assessing and treating the ankle, which has easy to follow videos on determining if the ankle may have restricted range of motion. Movement again is a great way to determine if the hip joint is dysfunctional. You could either take a look at the squat or lunge patterns to determine if the knees collapse inward during the movement. Here are pictures of people with this issue for you to see what I mean…

Valgus Collapse During the Lunge

Valgus Collapse During the Squat

After looking at the ankle and hip joint in one of the above movement patterns, you probably have an idea of where you issue may be. Fortunately for those with an ankle dorsiflexion restriction, a series of ankle mobility exercises were giving in my previous post here. If the hip was clearly your dysfunctional joint, be on the lookout for my next post called Self-Treatment of the Hip to Fix Anterior Knee Pain.

Garrett McLaughlin is an Athletic Trainer, Personal Trainer, and Certified Active Release Techniques Provider in the Greater Nashville area. In addition to fitness and rehabilitation, Garrett compliments his programs with soft-tissue manual therapy to help his clients restore proper function and stay injury-free. For more information, contact Garrett.