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Tips for reducing & preventing Anterior Knee Pain

Tips for reducing & preventing Anterior Knee Pain

Anterior knee pain is a very common condition and we treat many cases here at the clinic. 

The pain and dysfunction are usually related to the patellofemoral joint and needs to be treated carefully and specifically.

Here are some tips to help you get started:

knee 2768834 640Out and about

  • Stop and sit down for a rest before you knee gets sore
  • Plan your day so you are not on feet for long periods at a time
  • Avoid steep steps if possible, if not do them one at a time

Sitting

  • Avoid sitting with the knee bent beyond a ninety-degree angle eg in the car, at desks etc.
  • Get up and take a short walk every 20 minutes

Sports

  • Only do sports/ exercises which do not aggravate the knee pain during or up to 24 hours afterwards.
  • Running and jumping sports are most likely to aggravate
  • Be careful if doing gym exercises that involve bending and straightening the knee against resistance, your physiotherapist may prescribe specific exercises (see below).
  • If your knee is sore or swollen after exercise: rest, apply an ice pack for 20 minutes over a damp tea towel to the front of the knee, repeat 3 times. Do not continue with any sports until after your next physiotherapy session/review.
  • Allow at least 2-3 complete rest days each week.

Biomechanics

  • Your lower limb biomechanics including hip and pelvic control, knee alignment as well and ankle and foot posture may be contributing to your anterior knee pain if this is suspected a lower limb biomechanics assessment will be recommended.
  • It may be necessary to prescribe a prescription insole/orthotic to help support the ankle and foot which in turn will reduce strain to the knee. 

Medication

  • Applying a topical anti-inflammatory gel around the knee caps can help with pain and swelling - please check with a pharmacist for recommendations.
  • A course of stronger oral anti-inflammatories are sometimes required, your physiotherapist will advise if this may be necessary and arrange a GP visit if required.

Icing

  • If the front of the knees are tender, puffy/swollen or discoloured apply an ice pack for 20 minutes over a damp tea towel to the front of the knee, repeat 3 times - do not exercise the knees until the pain and swelling have settled.

Strengthening exercises

  • Anterior knee pain is usually associated with strength and stability deficits about the lower back, hips and pelvis, as well as inner thighs and ankles. Specific graded exercises will be prescribed to correct this if required. Please do the exercises regularly as prescribed and inform your physiotherapist if you are having any difficulty with the exercises.
  • Please do not try to progress on your own or do any other exercises before discussing with your physiotherapist.

Physiotherapy

  • Depending on the assessment findings, a course of 4-6 physiotherapy sessions may be required.
  • In addition to providing advice and education as well as appropriate exercises, other techniques such as electrotherapy, manual therapy, medical acupuncture including dry needling may be necessary to assist the healing and recovery process. Your physiotherapist will discuss whether or not a course of treatment will be required at your initial assessment.

Iy you have any questions, please get in touch.

By Lorraine Carroll MPhyty, BSc Physio, CMA

Chartered Physiotherapist

Image by Angelo Esslinger from Pixabay 

References:

Brukner P. Brukner & Khan's clinical sports medicine. North Ryde: McGraw-Hill; 2017

Dolak KL, Silkman C, McKeon JM, Hosey RG, Lattermann C, Uhl TL. Hip strengthening prior to functional exercises reduces pain sooner than quadriceps strengthening in females with patellofemoral pain syndrome: a randomized clinical trial. journal of orthopaedic & sports physical therapy. 2011 Aug;41(8):560-70.

Earl JE, Hoch AZ. A proximal strengthening program improves pain, function, and biomechanics in women with patellofemoral pain syndrome. The American journal of sports medicine. 2011 Jan;39(1):154-63.

Nascimento LR, Teixeira-Salmela LF, Souza RB, Resende RA. Hip and knee strengthening is more effective than knee strengthening alone for reducing pain and improving activity in individuals with patellofemoral pain: a systematic review with meta-analysis. journal of orthopaedic & sports physical therapy. 2018 Jan;48(1):19-31.

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