Anterior Knee Pain - How Physiotherapy can help! - Fighting Fit Physiotherapy Nerang Gold Coast

You might be wondering, what is anterior knee pain and can physiotherapy help?

The answer to that question is there is no clear definition as patients can present with different symptoms but physiotherapy can definitely be helpful.

Let’s break it down.

To make anterior knee pain easy to understand, we have to generalize it as pain in the front and middle aspect of the knee.

This knee pain on the front of the knee can be caused by a multitude of conditions such as patellofemoral pain syndrome, overuse injuries, chondromalacia patellae, Osgood-schlatter’s, knee bursitis, patellofemoral instability, patellofemoral osteoarthritis, quadriceps tendinopathy, and iliotibial band syndrome.

Also, 25% of the general population may have a form of anterior knee pain with athletes that are runners or jumpers having higher incidences (Crossley et al., 2016).

In general, patients with anterior knee pain may present very differently with symptoms such as having a functional deficit, crepitus (clicking,popping, crackling), and instability.

Oftentimes normal activities of life such as walking down stairs, squatting, and sitting for long periods of time in a bent knee position can make pain worse.

If you have any of these diagnoses and pain in the front of your knee, you may be thinking what can I do about it?

That’s what we are here to discuss.

Assessment and Diagnosis

When looking at anterior knee pain, we need to provide a thorough assessment to target the patient’s problems in order to properly manage physiotherapy.

This begins with obtaining a strong history of the patient.

Patient History:

Detailed discussions regarding the onset, duration, and nature of symptoms, along with any previous knee injuries/surgeries, are vital.
It should be noted that individuals with anterior knee pain often complain of pain with running, squatting, ascending and descending stairs, and following periods of prolonged sitting.
By getting a detailed history of what is causing the pain, we can do a physical exam that can look at what is causing it.
It can also be good to look at imaging like X-rays or MRI’s to see if structural damage has been done since this can affect treatment.

Physical Examination:

Clinicians evaluate range of motion, tenderness, swelling, and strength deficits.
It is also imperative to identify biomechanical, muscular, and myofascial impairments that can guide treatment and this information can be obtained from the clinical history.
Some symptoms that patients with anterior knee pain may experience are tenderness on palpation at the infrapatellar tendon and fat pad, tibial tubercle, and suprapatellar quadriceps tendon.
Functional tests assessing squatting or stair climbing may be conducted to gauge the impact of pain on activities.

Physiotherapy Management

The primary goal of physiotherapy in managing anterior knee pain is to alleviate pain, restore function, and prevent future recurrences. Key components include:

1. Pain Management

Activity Modification: Load management is extremely important to anterior knee pain treatment as movements like stairs, squatting, running, and jumping are usually associated with symptoms. So it is important for patients to be advised to modify or reduce aggravating activities while maintaining general mobility and fitness levels. A way that can monitor this is by scaling their pain level from 0-10 on how painful that activity is and should avoid activities or movements that cause greater than a 5/10. A pain of 2-5 is okay but still

2. Strengthening Exercises

Targeted Exercises:

Therapeutic exercise for anterior knee pain has the best evidence supporting it for physiotherapy management.

Strengthening the quadriceps, hamstrings, and hip stabilizers is critical and has shown to reduces short term and chronic pain while improving functional capacity for the medium to long term.

Closed-chain exercises, such as squats and step-ups, are particularly effective as they are generally better tolerated and promote functional movement patterns.

Physiotherapists should also provide exercise and education around fear avoidance as many patients will struggle with performing a movement like a lunge or deep squat which puts immense pressure on the knee.

This should be highly individualized for the patient to gain confidence as their symptoms and strength improve.

3. Education

Patient Education:

Teaching patients about their condition, expected recovery trajectories, and self-management strategies is critical for long-term success.

Clinicians should also target barriers to treatment, which can be hindering their exercise and daily activities. From evidence, successful education should include understanding of the structures surrounding the patella bone, such as muscles, nerves, ligaments, and tendons and connect it to what is going on with that patient.

Then being able to educate a plan that works at the appropriate level for the patient relating to tackling their symptoms.

Long-term Management

Regular physiotherapy follow-up assessments are crucial for monitoring progress as every anterior knee pain patient may display different symptoms and pain levels.

Physiotherapists should be adjusting rehabilitation strategies as needed.

Setting realistic goals and timelines can enhance patient motivation throughout the rehabilitation process, and physiotherapists should relate these goals with the patients.

Conclusion

Here at FightingFit physiotherapy, we treat anterior knee pain with a holistic and evidence based approach.

This is a multifaceted condition that can significantly impact an individual’s quality of life and athletic performance, so it is imperative that we take into consideration your goals and barriers that your anterior knee pain is causing.

We tackle this with a comprehensive physiotherapy approach that addresses education, pain management, and strengthening which has shown from evidence to be essential for effective outcomes.

With appropriate physiotherapy assessment and rehabilitation strategies, most individuals can achieve pain relief and return to their desired activities in a safe manner.

References

1. Bourne, R. B., et al. (2018). “The role of biomechanics in patellofemoral pain syndrome: A review.” Journal of Orthopaedic & Sports Physical Therapy, 48(4), 317-323.

2. Wang ZR, Ni GX. Is it time to put traditional cold therapy in rehabilitation of soft-tissue injuries out to pasture? World J Clin Cases. 2021 Jun 16;9(17):4116-4122. doi: 10.12998/wjcc.v9.i17.4116. PMID: 34141774; PMCID: PMC8173427.

3. https://www.physio-pedia.com/Anterior_Knee_Pain

Dean Phelps

Dean is a registered Gold Coast Physiotherapist with undergraduate and postgraduate studies in Human Movement and Exercise Science. His background has developed his vision for Fighting Fit Physiotherapy to focus on optimal health and peak physical performance for every single patient. Utilising his many qualifications, in depth knowledge of the body and passion for exercise he can provide a holistic approach to your treatment and exercise prescription to get the best outcome.

Brenda Samosa

05:52 07 Nov 24

I had a really bad shoulder and had been seeing a different physio for 3 months (from a different place) I got told Tyson was good. After just a few sessions the movement was coming back. I’m 66 and was worried I would have to stop surfing. But with a lot of help from Tyson I’m back in the waves ( thank you so so much)

Cyana Ferguson

08:16 30 Oct 24

Steve Harris

22:33 15 Oct 24

Great team, all friendly, super helpful and first class clinical advice and a big shout out to my Physio Noah with my shoulder issue

Andrea Bell

05:33 19 Sep 24

These guys are the best in the biz 🎉

Ryan Brockett

04:20 18 Sep 24

Shout out to Max from fighting fit physio. He helped me out massively straight after shoulder surgery and back into work and sports in no time. Couldn’t recommend anyone better!

Scotty

08:31 31 Jul 24

Five star service from Max & the team!
Professional & very thorough, you know that patient outcomes are of the highest priority.
I highly recommend this business.

Riley Wilson

08:27 14 Jul 24

Be AWARE they’ll immediately try to commit you to multiple follow up sessions after your initial consultation. This happened to me and then I later found out that as it just so happens, they have a cancellation policy that says you have to pay 100% of the consultation fee for cancelling. They failed to tell me this when they were pushy in committing me to 6 sessions after my consult, so that was a really nice little surprise.

I was already uncomfortable with how pushy they were in having me commit to so many sessions, so when I heard about the policy I just cancelled all together. So, I can’t speak further to the quality of their service throughout therapy phase. FYI this was also a few months ago now, it’s possible (though unlikely) they may have changed the policy. Just ask the question.

Megan Shelley

06:51 03 May 24

Fighting Fit Physiotherapy is hands down the best physio I've encountered. Having tried multiple physios for various injuries, I always find myself coming back to them. Their expertise consistently exceeds expectations, helping me get back to my sport faster than I thought possible. Their personalized approach and attention to detail make all the difference. I could not recommend a better or more exceptional physio team!

Gina Matthews

08:41 24 Mar 23

Can't recommend this place high enough. I was in so much pain with my knee an had been for months through advise an exercises I'm now looking forward to returning to gym an back riding my horses in endurance thank you so much

Courtney Halse

01:36 29 Nov 22

Kyle was knowledgeable, personable and professional. He saw me through my second pregnancy and continued to work with me until 6 months post partum on issues with my back. Would recommend anyone to go and see him.

Also shout out to Georgia on the front desk. She makes you feel welcome and brings a sense of warmth to the place!

Alli Davenport

08:07 04 Nov 22

After hip replacement surgery in February I wanted toget back into weight training legs, I started with Mitch 18 weeks ago and after a lot of hard work and sweat I am able to safely train again, I cannot thank Mitch enough for his support,encouragement and knowledge. The staff are friendly and helpful and I always looked forward to my session's

Robert Parkinson

10:50 15 Aug 22

This is the second time I have been treated by the team at FFP.
As a health professional myself I have been impressed with the level of care I have received from all members of the team.
The personalised treatment and rehabilitation programs have produced excellent results and I have completed both programs pain free and feeling stronger than before my injuries.
During the program there was constant communication and follow up and they were very accommodating with my work schedule.
All in all it was a very holistic experience and I would highly recommend the service.

Kiri Canavan

07:30 08 Jun 22

Tyson was amazing! We came up with an 8 week plan at my first consultation with weekly check ins and updates to exercises. 8 weeks later, I am pain free and able to train harder than ever. Highly recommend and the staff are all fantastic and super accomodating!

Assessment and Diagnosis

Physiotherapy Management

1. Pain Management

2. Strengthening Exercises

3. Education

Long-term Management

Conclusion

References

The Desk Worker’s Guide to a Pain-Free Neck

Hip Osteoarthritis: Why It Hurts and How Physio Can Help

The #1 Mistake Athletes Make After an Ankle Injury

The Secret to Beating Back Pain? Walk This Way!

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