The spontaneous onset of anterior knee pain is a fairly frequent occurrence. It is often diagnosed as “Patello-femoral pain” a term which describes the pain as originating at the kneecap. The kneecap is a disc-like bone that sits on the top of the knee joint and is embedded in the tendon of the large muscle at the front of your thigh, the Quadriceps muscle. As you bend and straighten your knee the kneecap slides up and down across the front of your knee and provides a bit of elevation for the quadriceps tendon thereby allowing the knee to be fully extended. The underside of the kneecap is composed of cartilage which can gradually wear down as we age and through the accumulation of impact injuries to the knee (eg sports injuries). Other factors that can contribute to the development of knee pain include excessive body weight, genetics, and the bony architecture of the individual.
Inflammation can develop under the kneecap over time leading to episodes of pain, particularly when the kneecap is compressed against the knee joint. This typically occurs with activities like kneeling, squatting down, climbing up and down stairs, or sitting with the knees bent at an acute angle.
Unfortunately, it is not possible to regrow cartilage therefore the damage to it is cumulative. There is ongoing research into possible substances that may help regenerate cartilage after injury. The most well known of these is probably Glucosamine Chondroitin and early studies look promising that it may be of some benefit. Otherwise, treatment can include non-steroidal anti-inflammatory medication, and/or physiotherapy.
Physiotherapy treatment aims to relieve pain through various interventions which can include taping, ultrasound, acupuncture, and education on avoiding pain-provoking positions. Once pain control is achieved, exercises should be introduced to restore flexibility and strength in the knee.
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