anterior knee pain Archives

Why Knee Pain Can Signal Other Health Problems?

July 6, 2021March 29, 2024
by Eva Hospital

Although knee pain is localized in the leg joints, it gives you a signal about other health problems in your body you may not know of.

Whenever you have knee pain, take a thorough look and get yourself investigated to know the root cause of the problem. Your pain might be a consequence of one or a combination of the following health conditions:-

An injury
A mechanical problem
Kinds of arthritis
Other problems.

Knee Pain Could Signal an Internal/ External Injury

If you are experiencing knee pain it could be due to a recent or chronic injury such as :

ACL tears
Meniscus tear
Fracture
Bursitis
Patellar tendinitis

Also Read: Post-Surgical Joint Replacement Precautions & Tips

You must understand the KNEE STRUCTURE and the terms. This joint joins the thigh with the leg and consists of two joints- the tibiofemoral joint & the patellofemoral joint.

The tibiofemoral joint is the one between the femur(thigh bone) and the tibia (shin bone). The patellofemoral joint is the one between the femur and patella ( knee cap).

The joints contain ligaments, tendons, and cartilage. It permits both flexion and extension along with slight internal & external rotation.

Your knee is vulnerable to injury, mostly affecting ligaments, tendons, or its fluid sacs or bursae that surround the joint. Let us give a look.

ACL Tears. The ACL or the anterior cruciate ligament is one of four ligaments that connect the shinbone to the thigh bone. An ACL tear is a common sports injury in persons who indulge in sports such as basketball or soccer that require abrupt changes in direction.
Fractures. Fracture pain is very acute, causes swelling and the patient cannot move the part. An accident or a fall can cause the patella or kneecap to break. Another reason for fracture can be severe osteoporosis. People with weak bones as a consequence of osteoporosis may fracture themselves simply by stepping wrong.
Meniscus Tear. The tough, spongy cartilage that acts as a shock absorber between your shinbone and thighbone is the meniscus. You may tear it if you twist your leg the wrong way with a strong force or weight.
Bursitis. There are small sacs of fluid called bursae that cover the knee all around to give the joint a cushioning. An inflammation in them is called bursitis and is painful.
Patellar tendinitis. Tendinitis causes tenderness & inflammation in the tendons – the patellar tendon in this case. It is a fibrous tissue that connects your kneecap to the tibia and allows you to kick, run and jump. an injury to his tendon causes bursitis and eventual pain.

Mechanical Problems

The musculoskeletal structure is after all a piece of machinery, and any part can dislocate or behave in an unaligned way. Such mechanical problems may happen in the knee as well- causing pain. Some examples of mechanics problems include:

Loose body. Sometimes a piece of bone or cartilage might break off or float in the joint space. It could be the result of an injury or deterioration. It is something like an object being caught in a door hinge, not allowing it to close properly.

IT band Syndrome. IT Band is the tough band of tissue that stretches from the outside of your hip to the outside of your knee. When it becomes so firm that it rubs against the outer portion of the femur, it is called the Iliotibial Band Syndrome. Runners & cyclists are particularly susceptible to iliotibial band syndrome.

Kneecap Dislocation. This happens when the triangular bone that covers the face of your joint slips out of place, normally to the outside of the knee. In most cases, you are able to see the dislocation.

Hip or foot pain. Your pain might be connected to a problem in the hip or foot. Hip and foot pain usually makes you change your gait to save yourself from foot pain. Your altered way of walking puts more stress on your knee & causes pain.

Kinds of Arthritis

Maybe your knee pain is a signal for arthritis in the bones. There are several types of arthritic conditions. The most common ones are:

Osteoarthritis. Also known as degenerative arthritis, osteoarthritis is a wear-and-tear condition that occurs when the cartilage in the knee damages with use & age.

Rheumatoid arthritis. The most weakening form of arthritis, rheumatoid arthritis is an autoimmune condition that can affect any joint in the body, including the knees. It is a chronic disease, which keeps varying in severity. Also, it comes & goes.

Gout. This type of arthritis occurs due to uric acid deposits in the joint. While gout most commonly affects the big toe, it can also occur in the knee.

Septic arthritis. It occurs due to infection in the joints, causing swelling, pain, and redness.

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Understanding Anterior Knee Pain (Patellofemoral Pain Syndrome) in Adolescents.

December 26, 2020March 30, 2024
by Eva Hospital

Anterior knee pain in adolescents is a trauma that is localized in the front and center of the knee, right above the shin bone, below the knee cap.

AKP is sometimes also called PF syndrome (PFS), or chondromalacia patellae. Commonly, it is referred to as “runner’s knee,”

Teenagers or young adults who take part in sports commonly experience this condition, especially females.

It is a common complaint diagnosed as such when all other conditions are ruled out.

Symptoms

The outset of the Anterior knee pain is gradual, though in rare cases, a sudden trauma may occur. The most predominant symptom is a vague discomfort around the kneecap or behind it.

The patient usually finds it hard to pinpoint the exact origin of the pain.

Other common symptoms include clicking noise, reduced knee flexion, and occasional giving-way of the joint.

Causes

Adolescent anterior knee pain has a broad and differential diagnosis. generally speaking, we might say that it occurs due to overuse or not backing up sports with sufficient strengthening and warming up exercises.

However, there can be multiple other causes to trigger this condition, namely:

Rigid or weak quadriceps and hamstrings.
Imbalance of thigh muscles that hold the knee joint
Unbalanced legs shape so that the kneecap or patella is out of alignment.
Undergoing inappropriate sports training methods or equipment
Issues caused by using new footwear or playing surface. There may be inflammation caused thus, around the joint.
Overuse of a set of muscles in performing sports workouts. Or, alterations in training causing stress on the tendons and bones in the frontal knee.
Referred pain from a problem in the hip or femur. Hips and the thigh bones should be carefully examined.
Osteochondritis dissecans-Cartilage defect in the knee joint.
Inflamed ligaments and tissues surrounding the knee.
Bony tumor – it is very uncommon and benign, but must be ruled out.
History of prior injury, surgery, or joint disease

Treatment

Anterior knee pain is a common complaint but can be a concern for children and their families. It is rarely caused by a serious medical condition. Once, diagnosed, the treatment largely depends on the causes.

Investigations may include an x-ray and MRI( magnetic resonance imaging) to determine the cause. MRI allows a more detailed evaluation of soft tissues, tendons, ligaments, and cartilage.

Clinically, your orthopedic surgeon would test the strength, flexibility as well as range of movement.

To control swelling and inflammation, ice packs and none steroid anti-inflammatory drugs or NSAIDs are prescribed. A rest from pain-inducing activities is required.

For overuse injuries, once the pain subsides, a modification in the athletic activities and training techniques is essential.

In most cases, a stretching and strengthening program designed by a physical expert can curtail the adolescent’s AKP. A knee guard or sleeve is also helpful in providing relief from the trauma.

Rehabilitation

To keep the anterior knee pain under control for your adolescents, especially when they are active in sports, you must adhere to a joint-friendly program.

The athletic training should be prescribed by your doctor. Workouts must include exercises that strengthen the hamstrings and quadriceps, making them flexible.

Movements that trigger pain should be curtailed.

Footwear must be carefully chosen based on the sport or activity the youngster is indulging in. There are specific shoes for jogging, tennis, football and all other games.

And of course, the child must wear shots.

The playing surface has a role to play too. If there has been a sudden shift in the ground type in the past, it should be contemplated in the future too.

Clay, concrete, wooden, and grass- different grounds impact the knees differently according to their buffering ability.

Instead of stopping everything, alternative sports such as cycling and walking should be encouraged.

Over a period of a few weeks, the child can return to normal sporting activities.

Conclusion

Anterior knee pain is prevalent in children and adolescents. Diagnosis is challenging & mandates a detailed history and physical examination.

Common causes involve the patellofemoral joint and the extensor mechanism of the knee.

It is important to rule out conditions of systemic diseases such as inflammatory conditions and malignancy.

A thorough study of the patient’s history and clinical exam leads to the correct diagnosis and treatment of PFP.

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