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 kneecap.
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.
Anterior Knee Pain Symptoms
The onset 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 a 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.
- An imbalance of the thigh muscles that hold the knee joint
- Unbalanced leg 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 pa laying surface. There may be inflammation caused, thus, around the joint.
- Overuse of a set of muscles in performing sports workouts. Or, alterations in training cause stress on the tendons and bones in the front 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
This knee pain is a common complaint, but it 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 an 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 and range of movement.
To control swelling and inflammation, ice packs and non-steroidal 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.
Impact of Playing Surface on Knee Health
The knee health of adolescents is influenced by their playing surface. The knees receive different levels of protection from playing surfaces because of how well those fields can reduce shock impact. For instance:
Concrete and asphalt playing surfaces alone put players at risk of stress on their joints.
Knee protection improves on surfaces made from grass and clay when compared to other surfaces.
They establish greater friction between feet and knees which heightens the probability of knee injuries when players use synthetic turf.
It’s important to monitor changes in the type of playing surface to minimize the risk of exacerbating AKP.
When to Seek Medical Help?
Most cases of anterior knee pain require treatment through rest periods as well as physical therapy programs to manage symptoms. Seek medical assistance because persistent pain lasting longer than a few weeks or pain that worsens requires proper medical treatment.
Hasty medical interventions stop knee pain from advancing to a chronic condition while enabling patients to recover their typical routines faster.
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.
