Anterior Knee Pain
Runners knee, or chondromalacia, is anterior knee pain due to irritation of the cartilage on the under surface of the kneecap. Chondromalacia is extremely common in athletes.
The Physio Clinic provides a comprehensive service for the diagnosis & rehabilitation of knee pain, knee injuries, osteoarthritis and knee deformities. We treat sports injuries of the knee including anterior cruciate, posterior cruciate ligament and meniscal tears. Ross has considerable experience in treating patello-femoral problems and anterior knee pain.
Should I Exercise my Painful Knee?
Most people with knee pain believe they need to rest their knees to prevent further ‘damage’’ to their injured or degenerated knees. This belief is harmful and can give rise to a more rapid deterioration in knee health. The last thing on people’s mind would be to do exercises such as squatting or running.
Although some of these activities may have brought on the pain in the first place, some modifications to technique may facilitate a return to sport or exercise more rapidly when performed under the guidance of an expert Chartered Physiotherapist.
Some of the structures that can give rise to knee pain include the knee cartilage, a ligament tear or the muscles around the knee. There are several myths regarding knee pain and exercise. Many of these beliefs are unfounded and can be dangerous to long-term knee health.
Myths Regarding Knee Pain and Exercise
Myth no. 1: Don’t exercise if you have knee pain
You should never induce pain when doing exercises; however, this is not to say you should not exercise at all.
The type and intensity of knee pain will dictate what type of exercise you can perform but in most cases a graded activity programme can be initiated immediately. An acute knee sprain should be rested for 48 to 72 hours after which rehabilitation exercises will commence.
Myth no. 2: Don’t exercise if you have knee arthritis
This myth is one of the more pervasive. The common belief goes something like this: “ I have wear & tear from overuse and therefore I need to rest the knee to protect it. Formerly, most doctors would advise rest for those suffering with knee arthritis in keeping with this belief system.
Research is constantly updating and more recent research has dispelled these old beliefs. Research by Roos & Dahlberg (2005) demonstrated that exercise improved knee cartilage quality in a group of individuals at risk of knee joint arthritis. This suggests that exercise is protective as opposed to being harmful in this population.
Myth no. 3: You should stop running for good
Running can induce knee pain in some cases; however with appropriate rehabilitation and a running technique review, a return to running should be a realistic goal. Although, in some cases, running can induce knee pain, this is not to say that running is ‘ bad for the knees’. Research is somewhat conflicting but the research base is growing which suggests that loading of the knee, as happens with running, is strongly beneficial for the knee.
Research has consistently demonstrated that those that run consistently do not suffer from an increased incidence of knee pain or arthritis when compared with sedentary individuals. Many people are often fearful of loading a degenerative or painful knee but you can rest assured that the research does not support a link between exercise or knee joint loading & knee arthritis (Chakravartv et al. 2008).
Best Physiotherapy Treatment for Anterior Knee Pain:
In the acute (early) stage consists of ice, strapping and re-education of movement to prevent further damage and restore normal function. Early restoration of function is paramount to accelerate recovery as movement stimulates tissue repair.
In many cases Physiotherapy may be all that is required to restore function and return an injured joint to full mobility, even in cases where significant pain or joint ‘cracking’ is present. In my experience, most people who experience cracking in the knees write themselves off as having “degeneration” and can sometimes, wrongfully, decrease their activity and cause further weakening of their knees.
How do I Strengthen My Knees Without Causing Pain?
Increasing strength is a vital element in improving the overall capacity of the knee to withstand normal activities of daily life.
An example of research used to rehab elderly patients with knee pain involved a heavy slow loading protocol. This was shown to improve muscle bulk in men with patellar tendinopathy. The patients were also taught that a little discomfort is acceptable as long as it doesn’t linger after the exercise program.
Physiotherapists use a range of interventions to address knee pain including biomechanical assessment, joint mobilisation and manipulation, exercise prescription & deep soft tissue treatment.
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