Front Knee Pain

Written By: Chloe Wilson, BSc(Hons) Physiotherapy
Reviewed by: KPE Medical Review Board

Front knee pain, aka anterior knee pain, is extremely common. In fact it is the most common reason people consult a knee specialist.

There may be a general ache at the front of the knee, a specific sharp pain that you suffer from, swelling or a feeling of instability.

It may limit your day to day activities, stop you participating in sports or even affect your sleep.

Common Causes of Front Knee Pain

The most common causes of front knee pain are:

• Runners Knee: a problem with how the kneecap moves
• Bursitis: inflammation of an anti-friction bag
• Osgood Schlatters: bone irritation linked with growth spurts
• Tendonitis: in the quadriceps or patella tendon
• Cartilage Damage: kneecap or knee joint cartilage
• Plica Syndrome: inflammation of the knee lining
• Knee Arthritis: wear and tear

We will start by looking at the most common causes of anterior knee pain and then go on to look at some of the more rare ones.

What Is It: Runners Knee is the most common cause of front knee pain caused by a problem with how the kneecap moves up and down in the trochlear groove. It doesn't only affect runners, it is just as common in office workers too!

Onset: Builds up gradually over time. No specific injury

AKA: Patellofemoral Pain Syndrome/Anterior Knee Pain

Treatment: Exercises, brace, orthotics, occasionally surgery. 

Find Out More: Visit the Runners Knee section for causes, symptoms, diagnosis & treatment

What Is It: Inflammation of the one of the bursa (fluid filled sac) at the front of the knee

Onset: Gradual onset in people who spend a lot of time kneeling e.g. carpet layers, plumbers, housewives, gardeners. Occasionally develops after a blow to the front of the knee

Treatment: PRICE, stretches, gel pads, injections, occasionally surgery

Find Out More: Visit the Knee Bursitis section for causes, symptoms and treatment options

CLASSIC SYMPTOMS: Tender, bony lump just below the kneecap, causing front knee pain. Typically affects adolescents. Worse with sports activities such as kicking, jumping and running.

What Is It: Irritation of the bone just below the kneecap. It is the most common cause of front knee pain in teenagers

Onset: Most common in boys aged 9-16. Often follows a growth spurt

Treatment: PRICE, knee straps, exercises, plaster cast, gel pads.

Find Out More: Visit the Osgood Schlatters section to find out about the causes, symptoms and best treatment options

CLASSIC SYMPTOMS: Front knee pain just below the patella, aching and stiffness after activity, thickening of the patella tendon. Worse with repetitive activities such as jumping and kicking

What Is It: Damage to the patellar tendon just below the kneecap

Onset: Gradual onset. Usually gets progressively worse

Treatment: Rest, ice, knee straps, exercises, surgery.

Find Out More: Visit the Patellar Tendonitis section for causes, symptoms and treatment options

What Is It: Changes in the bone caused by wear and tear, known as osteoarthritis or inflammation, known as rheumatoid arthritis

Onset: Symptoms gradually come on over time and may fluctuate 

Treatment: Exercises, brace, acupuncture, walking aids, injections, surgery.

Find Out More: The Knee Arthritis section covers everything you need to know including the causes, symptoms, stages of arthritis and best treatment options

CLASSIC SYMPTOMS: Dull, achy front knee pain, worse after activity or knee flexion, knee instability, locking, clicking and stiffness

What is it: Inflammation of the synvoial membrane folds lining the knee joint

Onset: Dashboard injury, fall onto knee, repetitive knee bending or kicking, sudden increase in activities

Treatment: Rest, exercises, injections, physical therapy, surgery

Find Out More: Visit the Plica Syndrome section to find out more about the causes and treatment options available

What Is It: Overstretching or tearing one of the ligaments in the knee. There are three grades of sprain depending on the severity of the injury

Aggravating Activities: Depends on the severity but likely to be any weight-bearing activity

Onset: Sudden twisting movements or a force through the knee

Treatment: PRICE, exercises, braces.

Find Out More: Visit the Knee Sprain section for in-depth info on all types of knee sprains

CLASSIC SYMPTOMS: Front knee pain, instability, recurrent knee dislocation, positive camel back and grasshopper eyes sign

What Is It: High riding patella where the kneecap sits too high on the thigh bone and therefore lacks structural support

Aggravating Activities: Walking, running, squatting, prolonged sitting, stairs

Onset: Typically a congenital defect but can develop after a knee injury e.g. patellar tendon rupture

Treatment: PRICE, exercises, taping, braces, surgery.

Find Out More: Visit the Patella Alta section for in-depth info on the causes, diagnosis and treatment options for high riding patella

CLASSIC SYMPTOMS: Occasional sharp pain with general background ache, clunking sensation with leg movements, locking, weakness, decreased leg movement and swelling. Worse with sports, twisting of the knee and on stairs. Typically affects teenagers.

What is it: Decreased blood supply to the bone causes fragments of bone and cartilage to detach

Onset: Occurs at any age but most prevalent 10-20 year olds. Three times more common in men. Fairly rare cause of front knee pain

Treatment: Rest, exercises, brace, surgery.

Find Out More: Visit the Osteochondritis Dissecans section for more information