Front Knee Pain

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

Common causes of front knee pain

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.

1. Runners Knee

CLASSIC SYMPTOMS: General ache around the front of the knee and patella pain, grinding sensation with knee movement, mild swelling. Gets worse with repetitive activities e.g. running or jumping, stairs and prolonged inactivity. 

Runners Knee aka Anterior Knee Pain is the most common cause of front knee pain

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

2. Chondromalacia Patella

CLASSIC SYMPTOMS: Achy pain in front of knee, swelling, clicking sounds and grinding sensation with knee movement. Worse when you first stand up, play sports, come downstairs and apply pressure through the kneecap. Typically affects young, healthy people.

What Is It: Damage to the cartilage on the back of the kneecap

Onset: Gradual onset. More common in women.

Treatment: Exercises, knee straps, orthotics, gel pads, occasionally surgery.

Find Out More: Visit the Chondromalacia Patella section for in-depth information

3. Knee Bursitis

CLASSIC SYMPTOMS: Pain, redness and swelling at the front of the knee - like a squashy orange. Symptoms aggravated by kneeling, walking and bending the knee

Housemaids knee causes anterior knee pain and swelling

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

4. Osgood Schlatters

Osgood Schlatters is a common cause of front knee pai

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

5. Patellar Tendonitis (Jumpers Knee)

Patellar tendonitis causes pain just below the kneecap

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

6. Cartilage/Meniscus Tear

CLASSIC SYMPTOMS: Knee swelling, locking (where the knee gets stuck), instability, difficulty straightening the knee, catching pain with knee movements. Worse when weight-bearing e.g. walking and running, on stairs and when squatting.

What Is It: Tear in the cartilage lining the joint

Onset: Can occur suddenly with a force through or sudden twisting of the knee, or gradually through wear and tear

Treatment: PRICE, exercises, brace, tubigrip, sometimes requires surgery. Can take a long time to heal

Find Out More: Visit the Meniscus Tear for in-depth information on causes and treatment

7. Knee Arthritis

CLASSIC SYMPTOMS: Morning stiffness in the knee, generalised swelling, clicking/grinding noises and sensations, knee stiffness with loss of end range movements. Symptoms tend to be worse after rest which gradually improve with gentle movement, in cold weather and after activities. Most common cause of front knee pain in the over 50's.

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

8. Plica Syndrome

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

Rarer Causes of Anterior Knee Pain

1. Quadriceps Tendonitis

CLASSIC SYMPTOMS: Front knee pain just above the patella that gets worse with activity, weakness, stiffness, knee swelling.

What Is It: Small tears in the quadriceps tendon above the knee resulting in inflammation and degeneration

Onset: Tends to come on gradually over time, affecting people who do lots of jumping and sprinting activities

Treatment: Rest, ice, strengthening & stretching exercises, knee straps, physical therapy and sometimes surgery

Find Out More: Learn more about the causes, symptoms and treatment in the Quadriceps Tendonitis section

2. Knee Sprain

CLASSIC SYMPTOMS: Instability - knee gives way, knee swelling, bruising at time of injury, generalised pain and stiffness i.e. reduced knee movement.

There are three grades of knee sprain, depending on the severity of the injury

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

3. Quadriceps Strain

CLASSIC SYMPTOMS: Anterior thigh pain, swelling and bruising, limited function e.g. stairs and getting in and out of a chair

What Is It: Overstretching or tearing one of the four quadriceps muscles

Aggravating Activities: Running, jumping, kicking, stairs, getting in and out of a chair

Onset: Thigh pain and swelling following forceful knee extension

Treatment: PRICE, exercises, physical therapy and occasionally surgery 

Find Out More: Visit the Pulled Quad section for in-depth info on quadricep strains

4. Patella Alta

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

5. Osteochondritis Dissecans

Osteochondritis Dissecans is one of the less common causes of anterior knee pain

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

6. Patella Injuries

CLASSIC SYMPTOMS: Usually caused by a fairly major injury resulting in severe pain, knee swelling, restricted movement. Knee may appear deformed. All knee movements will be painful and restricted.

What is it: Damage to the kneecap such as a dislocation (where it shifts out of place) or a fracture

Onset: Sudden onset from a fall, awkward twisting or RTA. It takes a great deal of force to dislocate or break the patella

Treatment: Rest, knee brace, exercises, taping and in some cases surgery.

Find Out More: About both types of injury in the kneecap injuries section

Find Out More About Front Knee Pain

Front knee pain is extremely common, but is usually fairly simple to overcome. If you would like some help working out what is causing your problem and what you can do about it, visit the knee pain diagnosis section. Remember, the best way to accurately diagnose your front knee pain is to see your doctor.

Find out more about the most common causes of front knee pain, including in-depth information on the causes, symptoms and treatment options by clicking on the links above. 

Page Last Updated: 10/06/21
Next Review Due: 10/06/23

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