Knee pain in the Front
The ACL is a stabilizing ligament in your knee that prevents hyperextension and resists twisting movements of your knee. An overstretch to the ligament can cause tears in this knee ligament. 70% more common in non-contact injuries. The pressure from your body weight at a specific angle of pull, pushes the ligament beyond its normal limits causing a ACL sprain or tear. Swelling & knee pain in the front &inside of your knee when walking, but the knee will feel unstable is a far more concerning warning sign.
Tendons are the extension of the muscle and attaches the muscle to the bone. Overuse & overload on the tendons that run above and below your kneecap gets irritated, inflamed, swollen and painful. The tendons must be able to withstand the pulling force when its suddenly loaded, but if not, they start tearing the tendon apart. This causes pain on the inside & front of your knee.
In the front of your knee you have four muscles of the quadriceps that converge to form the Supra-patellar tendon (‘Supra’ meaning above), weaving around the patella to anchor onto the front of your shin, as it passes to the front we refer to the tendon as the infra-patellar tendon (‘infra’ meaning below). At the back of the knee we have the hamstrings, two tendons running around the inside (Semi-membranous & Semi-tendinous) and one on the outside (Bicep femoris tendon).
Tendinitis of the Quadriceps tendon is a condition when the thigh muscles’s tendon become inflamed and irritated. The quadriceps muscles are four large muscles in the front of the thigh just above the knee cap.
Overstretch & traction injury to the Quad tendon at the point where it attaches to the top of the kneecap or patella. The Tendon tendons must be able to withstand the pulling force when its suddenly loaded, but if overloaded the Quadriceps tendon becomes painful. Knee pain when coming up from a crouched position, contracting the quadriceps muscles or pressing in at the top of the knee.
Jumper’s knee or patellar tendonitis is an overuse injury that results in pain at the front of the knee, specifically at the bottom of the kneecap. Overuse from running or jumping causes inflammation, or more likely, degeneration of the patella tendon. This repetitive contraction with excessive force causes micro-tears in the knee tendon. The bottom & front of the kneecap will feel very tender and may seem swollen compared to the other knee. It is likely to ache and feel stiff after exercise.
A knee meniscus is a tear of of a disc ‘spacer’ & shock absorber that sits between the Femur and Tibia. There are one on the inside, and one on the outside. These tears happen when your knee is twisted & knocked inwards which causes a the disc to be sheared off. Locking, catching & clicking of your knee joint at a certain point brings on your knee pain. Severe swelling & knee pain gets worse over the first few days.
Bursitis is inflammation of a fluid filled sac or cushion (bursa) over the front of your knee. A bursa is a small sac of fluid whose function is to lubricate the movement between tendons and bone. This condition occurs when the bursa becomes irritated, compressed or infected. A lump may be visible and the kneecap may be warm to touch. Kneeling will bring on the knee pain.
Fat pad impingement
The infrapatellar fat pad is also sometimes known as Hoffa’s pad. It is a soft tissue that lies beneath the kneecap which can get pinched, causing knee pain. This knee injury can be caused by a severe impact which traps the pad between the patella and femoral condyle. Tenderness at the bottom and under the kneecap can suggest this injury, and sometimes the kneecap seems to tilt outwards, because of swelling.
Its a common cause of pain in the front of their knee in children between 10 to 15 years old. Pain at the top of the shin where the infra-patella tendon anchors on the Tibia, below the kneecap. Repetitive contraction with excessive force causes micro-trauma to the attachment onto the bonecausing it to become swollen & painful. Usually the pain gets worse the more active they are and improves with rest. Latent pain that lasts for days to weeks.
Mainly affects young athletes and children causing pain at the front of the knee, at the lowest point of the patella or kneecap. The knee tendon and soft tissue have not adjusted to new bone growth. The bottom of the kneecap may feel tender and the pain will get worse during and after exercise. Symptoms are very similar to Jumper’s knee, but the injury is more like Osgood Schlatter’s disease but at different sites.
Patellofemoral pain syndrome
Causes pain in the front & around your knee cap. It happens when your patella slides out of alignment as you move. The back surface of the patella rubs against the femur bone which erodes the cartilage at the back of your patella. Dull ache with mild swelling around your knee cap. Knee pain tends to radiate towards the outside of your knee. Worse only a few hours after the activity like walking up & down stairs, the pain has a delay in flaring up.
Chondromalacia patella is damage to the articular cartilage under the patella which serves as a smooth gliding surface for the patealla to move over the femur. A grinding or clicking feeling may be felt when moving the knee. Symptoms are similar to patellofemoral pain at the front of the knee. The kneecap rubs on the bone underneath causing swelling and pain under the kneecap. Pain can worsen when walking downstairs or after sitting for long periods.
Its a progressive condition where the cartilage between your bones, in this case the femur and tibia, degenerate over time. It is similar to getting grey hair, it is a completely normal part of aging. Knee pain caused by osteoarthritis is due to wear & tear on the cartilage of your your knee joint. Deep ache inside your knee accompanied by stiffness that tends to be worse in the mornings and after a period of sitting.