Adolescent anterior knee pain
Knee pain in adolescents can be caused by overuse or incorrect balance of muscles and muscle groups, causing the knee and patella (kneecap) to be pulled out of correct alignment on exertion and during exercise. Tightness of the fascia (tissue layer) on the lateral aspect (outer edge) of the thigh and reduced flexibility can also act on the knee.
Following examination, imaging including Xray, ultrasound and MRI may be used to check the structure and alignment of the knee. In cases where the knee is structurally sound, a course of physiotherapy is often recommended as a first-line treatment along with resting the knee, using ice and pain medications including anti-inflammatories.
Incorrect exercise and sports training techniques can cause many of the problems listed above. These can be addressed by the physiotherapist or knowledgeable sports trainer.
Anterior knee pain treatment
Physiotherapy can include exercises and treatments to increase flexibility, reduce tightness in the fascias, rebalance muscle groups (particularly the hamstrings and quadriceps) and to redress any problems of hip or ankle which may cause problems throughout the lower limb. In some cases, orthotics or insoles are advised.
If physiotherapy is not successful in significantly reducing knee pain, or if there is a likely structural cause of the pain, joint injections and/or surgery may be considered.
Injections of a long lasting anaesthetic can relieve pain in the joint. These can also be used diagnostically. If injecting a particular structure in the knee relieves pain, this structure can then be identified as the likely cause of the pain and surgery in this area may be helpful.
Pain around the patella (knee cap) is commonly caused by either patella maltracking, patella instabillity or patella tendonosis (or a combination).
- Patella maltracking is when the patella does not run smoothly in it’s groove. This is commonly due to muscle imbalance, pulling the patella out of it’s normal position, or by a structural problem of the patella or even the hip. If physiotherapy is not successful or not suitable for readjusting the tracking, surgery may be considered to the affected structures.
- Patella instability is usually either caused by a structural problem with the patella or from an injury. Depending on the cause and severity of the problem, surgery may be recommended.
- Patella tendonosis. The patello-femoral ligament can become inflamed through activity, overuse or due to one of the of the above conditions. If physiotherapy is not effective, injection therapies or a tendon operation can be performed.
Due to the complexity of diagnosing the cause of anterior knee pain, it is important to be fully assessed by an experienced knee specialist who can provide an individually tailored care plan.