According to physical therapist Sarah B. Briley, anterior knee pain, also called patellofemoral pain, is one of the most common symptoms seen in clinical sports medicine. Felt in the front of the knee, anterior knee pain typically affects athletes, especially endurance runners. The American Academy of Orthopaedic Surgeons states that rest, stretching and strengthening through physical therapy are the most common treatments, along with surgical options that include knee cap realignments and arthroscopes.
Weak Glutes
The glutes are the muscles that make up the buttocks. One particular muscle of the glutes, the gluteus medius, is frequently under-active in runners and endurance athletes, says Briley. According to Dr. Mark S. Juhn, writing in the "Orthopedic and Sports Physical Therapy" book, when the gluteus medius works inadequately, the upper leg rotates inward, causing the patella to be pulled toward the inside of the leg and out of alignment. The poor tracking of the patella can cause damage to surrounding tissues such as cartilage and ligaments, as well as the joint lining itself.
Ilio Tibial Band Tightness
The ilio tibial band is a thick, sturdy band of fibrous tissue that connects the outside of the hip to the outside of the patella, states "Orthopedic and Sports Physical Therapy." In distance runners and endurance athletes, the band can become very tight and prevent the patella from tracking properly. Pain is felt along the side and front of the knee due to the irritation caused by the patella
Muscle Imbalance in the Quadriceps
The quadriceps are the four large muscles of the front of the thigh. According to "Orthopedic and Sports Physical Therapy," athletes tend to over-train the outermost portion of the quadriceps, the vastus lateralis, and neglect the innermost portion, the vastus medialis, resulting in a muscle imbalance between the two muscles: during running, the vastus lateralis overpowers the vastus medialis and causes patellar misalignment.
Calf Tightness
According to "Orthopedic and Sports Physical Therapy," when runners neglect stretching, the muscles of the calf can become very tight. During running, these tight calves force the foot into pronation to achieve normal movement. The pronation causes the lower leg to rotate, which leads to patellar tracking problems and pain.
Bursitis
The knee joint has a series of fat pads, called bursa, that cushion and protect it. "Orthopedic and Sports Physical Therapy" states that tight tendons and ligaments, as well as poor patellar tracking, can cause irritation and swelling of these bursa. The inflamed bursa are not only unable to adequately protect the knee, but cause greater problems by decreasing space in the joint for normal movement, thus increasing pain.
References
- Sarah B. Briley, P.T.; Regional Rehabilitation Center; Greenville, North Carolina
- "Orthopedic and Sports Physical Therapy"; Terry R. Malone, Thomas McPoil and Arthur J. Nitz; 1997
- American Academy of Family Physicians: Patellofemoral Pain Syndrome: A Review and Guidelines for Treatment
- American Academy of Orthopaedic Surgeons: Your orthopaedic connection: Runner's Knee (Patellofemoral Pain)
