The aches and soreness you feel after a workout are often expected and somewhat appreciated since they prove that your efforts are paying off. But if those mild aches become downright painful, it could indicate a serious injury. If you experience frequent pain just below the knee after a workout, consult your physician to determine the exact cause of the tenderness.
Patellofemoral Pain Syndrome
Patellofemoral pain syndrome occurs when the patella, or kneecap, does not move correctly during movement of the knee. Several structures hold the kneecap in place between the femur bone in the upper leg and the tibia bone in the lower leg. If one of these structures weakens or loosens, the patella might move laterally across the knee, rather than its normal vertical motion. As this occurs, the surrounding tissues become inflamed and irritated. Pain develops at the front, sides and bottom of the kneecap. Typically, symptoms occur gradually and become worse with activity. The injury is common among distance runners, hill runners and athletes with tight muscles, weak quadriceps muscles, small kneecaps, history of knee dislocation or feet that pronate during activity.
Fat Pad Impingement
A thin layer of soft tissue, referred to as the infrapatella fat pad, sits between the bottom of the kneecap and the leg bones. This fat pad acts as a shock absorber and cushion to protect the bones from grinding against one another during activity. If you experience a direct blow to the kneecap during your workout, the fat pad could become trapped between the bones. Since the fat pad is extremely sensitive, impingement causes intense pain and tenderness around the bottom of the kneecap. The pain often becomes worse when the leg is straightened.
Pre-patellar Bursitis
The pre-patellar bursa is a small sac of fluid that sits in front of the kneecap. The bursa allows the kneecap and its overlying skin to move easily against one another without creating friction. Occasionally, this bursa might become swollen and inflamed, a condition known as bursitis. Causes of bursitis include a direct blow to the knee or constant pressure on the kneecap. In fact, the condition is commonly referred to as "housemaid's knee," since housemaid's spend long periods of time kneeling to wash floors. If your workout involved frequent kneeling or you happened to fall or knock something into your knee during your workout, the bursa might be inflamed. Symptoms include pain and tenderness on the surface of and just below the kneecap. Visible swelling might also be present.
Osgood-Schlatter Disease
Common among children and athletes age 10 to 15, Osgood-Schlatter disease occurs when frequent workouts interfere with an episode of rapid bone growth. As the bones grow, the patellar tendon stretches excessively, which places stress on the bony prominence at the top of the shin bone. In response to this stress, the bony prominence becomes inflamed, swollen and painful. Although the injury affects the lower leg bone, pain occurs just below the knee. Pain often becomes worse during and after a workout, especially when the quadriceps muscle contracts.
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