Pain in front or underneath the kneecap is a prevalent complaint that can occur in individuals of any age. A variety of factors can contribute to anterior knee pain, including overuse, poor tracking of the kneecap, imbalanced quad muscles (tight quads or hamstrings) strength, and direct injury to the knee. Kneecap problems can be divided into three main conditions: patellosfemoral syndrome, patellar tendinitis, and chondromalacia.
- Patellofemoral syndrome: More common in runners, athletes, and females, patellofemoral pain exists when the kneecap is not tracking appropriately in its groove and there is an imbalance in the structures controlling knee mechanics. This condition presents as an aching pain that can be worse with stairs, squatting, kneeling, or after sitting with the knee bent for a period of time. Treatment includes physical therapy, anti-inflammatory medication, and gradual return to activity. It is important to continue physical therapy exercises at home to maintain proper muscle balance.
- Patellar tendinitis: Also called “jumper’s knee,” occurs when the patellar tendon becomes inflamed and irritated. This is more common in athletes who play basketball or volleyball, but can happen in any individual. You may experience pain over the tendon (just below the kneecap), swelling, and pain that is relieved by rest. Anti-inflammatory medication, proper stretching, ice, and a short period of rest will often treat this condition.
- Chondromalacia: Sometimes the cartilage on the backside of the kneecap can become worn or damaged as a result of poor kneecap alignment. Pain with activity, “grinding sensation,” stiffness, and pain going up and down stairs can be present. Treatment includes activity modification, anti-inflammatory medication, weight loss if overweight, and physical therapy. Cortisone injections can provide relief by reducing the inflammation in the knee. Patients who find no relief after trying the above treatments may be candidates for an arthroscopic procedure to clean or shave off the worn areas on the kneecap.