Knee pain that is present in the front of the knee is a very common complaint among athletes, particularly high school and college aged females. Often times, they might be diagnosed with patella femoral pain syndrome. This is just a term describing that the pain is presenting in the anterior portion of the knee. This is a common diagnosis we see in physical therapy.

            I have spoken with several soccer teams in the area and almost always there are several girls who raise their hand when I ask who out of the group has knee pain. It needs to be stressed that if untreated, this pain can get worse and worse and may impact their ability to play on a sports team. Therefore, if you or your child or one of your athletes is complaining of knee pain, recommend they see a doctor and get referred to physical therapy.

            What can you expect when you come to physical therapy? When you make an appointment, your first visit with your therapist will be an evaluation. We look at your posture, flexibility, range of motion, balance, hip strength, knee strength, ankle strength, how you walk, and how you jump. Based on what we find during this time, we design a comprehensive group of exercises for you to begin at home.

            If I am doing exercises at home, do I need to come to PT? Yes! Often times, we will give you basic stretches and strengthening exercises to address your biggest limitations or functional deficits. When you come to therapy, your physical therapist will perform soft tissue mobilizations to areas that were found to be tight as well as stretch the tight muscles. Your PT will teach you exercises to strengthen the muscles that were found to be weak during your evaluation.

            What causes anterior knee pain? There are several reasons that people get anterior knee pain. The most common reason is a weakness, especially in the hip. Yes, the hip! If the hip is not strong, it will not hold the pelvis stable, creating an inward angle at the knee, which will eventually cause pain. This angle causes the knee cap to track incorrectly. Repetitive poor tracking eventually leads to knee pain. Also, if this weakness in the hip is present (generally, the weakness is in the hip abductors and external rotators) and a person is performing squats, lunges, or jumping and even running on a regular basis, then the knee will eventually be the weakest link and present with pain.

            Are there simple things I can do at home? Definitely! Here are two exercises that can strengthen the hip abductors and external rotators:

  1. Sidelying Hip Abduction: Lie on the side that does not have pain. Bend the knee of the leg you are lying on. Straighten the top leg, make a tight muscle and lift your leg into the air. When you lift, your body should be in a straight line. Commonly, as people fatigue, their leg starts to come forward. If anything, the leg should move back a little as you lift.
  2. Clamshells: Lie on the side that does not have pain. Bend both knees. Keep your ankles/feet together and slowly lift the top knee away from the bottom knee. As this gets easy, you can add a theraband around your knees to give you some resistance.

These are just 2 simple exercises that one can perform at home. If these exercises cause pain, please stop and consult a doctor. If you are experiencing anterior knee pain and it is not going away, consult a physician and be seen by a licensed physical therapist for the appropriate treatment.