Pain in the front of the knee, known as anterior knee pain, often results from overuse of, and injury to, the knee’s joints, tendons, and tissues. It can also be a symptom of conditions such as arthritis. Treatment may include rest, pain relief, and lifestyle changes.

Several factors can contribute to the cause and severity of pain in the front of the knee. These include lifestyle factors such as exercise, injury, and poor posture when exercising.

This article explores the causes of anterior knee pain, or pain in the front of the knee.

We also discuss the symptoms of this knee pain and the treatment options.

A person holding their knees with their head resting on them. Front knee pain can be caused by injury and over-excercising.Share on Pinterest
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Patellofemoral pain syndrome (PFPS), sometimes known as runner’s knee, is one of the most common causes of anterior knee pain.

PFPS can happen due to overuse, injury, or kneecap malalignment. It is common in people who participate in sports such as running.

Symptoms

Common symptoms of PFPS include:

  • pain in the front of the knee during exercise that repeatedly bends the knee, such as climbing stairs, running, and jumping
  • pain in the front of the knee after long periods of sitting
  • a popping or crackling sound when moving or sitting for long periods of time (crepitus)

Treatment

In many cases, it is possible to treat PFPS at home. This usually involves:

Learn more about reducing swelling in the knee here.

Patellar tendonitis, also known as jumper’s knee, occurs when there are small tears in the patellar tendon. The patellar tendon connects a person’s kneecap (patellar) to their shin bone (tibia).

Small tears usually occur due to pressure that accumulates on the patellar or quadriceps tendon as a result of strenuous exercise. The tendon can tear away from the kneecap in more severe cases.

Symptoms

The symptoms of patellar tendonitis include:

Treatment

There are both surgical and nonsurgical options to treat patellar tendonitis. These include:

  • Nonsurgical:
  • Surgical:
    • reattaching the tendon in cases where it has torn away from the kneecap
    • repairing small tears by installing suture anchors

Hoffa’s fat pad, also known as the infrapatellar fat pad, is a fatty soft tissue that lies under the knee cap.

It contains many nerves and can be a source of anterior knee pain. Injury or repeatedly overextending the knee can cause this pain.

Symptoms

The symptoms of Hoffa’s syndrome include:

  • pain at the front of the knee and bottom of the kneecap
  • swelling and tenderness
  • pain when extending the leg for long periods of time, such as when standing

Treatment

The treatment options for Hoffa’s syndrome include:

Patellofemoral arthritis affects the underside of the patella (kneecap) and the groove in the thighbone that the patella sits in.

It occurs when the cartilage along the groove and under the patella wears down and becomes inflamed. This can happen as a result of injury or overuse of the knees.

Symptoms

The symptoms of patellofemoral arthritis include:

  • pain in the front of the knee during rest or activity
  • a crackling sensation during movement
  • the kneecap becoming “stuck” when straightening the leg

Treatment

There are several treatment options for patellofemoral arthritis. These include:

  • NSAIDs for pain and swelling
  • avoiding high-impact exercises such as running and squatting
  • trying low-impact exercises such as walking or swimming
  • viscosupplementation (where a doctor injects hyaluronic acid into the knee)
  • corticosteroid injections

In more severe cases, healthcare professionals may consider surgery. Surgical options include:

  • Autologous chondrocyte implantation: The surgeon removes a small piece of cartilage and uses it to grow new cartilage cells, which they implant into the knee.
  • Patellofemoral replacement: The surgeon replaces damaged cartilage with plastic and metal.
  • Total knee replacement: A procedure to replace both sides of the knee joint.
  • Tibial tubercle osteotomy: This procedure realigns parts of the knee.

Quadriceps tendonitis results from degenerative changes to the quadriceps tendon due to injury and overuse from activity. It causes knee pain with tenderness on the border of the kneecap.

The quadriceps tendon is essential for straightening the leg and knee from a bent position. It attaches the four quadricep muscles to the kneecap and sits just above it.

Learn more about tendinitis here.

Symptoms

The symptoms of quadriceps tendonitis include:

  • tenderness
  • pain on the border of the kneecap that worsens with activity
  • swelling

Treatment

The treatment options for quadriceps tendonitis include:

In more severe cases, surgery may be an option to remove the damaged tendon or reattach it.

A plica is a thick band of tissue that extends from joints. Plica tissue most commonly affects the knee joint.

Plica syndrome occurs when this tissue becomes inflamed due to overuse or injury. This can cause friction between the kneecap and the lower part of the thigh bone.

Symptoms

The symptoms of plica syndrome include:

  • pain in the front of the knee
  • hearing a popping or clicking sound during movement
  • tenderness
  • stiffness

Treatment

The treatment options for plica syndrome include:

The other possible causes of anterior knee pain include:

Learn more about anterior knee pain here.

There are several things an individual can do to help prevent anterior knee pain.

Some of these are:

  • strengthening the knee and improving flexibility
  • improving exercise form
  • wearing the right shoes for running
  • maintaining a moderate weight
  • incorporating low-impact exercises, such as walking and swimming, into their routine

Learn more about running shoes to try here.

A person experiencing anterior knee pain should seek medical help if one or more of the following apply:

  • the pain does not improve with over-the-counter (OTC) treatments, such as NSAIDs
  • the pain lasts more than a few days
  • there is swelling, or the knee has changed shape
  • the knee is red and warm to the touch, which can be a sign of infection
  • the pain prevents them from carrying out day-to-day activities

Overuse and injury often contribute to a person developing anterior knee pain and associated conditions.

There are several treatment options, including OTC medications, rest, and, in some cases, surgery. People experiencing persistent pain with little to no relief from OTC treatments should seek immediate medical help.

There are several precautions a person can take to prevent knee pain, including maintaining a moderate weight, improving exercise form, and improving flexibility and strength of the knees through conditioning exercises.