A picture of a man holding the front of his left knee.

Anterior knee pain, often referred to as patellofemoral pain syndrome by orthopedic surgeons, is pain in the front of the knee.

Extremely common and often called “jumper’s knee” or runner’s knee”, PFPS gained its name due to prevalence in athletes –particularly females and young adults.

Treatable by simple exercises and medication, PFPS rarely requires surgery.

Anatomy

There are four quadriceps muscles in the thigh. There are two in the middle, one in the inside (vastus medialis obliquis or VMO), and one on the outside (vastus lateralis).

A labeled picture of the thigh muscles of the right leg.
A labeled picture of the anatomy of the right knee, with emphasis on the quadriceps muscle.

The quadriceps muscles insert into the patella or kneecap via the quadriceps tendon. The patellar tendon inserts into the tibial tubercle portion of your shin bone. This whole apparatus is necessary to extend or straighten your knee.

Causes of Anterior Knee Pain

PFPS’s common cause is an imbalance in the muscles that extend the knee. More specifically, weakness of the inside muscle or VMO, leads to an overpull of the lateral muscle. This results in tilting of the patella.

A labeled cross sectional picture of the bones about the knee, emphasizing the patella down the trochlear groove.

This lateral tilt increases the pressure behind the kneecap, which can cause pain in the front of the knee. The pain is usually worse with activities, especially going down stairs.

This can occur from injuries, such as falling on the front of the knee or in a car accident. Usually it just happens from wear and tear.

Treatment of Anterior Knee Pain

If the anterior knee pain happened after an injury; rest, ice, compression, and elevation are helpful. Avoiding activities which aggravate or cause the pain is important.

Medications For Anterior Knee Pain

Nonsteroidal anti-inflammatory medications, such as ibuprofen, or all natural anti-inflammatories, such as Nature’s Trifecta<sup>®</sup>, can be important in the short term. 

The most important treatment for PFPS is through exercises. I like two simple exercises to treat PFPS. Since they are simple, you are more likely to be compliant in performing them, and thus get maximal benefit. The exercises are hamstring stretching and VMO strengthening.

A man using a green strap to stretch his right hamstring. The opposite leg is flexed at the hip and knee.
Hamstring Stretching

To receive the maximum benefits of hamstring stretching, lay on your back and stretch one leg at a time. I find it best to hold the stretch for 30 seconds each leg x3.

A man doing a straight leg raise with his foot rotated externally approximately thirty degrees.
VMO Strengthening

Similarly, laying on your back also increases the benefits of VMO strengthening. Do a straight leg raise with your foot rotated outward 30°.  Do this 30x and do it slowly.

These simple exercises can treat and also prevent anterior knee pain.

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Nature’s Trifecta. An all-natural pain reliever, anti-inflammatory, and antioxidant*. 1320mg Standardized 95% Curcuminoids. With Black Pepper Extract and Organic Alma Powder

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