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How to relieve anterior knee pain

Two teams of girls play volleyball.
Health Information

/ by Jenni Williams, MS, ATC, LAT

We commonly see athletes who have knee pain in the front of their knee around the knee cap – this is called patellofemoral pain syndrome or patellofemoral dysfunction. Various issues can cause anterior knee pain, including:

  • Imbalance of thigh muscles (quadriceps and hamstrings) that support the knee joint.
  • Weak quadriceps muscles, which may need strengthening to hold the knee cap in the right position.
  • Problems with alignment of the legs between the hips and the ankles.
  • Problems with the shape of the bones in the legs when the athlete stands and walks – this is more common in females because of their wider hips.
  • Recent growth spurt that may have caused pain at the growth plates on the patella.
  • Improper sports training techniques or equipment.
  • Changes in footwear or playing surface.

Athletic trainers can talk to athletes and evaluate them to understand what is causing the pain and determine the best way to treat it. Anterior knee pain usually affects both knees, although one side may be worse than the other. The pain is usually described as a dull ache that gets sharper with activity. The pain is made worse by activities that involve bending the knee, including walking up and down stairs or any activity involving squatting, sitting, jumping or kneeling. Athletes may also complain of stiffness, especially after long periods of sitting.

Adolescent anterior knee pain is usually fully relieved with simple measures. Athletic trainers may encourage athletes to:

  • Ice the area after activity when they are sore.
  • Wear knee sleeves with padding, which may take away the pain that occurs when athletes hit their knees.
  • Wear a patellar tendon strap, which may also help with pain by relieving some of the pressure where the patellar tendon attaches to the knee.
  • Buy a new pair of shoes that has better support or buy insoles for their current shoes.

The athletic trainer may also have the athlete perform exercises that include strengthening of the hip, thighs and core. They may add balancing activities and plyometrics (jumping and explosive movement training) as well. It is essential when dealing with anterior knee pain to maintain appropriate conditioning of the muscles around the knee, particularly the quadriceps and hamstrings.

Coaches need to make sure an athlete is using correct form when doing the sport-specific activities. Some modifications may need to be made if the athlete cannot do the activities correctly.

Sometimes, a parent may decide to give an athlete over-the-counter medicine to help with the discomfort.

Additional steps can be taken to prevent recurrence of anterior knee pain, including:

  • Wearing shoes appropriate to the sport.
  • Warming up thoroughly before physical activity.
  • Incorporating stretching into the warm-up routine and stretching after physical activity.
  • Limiting the total number of miles run in training and competition.
  • Incorporating hip and core strengthening activities to the daily practice.

If an athlete does not feel better after trying some of these options, further evaluation by a doctor may be necessary.