Answer:
Thanks for the question! Some of the most common questions/complaints that orthopedic
surgeons discuss with patients are knee cap issues. This small bone on the front of
the knee (anatomically called the patella) has a huge job and gets little respect.
Every squat, kneel, crawl, climb, and jump depends on the patella doing its job well.
Over the course of years, this bone and its overlying cartilage layer can wear down
a little, and the beginnings of arthritis pain can start. The good thing is that the
cartilage layer on the knee cap is the thickest layer we have in our bodies - ensuring
that arthritis doesn't start too early!
Pain on the front part of the leg that is felt deep in the center of the knee can often be from wear of this cartilage. This cartilage wear is called chondromalacia and the pain syndrome may be called patellofemoral syndrome (or PFS for short).
There are many causes for anterior knee pain. Overuse in work or exercise, sports injuries, arthritis, and even flat feet have been implicated in causing this type of pain. The symptoms are numerous and include pain with kneeling, "start-up" pain that occurs after sitting for too long, and the classic "theater" sign -- pain in the knee cap area while sitting in a cramped seat like in a movie theater. Sometimes the knee can "catch" or "grind" or even swell in certain situations. If there is swelling, the knee can feel warm, as well.
Treatment is aimed at quieting down the inflammation with ice/rest/elevation and sometimes using anti-inflammatory medications. These pills can have some side effects, so be sure to read the instructions and contact your PCP if you are unsure if they are right for you.
Exercises to strengthen the quadriceps muscle in the front of the thigh have also been shown to slowly decrease these symptoms. Sometimes a doctor will prescribe orthotics/inserts for your shoes if the alignment of the knee cap is out of balance. Formal physical therapy is reserved for long-term problems, and surgery is done rarely at this stage.
As always, if this pain persists or is associated with new symptoms or a new injury, be sure to talk to your PCP or orthopedic surgeon as further investigation may be necessary.
Pain on the front part of the leg that is felt deep in the center of the knee can often be from wear of this cartilage. This cartilage wear is called chondromalacia and the pain syndrome may be called patellofemoral syndrome (or PFS for short).
There are many causes for anterior knee pain. Overuse in work or exercise, sports injuries, arthritis, and even flat feet have been implicated in causing this type of pain. The symptoms are numerous and include pain with kneeling, "start-up" pain that occurs after sitting for too long, and the classic "theater" sign -- pain in the knee cap area while sitting in a cramped seat like in a movie theater. Sometimes the knee can "catch" or "grind" or even swell in certain situations. If there is swelling, the knee can feel warm, as well.
Treatment is aimed at quieting down the inflammation with ice/rest/elevation and sometimes using anti-inflammatory medications. These pills can have some side effects, so be sure to read the instructions and contact your PCP if you are unsure if they are right for you.
Exercises to strengthen the quadriceps muscle in the front of the thigh have also been shown to slowly decrease these symptoms. Sometimes a doctor will prescribe orthotics/inserts for your shoes if the alignment of the knee cap is out of balance. Formal physical therapy is reserved for long-term problems, and surgery is done rarely at this stage.
As always, if this pain persists or is associated with new symptoms or a new injury, be sure to talk to your PCP or orthopedic surgeon as further investigation may be necessary.