Hi guys! In this video, I'm going to discuss pain that you feel over the front of the knee,
or anterior knee pain, that you can get from weightlifting or jumping activities
or even the combination of that, like you get in CrossFit. So, for those of you who
don't know me, my name is Maryke. I'm one of the physiotherapists from sports-injury-physio.com,
where you can get online physiotherapy assessment as well as treatment for your injuries.
Have a look at the Description of this video if you want a link to our website.
Okay, so, the pain that you feel over the front of the knee from either doing weightlifting or
jumping and hopping activities is mainly usually due to two … one of two reasons;
and it's quite important to distinguish between the two, because the treatment for them are
quite different. So, the first is that it can be coming from your kneecap or your patellofemoral
joint. Now, the kneecap is the knobbly bit that you feel over the front of the knee,
there, and if you have your knee totally relaxed, you can move it from side to side.
The kneecap has a cartilage ... is a joint; so, between the kneecap and your bones, at
the bottom, it forms a joint, and it's lined with cartilage. And if you do a lot of deep squatting,
especially with weight, that cartilage underside can become irritated and sore, especially if you
do a lot of it or a lot more than what you’re used to, or you don't allow it to recover enough.
Also, if your squat technique isn't that great, and it's moving in … Well, squat, lunge,
anything that bends the knee, really, and your legs don't quite move in a good pattern – that
can cause it also to become irritated. Now, the other thing that can cause pain in that area
is the patellar tendon. So, the patellar tendon runs from your
kneecap ... So, if you can feel the bottom point of your kneecap; it's the tendon that you can feel
there that runs and attaches to this part of your tibia. So, if you go over that, you can feel that
nice thick tendon there. And usually, if it's the tendon that's painful, you'll often find,
if you really press firmly on it where it attaches to the kneecap, that's where it's most commonly
injured. But it can be in the middle, and it can also be lower down that it gets injured.
So, how do you know which one have you injured? Is it the kneecap or is it that tendon? The first
thing that you can … that can usually tell you is if your pain moves around. So, sometimes the
pain is more on this side, sometimes the pain is more on that side, it feels as if it's inside; you
can't really find something to press on that makes it hurt. That is usually when it's more the kneecap.
If, however, the pain is very much below, in this area, and you can actually find a tender spot to
push on, it is very much more likely that it's the tendon that you've injured.
Both of these do not like stretching. So, doing a quad stretch type thing will often aggravate it;
even if it's not in the moment, it may be later on. Both of them can hurt when you do deep squats,
but the big difference is where you feel that pain. Now, how do you get it better?
In all honesty, it's … The first bit is very similar; it's relative rest, is the first
step towards that. So, you've got to cut out all activities that cause it to be aggravated. Now,
sometimes it doesn't mean you've got to stop all of it, it's just that you adjust it. So,
for instance, if we think of adjustments that could work is that you limit the range of motion
of where you squat. So, the kneecap specifically, the lower down you squat, the more it compresses
against the other bones and the more uncomfortable it will get. Something else that you can do is,
you can reduce the weight dramatically until you find that sweet spot of weight that doesn't
aggravate the pain that you get. And remember, it's not just pain that you feel in the moment,
because specifically for tendons, you often don't feel pain while you're training,
it's the next morning when you wake up that you go, “Oh, my knee is now stiff!” That's
another tell-tale sign that it's your knee. So, you've got to get that relative rest
right in that, do not put loads through it that cause it to hurt more, rest it if it needs rest,
but often it doesn't need total rest; and that's where somebody can help you to decide what is
right there, but it needs that to recover. Then, you've got to look at, why did this develop?
Was it that you overloaded it in one session by just doing too much in that one session,
or was it actually that you didn't allow enough recovery between sessions or maybe
over several weeks? Because you've got to change that so that you don't make that same mistake.
And then, you've got to slowly strengthen it back up. So, that may mean that you start with
just bodyweight exercises first. Now, if it is the patellar tendon, you'll notice,
if you google it on the Internet, there are things like decline squats you can do; there's
all sorts of ways to load that tendon to get it stronger. But make sure that you know whether it's
the patellar tendon or the kneecap causing your pain because, like for instance, a decline squat
can really aggravate the kneecap because it will put more pressure through that anterior portion
of the knee, which includes the kneecap. So, I would say, to decide what exercise is best,
definitely work somebody to decide on that. So, to recap. Most common cause for anterior knee pain is
either patellar tendinopathy or the kneecap itself – patellofemoral syndrome. And to get it better,
it's relative rest; so, you've got to reduce the activity so that the body can recover. But then,
at the same time, identify what level of strength training and activity you can do that does not
cause your symptoms to flare in the 24 hours afterwards, and start there, and slowly increase
from there. Excellent! If you need more help with an injury, you're welcome to consult one of us via
video call – remember that the link to the website is in the Description of this video. Take care!