Front Knee Pain

Written By: Chloe Wilson, BSc(Hons) Physiotherapy
Reviewed by: KPE Medical Review Board

Front knee pain, aka anterior knee pain, is extremely common. In fact it is the most common reason people consult a knee specialist.

There may be a general ache at the front of the knee, a specific sharp pain that you suffer from, swelling or a feeling of instability.

Anterior knee pain may limit your day to day activities, stop you participating in sports or even affect your sleep. But the good news is, there is lots that you can do to help.

If you pain is more at the top of the knee or in the lower thigh, then check out the Pain Above The Knee article.

What Causes Anterior Knee Pain?

The most common causes of front knee pain are:

• Runners Knee: a problem with how the kneecap moves
• Bursitis: inflammation of an anti-friction bag
• Osgood Schlatters: bone irritation linked with growth spurts
• Tendonitis: in the quadriceps or patella tendon
• Cartilage Damage: kneecap or knee joint cartilage
• Plica Syndrome: inflammation of the knee lining
• Knee Arthritis: wear and tear

Common Causes Of Front Knee Pain

Let's start by looking at the most common causes of anterior knee pain and then go on to look at some of the more rare ones.

The most common cause of front knee pain is Runners Knee, aka Patellofemoral Pain Syndrome or Anterior Knee Pain. But don't be fooled by the name - it is just as likely to affect office workers as it is runners!

Runners knee is caused a problem in how the kneecap moves and accounts for a quarter of all knee injuries seen in clinics.

Typical symptoms of runners knee include a general ache around the front of the knee and patellofemoral pain, a grinding sensation with knee movement and mild swelling at the front of the knee.

Symptoms typically develop gradually over time, rather than due to a knee injury, and front knee pain from Runners Knee typically gets worse with repetitive activities e.g. running or jumping, stairs and prolonged inactivity. 

You can find out loads more about the common causes, symptoms and best treatment options in the Runners Knee section.

Another common cause of front knee pain is knee bursitis.

Knee bursitis is where there is inflammation of the one of the knee bursa - small fluid filled sacs found at various points around the knee.

Knee bursitis tends to develop gradually over time, typically affecting people who spend a lot of time kneeling e.g. carpet layers, plumbers, housewives, gardeners. It can also develop after a blow to the front of the knee

Typical symptoms of knee bursitis include front knee pain, redness and swelling at the front of the knee - like a squashy orange. Front knee pain from bursitis typically gets worse when kneeling, walking or bending the knee.

There are four types of bursitis that can cause pain and swelling in front of the knee:

• Prepatellar Bursitis: swelling in front of knee cap
• Suprapatellar Bursitis: swelling above the knee
• Infrapatellar Bursitis: front knee swelling below the kneecap
• Pes Anserine Bursitis: medial front knee swelling

Find out all about the different types of knee bursitis, why they cause front knee pain and swelling and how to treatment them in the Knee Bursitis section.

Osgood Schlatters Disease is the most common cause of front knee pain in children and adolescents.

Osgood schlatters is caused by irritation of the bone just below the kneecap, usually following a growth spurt due.

The most classic feature of osgood schlatters is a tender bony lump in front of the knee, just below the kneecap, causing front knee pain.

Symptoms typically get worse with sports activities such as kicking, jumping and running but respond very well to stretching programs.

You can find out all about the causes, symptoms, treatment options and best exercises to reduce front knee pain in the Osgood Schlatters Disease section.

Another possible cause of front knee pain is Patellar Tendonitis, aka Jumper's Knee.

Patellar tendonitis is caused by damage to the tendon that sits just below the knee cap, most typically from sports involving lots of jumping or kicking.

Jumper's knee typically results in front knee pain just below the patella, aching and stiffness after activity. There may also be thickening of the patella tendon resulting in a lump in front of the knee and the tendon is often tender to touch.

You can find out loads more about the common causes, symptoms and treatment options for anterior knee pain in the Patellar Tendonitis section.

A common cause of anterior knee pain following an injury is a meniscus tear aka torn knee cartilage.

The meniscus is a special, thick layer of cartilage found in the knee. The meniscus may be torn with a knee injury from sudden twisting or overloading of the knee, or tears may develop gradually due to repetitive wear and tear.

Typical symptoms of meniscus tears include knee swelling, locking (where the knee gets stuck), instability, difficulty straightening the knee and catching pain with knee movements.

Front knee pain from a meniscus tear often gets worse when weight-bearing e.g. walking or running, on stairs and when squatting.

Find out all about the front knee pain from cartilage injuries and how best to treat them in the Meniscus Tear section.

The most common cause of front knee pain in people over the age of 50 is knee arthritis.

Knee arthritis may be caused by wear and tear and degeneration of the knee cartilage with the formation of bone spurs, known as osteoarthritis, or inflammation in the joint, known as rheumatoid arthritis.

Common symptoms of knee arthritis include morning stiffness in the knee, generalized swelling, knee clicking or grinding and joint stiffness with loss of end range movements.

The symptoms of knee arthritis tend to be worse after resting, in cold weather and after activities.

The Knee Arthritis section has loads of information and covers everything you need to know including the causes, symptoms, stages of arthritis and best treatment options.

Another possible cause of front knee pain which often goes undiagnosed is knee plica syndrome.

Plica syndrome occurs when there is inflammation in the folds of the synovial membrane that lines the knee joint.

Knee plica syndrome may develop suddenly with a knee injury such as a dashboard injury or fall onto the knee, or gradually from repetitive knee bending or kicking or sudden increases in activity.

Common symptoms of knee plica syndrome include dull, achy front knee pain, knee instability, locking, clicking and stiffness. Anterior knee pain from plica syndrome typically gets worse after activity or with knee flexion.

You can find out all about the causes, symptoms, diagnosis and treatment in the Knee Plica Syndrome section.

What Is A Knee Sprain: Overstretching or tearing one of the ligaments in the knee. There are three grades of sprain depending on the severity of the injury

Aggravating Activities: Depends on the severity but likely to be any weight-bearing activity

Onset: Sudden twisting movements or a force through the knee

Treatment: PRICE, exercises, braces.

Find Out More: Learn more about the causes, symptoms and treatment in the Knee Ligament Sprain section.

CLASSIC SYMPTOMS: Front knee pain, instability, recurrent knee dislocation, positive camel back and grasshopper eyes sign

What Is Patella Alta: High riding patella where the kneecap sits too high on the thigh bone and therefore lacks structural support

Aggravating Activities: Walking, running, squatting, prolonged sitting, stairs

Onset: Typically a congenital defect but can develop after a knee injury e.g. patellar tendon rupture

Treatment: PRICE, exercises, taping, braces, surgery.

Find Out More: Visit the Patella Alta section for in-depth info on the causes, diagnosis and treatment options for high riding patella

CLASSIC SYMPTOMS: Occasional sharp pain with general background ache, clunking sensation with leg movements, locking, weakness, decreased leg movement and swelling. Worse with sports, twisting of the knee and on stairs. Typically affects teenagers.

What is Osteochondritis: Decreased blood supply to the bone causes fragments of bone and cartilage to detach

Onset: Occurs at any age but most prevalent 10-20 year olds. Three times more common in men. Fairly rare cause of front knee pain

Treatment: Rest, exercises, brace, surgery.

Find Out More: Visit the Osteochondritis Dissecans section for more information