Why Do You Have Pain at the Front of Your Knee? Causes and Physiotherapy Treatment
Pain at the front of your knee and around the kneecap is one of the most common reasons people visit a physiotherapist. This type of knee pain can affect people of all ages, from runners and gym-goers to office workers and people trying to stay active.
Because several different structures sit around the kneecap, it’s important to identify exactly what is causing the front knee pain. Two conditions that are often confused are fat pad irritation and patellofemoral pain. While both cause pain around the kneecap, they usually become painful during different movements, and understanding the difference is important for effective treatment of front knee pain.
What is Fat Pad Irritation?
The fat pad is a soft, cushion-like structure that sits just below the kneecap inside the knee joint. It helps absorb pressure and protect the knee during movement.
Fat pad irritation often develops from repeatedly over-straightening the knee, standing with locked knees, or after a direct knock to the front of the knee.
Common symptoms of this type of front knee pain include:
- Pain just below the kneecap
- Sharp or pinching pain when the knee fully straightens
- Pain when standing for long periods
- Discomfort during walking or exercise if the knee over-straightens
The key feature is that symptoms of this type of front knee pain usually increase when the knee straightens too far.
What is Patellofemoral Pain?
Patellofemoral pain is irritation around or behind the kneecap. It is often linked to how the kneecap moves during bending activities such as squatting, running, or climbing stairs.
Common symptoms include:
- Aching pain around or behind the kneecap
- Pain when using stairs, especially downstairs
- Discomfort during squats or lunges
- Pain after sitting with bent knees for long periods
- Pain that builds with repeated bending activities
Unlike fat pad irritation, this type of front knee pain is usually aggravated by bending the knee under load. Activities such as running, jumping, squatting, or walking downhill commonly make symptoms worse.
Why Correct Diagnosis Matters
Although both conditions cause front knee pain, treatment for each problem is different.
Fat pad irritation often improves by reducing activities that force the knee into excessive straightening. Patellofemoral pain usually responds better to strengthening exercises and improving movement control during bending activities.
If the wrong diagnosis is made, exercises may actually worsen front knee pain and delay recovery.
It’s Often More Than Just a Knee Problem
Pain around the kneecap is not always caused by the knee alone. The hips, ankles, feet, and surrounding muscles all influence how pressure moves through the knee.
A physiotherapy assessment may look at:
- Hip and glute strength
- Knee alignment and control
- Foot posture and ankle mobility
- Walking and running technique
Weakness or poor control in one area can increase stress on the kneecap and contribute to ongoing pain.
How Physiotherapy Can Help Knee Pain
Treatment depends on the exact cause of the pain, but physiotherapy may include:
- Reducing pressure on irritated structures
- Improving movement patterns and knee control
- Strengthening the hips, thighs, and supporting muscles
- Improving ankle mobility and foot control
- Gradually returning to running, stairs, squatting, or sport
Key Takeaway
Not all pain around the kneecap is the same. Fat pad irritation is usually worse when the knee straightens too much, while patellofemoral pain is usually worse during bending activities.
Understanding the difference is important for choosing the right treatment and recovering properly. If your knee pain has been ongoing or you are unsure what is causing it, a physiotherapy assessment can help identify the source of the problem and guide the right rehabilitation plan.
Click here to book an appointment today or call 8555 4099.
Written by: Shreya Balakrishnan – Physiotherapist
