Anterior Knee Pain in Young Athletes

Rehabilitation activities are an essential part of therapy for the relief of knee pain and return to athletic activity. Rehabilitation involves several important parts.

Pain relief

It is very important to relieve the initial knee pain for comfort and to enable the performance of other rehabilitation exercises. Ice is effective in controlling pain and swelling after sports and after rehabilitation exercises. A bag of ice chips or frozen vegetables can be placed over the knee for 10 to 20 minute, or water can be frozen in a paper cup and portion of the cup can be torn away to rub the ice over the knee. Ibuprofen can help ease pain and inflammation and can be used in the short term for pain relief after activity. Elevation of the knee above the level of the heart can also relieve swelling after activity.

Stretching

Knee pain often results from a decrease in flexibility in the quadriceps (front of the thigh), hamstring (back of the thigh), and calf (lower leg) muscles. Stretching these muscles is essential to help prevent or decrease future knee pain. Stretching should be done after warming the muscles with gentle exercise or soaking in a warm tub. Stretching should not be forced.

Strengthening

Knee pain can be associated with a decrease in the size and strength of the quadriceps, and this muscle must be strengthened to all return to optimal activity. Strengthening should be done several times a day and should not cause much pain.

Straight Leg Lift

To do straight leg lifts, sit on the floor with your legs stretched out in front, and lean back on your elbows. Bend your left knee so the heel is next to your right leg and your left foot is flat on the floor. Tighten your right thigh so the knee is tight and stiff. When the thigh muscle is tight, lift your right leg straight up into the air until your knees lightly touch. Hold this position for 5 seconds, and then slowly lower your leg, keeping the knee stiff. Repeat 10 times, and then switch legs. Try to do 3 sets of 10 repetitions, alternating legs. Weight can later be added to the ankle to progress exercises.

See your doctor if

1. The pain is a result of a sudden injury during practice or play. See your doctor as soon as possible or go directly to an emergency department.
2. You have persistent pain lasting until the morning after activity.
3. There is a lot of swelling or a limit to range of motion of the knee.
4. True “locking” of the knee (unable to straighten it) occurs.
5. There is no improvement after the first 4 weeks of therapy or worsening during the first 2 weeks.

 You may return to play if

1. Pain during activity is gone by the next morning.
2. There is no limping (interferes with normal protective reflexes).
3. You can bend and straighten the knee completely.
4. There is no noticeable swelling
5. No ice or pain medication is needed before activity.