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Other causes of knee pain

Anterior knee pain

Anterior knee pain is pain in the front of the knee.

This pain can come from different parts of the knee:

  • It can often come from strained tendons (tendinitis).
  • It can also be irritation or softening of the cartilage that lines the underside of the kneecap.
  • It may be related to a sprain along the ligaments that hold the kneecap in place.
  • It can be caused by arthritis of the knee.
  • It can be caused by muscle imbalance or a change in your activity level.

These problems often begin when the kneecap does not move properly and rubs against the lower part of the thigh bone. Anterior knee pain is more common in:

  • Adolescents and healthy young adults, especially girls
  • Runners, jumpers, skiers, bicyclists, and soccer players, who exercise often
  • People who have a sudden change in activity levels

Anterior knee pain can be a dull, aching pain that people feel most often:

  • Behind the kneecap (patella)
  • On the sides of the kneecap

Symptoms may be worse when you do deep knee bends, go down stairs, run downhill, or stand up after sitting for a while.

Stretching and strengthening the muscles on the back (hamstrings) and strengthening the front (quadriceps) of your upper leg will help.

  • Warm up before and stretch after you exercise.
  • Your health care provider or a physical therapist can show you what stretches to do.
  • Stronger muscles around your knee will help hold your kneecap in the correct position and allow it to track better.
  • Improved core stability can help decrease the pain in your kneecap.
  • Losing weight can reduce the load in your knee cap and result in less knee pain.

Changing the way you exercise may help. Try these things:

  • Avoid running straight down hills -- walk down instead.
  • Bicycle or swim instead of run.
  • Reduce the amount of exercise you do.
  • Run on a smooth, soft surface, such as a track, instead of on cement.
  • Make sure your running shoes are made well, fit well, and have good cushioning.
  • Avoid doing knee extension exercises.

Some other tips that may reduce your knee pain are:

  • Lose weight if you are overweight. Every pound that you are overweight is around 5 extra pounds on the kneecap when you go up and down stairs, and 10 extra pounds when you jump. Ask your health care provider for help.
  • If you have flat feet, try special shoe inserts and arch supports (orthotics).
  • Tape your knee to keep your kneecap aligned. Your provider or a physical therapist can show you how.

Bursitis

Bursitis is the swelling and irritation of a bursa. A bursa is a fluid-filled sac that acts as a cushion between muscles, tendons, and joints.

Bursitis is usually a result of tendon overuse or changes in the way a joint moves. It can be caused by a change in activity level, such as training for a marathon or by being overweight. Your doctor will talk to you about strategies that can restore your normal activity.

When you have bursitis of the knee, you may notice:

  • Pain when you move or when you press on the side of your knee.
  • Stiffness and achiness when you move your knee.
  • Warmth, swelling, or redness around your knee.
  • Most of the time the swelling is on top of your patella.

Tips to relieve bursitis pain:

  • Use ice 3 to 4 times a day for the first 2 or 3 days. Cover your knee with a towel and place the ice on it for 15 minutes. Do not fall asleep while applying the ice. You can leave it on too long and get frostbite.
  • Try not to stand for long periods of time. If you must be standing, stand on a soft, cushioned surface. Stand with an equal amount of weight on each leg.
  • When sleeping, do not lie on the side that has bursitis. Placing a pillow between your knees when lying on your side can help decrease your pain.
  • DO NOT just stop doing activities. Lower level non-impact activities are still important to help with recovery.
  • Flat shoes that are cushioned and comfortable often help.
  • If you are overweight, losing weight may also be helpful.

Baker's cyst

A Baker's cyst is fluid collection at the back of your knee. This can be caused by swelling inside the knee. The swelling is caused by an increase in the fluid that lubricates the knee joint. This fluid is called synovial fluid. When pressure builds up from too much fluid, the fluid spreads to the back of the knee.

With a Baker's cyst, there may be a painless or painful swelling behind the knee.

The cyst may feel like a water-filled balloon. Sometimes, the cyst may break open (rupture), causing pain, swelling, and bruising on the back of the knee and calf.

A Baker's cyst commonly occurs with:

  • A tear in the meniscus (a type of tissue) of the knee
  • Knee arthritis (in older adults)
  • Rheumatoid arthritis
  • Other knee problems

Often, Baker's cysts do not need to be treated. Your provider can watch it over time.

If the cyst is painful, treatment may be done to correct the problem that is causing it. Two possible causes of a Baker's cyst are arthritis or a meniscus tear.

Usually the cyst is not removed because it can come back. But if you have a lot of symptoms, a surgeon can remove the cyst. The cyst usually comes back if the underlying condition that causes it is not treated.

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Review Date: 8/9/2018

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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