Knee pain in young adults

Knee pain is fairly common in young adults and teenagers, affecting 1 in 3 at some time or other.

Often knee pain is described as chondromalacia patellae. This is a problem with the back of the kneecap.

• The kneecap or patella sits at the front of the lower end of the thighbone or femur
• Its upper part is attached by a tendon to the quadriceps or thigh muscle
• The lower part is attached by a tendon to your shinbone or tibia
• It allows the leg to straighten and to stabilise the knee joint when walking

The main symptoms are pain and grinding/ clicking or crepitus. The level of these symptoms varies from person to person.

Pain is normally felt at the front of the knee, often behind the kneecap, which can be severe. It may affect some every day activities like going up and down stairs. Or, you may feel a dull ache when you have been sitting for too long.

You may feel grinding behind the kneecap when you move your knee. You may get this grinding but not have any pain.

The exact cause is not known. There are some theories, which suggest that cartilage changes happen because of small injuries during vigorous exercise of minor falls.

Slack ligaments or the kneecap being in slightly the wrong position may also cause the symptoms.

The problems normally get better on their own without any treatment, but the symptoms may last for several years. There are some measures that can be taken which should help reduce the pain.

This should be discussed with your GP or pharmacist but simple painkillers such as paracetamol can help. You may be prescribed a non-steroidal anti-inflammatory drug (NSAID).

It is important to keep your quadriceps or thigh muscles as strong as possible. The exercises below show you how to do this without needing to bend the knee. This allows pain free exercise.

It is important not to give up all exercise. This will lead to further weakness of the thigh muscles.

Making changes to the type of sport you do can make a difference. Swimming is usually a good exercise for people with knee pain. Tougher sports like football, rugby and cross-country running can often make the pain worse.

An operation is rarely needed. However, in the most severe cases the rough surface of the back of the kneecap may need to be smoothed off.

The exercises below are designed to improve the strength of the quadriceps muscles. They should be done
regularly to make sure the benefits are maintained.

1. Sit or lie on your back with your affected leg straight
2. Press the back of your knee downward and pull your toes towards you
3. This will tighten the muscle on top of your thigh
4. Hold 10 seconds
5. Repeat 10-15 times, 3-4 times a day

1. Lie on your back with your affected knee straight and the other knee bent as shown
2. Keep the leg completely straight, then raise it up 30 to 40cm off the floor
3. Hold 10 seconds and slowly lower
4. Repeat 5-10 times, 3-4 times a day