What common muscle imbalance can give rise to anterior knee pain?
Patellar maltracking resulting from a relative weakness of the vastus medialis portion of the quadriceps. This maltracking leads to increased pressure on the lateral facet of the patella and pain. With time, it can lead to chondromalacia. The patellar grind and apprehension tests are often positive. It is common in young adults and responds to directed rehabilitation of the quadriceps and stretching of the hamstrings. Adjunctive modalities of oral NSAIDs and patellar centralizing bracing or taping can also be effective.
Other common conditions that affect the patella and give rise to anterior knee pain are true patellar malalignment, limb malrotation, and tendinitis. One should always evaluate the patient for pes planus with foot pronation to see if this is contributing to patellar maltracking. If present, foot orthotics can help the anterior knee pain.