PAIN IN THE FRONT OF THE KNEE ??

Pain in the front of the knee 

Pain in the front of the knee is a very common complaint. The pain usually originates from the tissue around the kneecap including the tendons, bones and cartilage surfaces. These tissues are put under high forces during many common activities and especially during sports. Running, jumping, hiking, squatting and lunging can place up to six times an individual's body weight through these tissues. Repetitive high loading eventually leads to tissue breakdown and subsequent pain. Women are more susceptible to these problems because their kneecaps are smaller and often "track" abnormally. High forces in a small distribution area leads to painful "chondromalacia" (chondro=cartilage; malacia=bad).
The most common medical finding is damage to the cartilage behind the kneecap (patella). The cartilage covering, or articular cartilage, that covers the knee cap bone is the thickest cartilage covering in the entire human body. The reason the cartilage covering in this area is so thick is because the knee cap takes more pressure per unit of area than any other joint in the body. With squatting and lunging activities up to six times the body weight is placed into the small bone of the knee cap and the cartilage. With activities this cartilage can begin to breakdown and produce pain.
The thigh muscles (quadriceps) help keep the kneecap (patella) stable and in place. Weak quadriceps increase the risk of patellar tracking disorder.

Ligaments and tendons also help stabilize the patella. If these are too tight or too loose, you have a greater risk of patellar tracking disorder.

The goals of nonsurgical treatment of patellar tracking problems are to decrease symptoms, increase quadriceps strength and endurance, and return to normal function. Exercises for patellar tracking disorder are not complicated and can be done at home in about 20 minutes a day.

Most patellar tracking problems can be treated effectively without surgery. Nonsurgical treatment may include rest, regular stretching and strengthening exercises, taping or bracing the knee, using ice, and short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).1
Quadriceps strengthening is the most commonly prescribed treatment for patellar tracking disorder. Exercises to increase flexibility and to strengthen the muscles used for hip rotation can also help.1
Patience and dedication are essential. The slow progress and improvement can be frustrating, but most people can be spared a surgical procedure by closely following a conservative therapy program.