Teenage friends in their teens often experience pain in the front of the knee, what’s going on? It turns out that this is an injury caused by improper exercise. The front of the knee joint, below the patella, is where the patellar ligament stops, and at the age of 11-18, there is an epiphysis that is not too firmly connected to the tibia, the tibial tuberosity epiphysis (see diagram). When the knee joint is straightened, the quadriceps muscle of the thigh exerts force and pulls this epiphysis through the patellar ligament to drive the lower leg forward. Therefore, when bouncing and running, the tibial tuberosity epiphysis is subjected to strong pulling force, which can easily cause injury. The accumulation of this injury can cause ischemic necrosis of the tibial tuberosity epiphysis, which is manifested as pain in the front of the knee joint, the tibial tuberosity. This disease occurs in elementary and middle school students who like to play sports. The pain at the tibial tuberosity suddenly increases after strenuous exercise and generally occurs unilaterally, with more frequent occurrence on the side of exertion. The pain is characterized by aggravation after activity and relief after rest. After repeated episodes, a bulge may appear at the tibial tuberosity with significant tenderness. Diagnosis usually does not require special tests such as x-rays, and an experienced physician can make an accurate diagnosis based on the medical history and manual examination. In mild cases, most of them can be cured by limiting bouncing and running; in severe cases, the knee joint should be braked for 1-2 months, and symptomatic treatments such as local physical therapy and topical medications should be used to reduce symptoms and improve blood circulation to the epiphysis. In cases where the tibial tuberosity is already elevated, it will not shrink to normal and will remain elevated on the normal side after development, but it will not affect the function of the knee joint, so there is no need for surgery to correct it.