Pain In The Patella

woman runner

Patellar tracking disorder or Patellofemoral pain is the result of the kneecap (patella) tracking typically to the outside of your knee when performing an activity or task which requires increased bending (flexion) of the knee. The Patella tracks in the femoral groove when bent and misalignment can result from tendons, muscles or ligaments that are too tight or too loose.

Causes could be anything from trauma to the area, cartilage damage, overuse, the shape/shallowness of the anatomy, but most commonly an imbalance of muscles, tendons and ligaments. Just as there is typically never one singular cause of a tracking disorder; there are several risk factors at play as well. These include improper footwear, body weight, sport specific activities requiring prolonged bending or squatting, weak quad muscles and imbalances between the inner/outer musculature of the thigh.

Because all patients and injuries are different, and all treatments are individually based, we will focus on the most common theme in Patellar Tracking disorder which is muscle imbalance from overuse. The Quadriceps is made of four muscles and the most important of which for this type of injury is the vastus medialus. It aides in locking the kneecap when in extension and is engaged within 0-30degrees of flexion. It is located on the medial side of the the thigh and pulls on the medial boarder of the patella. With overuse type injuries (ex: running), as fatigue sets in, the body compensates for the tired legs and tends to use hip muscles to circumduct the leg pulling it outward; thus increasing the pull laterally on the patella. This imbalance of tightness to strength can typically cause a patellar tracking issue most notably symptomatic of pain or even a clicking/grinding sensation. A typical treatment would be focused on stretches to loosen up the lateral musculature and our primary focus would be to strengthen the Vastus medialis muscle to pull the knee cap back into place.

If you suspect you may have patellar tracking disorder, it is important to have a trained therapist determine a proper treatment plan for you. Come schedule your appointment today with one of Aquacare Physical Therapy’s physical therapists.


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