Patellar Tracking Disorder

Does your knee pain make you think twice about taking the stairs?

Have you ever found yourself avoiding the stairs because of your knee pain? In this blog we answer what is poor patella tracking? What causes poor patellar tracking? What are the symptoms of patellar tracking? How a chiropractor can treat your patellar tracking issue? As well as running through some at home exercises which can help with knee pain.

There is a common misconception that chiropractors only treat back pain – this is not true! Knee pain is a problem treated frequently by the chiropractors at Quay Health with great results. While there are several causes of knee pain, one of the most common diagnoses seen is a patellar tracking issue.

What is poor patellar tracking?

Patellar tracking refers to the movement of the patellar (kneecap) relative to the femur (thigh bone) during knee flexion and extension.

Poor patellar tracking occurs when the kneecap shifts out of place as the leg bends or straightens. In most cases the patellar shifts too far towards the outside of the leg (lateral tracking), however in some cases it may shift toward the inside too (medial tracking).

The knee joint is a hinge-like joint that joins the two bones of the lower leg (tibia and fibula) to the thigh bone (femur). The kneecap is held in its natural position by ligaments on its sides and by tendons above and below. Inside the knee, under the kneecap, is a layer of cartilage that acts as a cushioning surface between the joint and as a smooth plate for the kneecap to glide over. When the knee is working properly; the kneecap glides through a groove near the end of your thigh bone called the trochlear groove.

The kneecap can rotate or shift out of its natural position if the cartilage is damaged or if the groove of the femur is too shallow. Misalignment of the kneecap can result from muscles, ligaments or tendons that are too tight or too loose.

What causes poor patellar tracking?

Generally,  poor patellar tracking comes from high stress on the knee, especially during twisting/fast changes of direction during sports. Some more specific examples are:

  • Underactive glute muscles
  • Irregular shaped patella
  • Damaged cartilage
  • Poor alignment
  • Weak thigh muscles
  • Being overweight
  • Turned in knees (valgus)
  • Flat feet (pes planus/hyper-pronation)
  • Quadriceps overloading
  • Activities/overuse injuries that stress the knee 

Patellar tracking is almost always due to a combination of problems relating to muscle weakness or imbalances, poor leg biomechanics, structural abnormalities and cartilage damage.

What are the symptoms of a patellar tracking issue?

Patella tracking issues are more common in women due to their tendencies to be hypermobile and also in athletes of both sexes. However, it can also affect older people who suffer from arthritis. Some signs/symptoms to look out for include:

  • The patellar is visually not moving in the correct way/is moving asymmetrically
  • Visible swelling in the front of the knee that may increase when jumping/squatting/kneeling/running/doing stairs
  • Popping, grinding or catching sensation felt at the patella during bending/straightening of the leg
  • Pain or discomfort during sit to stand, sitting for long periods, sitting to standing, squatting
  • Knee giving way/buckling

Pain varies depending on the severity of the issue. An example of a severe case of maltracking is a dislocation. If the kneecap is completely dislocated, there will be a lot of pain. The leg may appear bent or disfigured and you may not be able to bend/straighten the knee or walk on.

Source: Everkinetic

Chiropractic treatment for patellar tracking issues:

The Chiropractic approach to treating a patellar tracking issue will firstly be structured around reducing your knee pain and any inflammation. Your chiropractor will use a range of soft tissue techniques, taping techniques, mobilization techniques as well as adjustments to restore alignment and full range of motion to the knee. This will aim to reduce any swelling and pain. As you pain levels come down and your range of motion is restored your chiropractor will set you a rehab program whereby exercises will be prescribed to increase control of movement and to strengthen any deficient muscles of the hip/knee/ankle and foot. It is important that you follow the advice of your chiropractor to ensure you have as speedy a recovery as possible with long term results.

Chiropractic Sydney CBD - knee assessment

At home exercises you can do to reduce knee pain:

People of all ages may experience knee pain, and while it may be tempting to avoid exercise and activity whilst in pain – it is not always the most appropriate solution. Certain exercises can help alleviate the existing knee pain and also prevent future pain or injury to the knee by providing it with extra support. This extra support is created by developing strong and flexible muscles around the knee, thus taking the pressure off the joint to reduce the strain/load. Have a go at these at home exercises next time you are experiencing knee pain.

1. Knee extension
Sitting on a chair, slowly extend your knee as you contract the muscles in your thigh. Hold for 10 seconds then slowly lower the leg back to the ground.

2. Sit to stand exercises
Sitting in a chair, slowly rise to standing by squeezing your buttocks and thigh muscles as you rise. Repeat for 5-10 times.

3. Heel raises
Start standing and slowly rise up onto your tippy-toes, hold for 5 seconds, then return back down. Repeat this 5-10 times.

4. Quadriceps stretches
While standing bend your problem knee and using your hand try to bring the same heel as close to your buttocks as possible, you should feel a stretch down the front of your thigh. Hold for 20 seconds.

5. Walking or swimming
Low impact aerobic exercises provide gentle movements in the knee and promote healing.

Low impact exercises are a noninvasive and healthful way to help with the onset of knee pain. Knee strengthening exercises are an effective way to help prevent further injury and to keep the legs strong and functional within their full range. Stretching can also help to alleviate muscle pain/spasm around the knee joint and improve flexibility. While these at home exercises can provide relief, it is important you get into see your Chiropractor or Physiotherapist for a thorough assessment and treatment plan tailored to your specific condition and needs (especially if the knee pain has come on insidiously and without any trauma).

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