Knee pain

A good percentage of my clientele suffers from knee pain.  They are runners, tennis players, hikers and even sedentary desk jockeys.  One major component of knee pain is poor patellar tracking.  In lay terms, this means the knee cap is not moving properly up and down inside the femoral groove as you bend and extend you knee.  This post will help explain the reason for poor patellar tracking and offer some simple home exercises to help resolve it.  As always, consulting a physical therapist for an evaluation and treatment would be highly advisable. 

The patella is a diamond shaped bone that sits in a groove at the end of the femur.  The patella should track up when extending the knee and down when flexing the knee.  The up and down movement in kept in balance by equal forces from all sides of the patella.  Due to increased tension in the lateral quad muscle and distal iliotibial band (IT band), in combination with weakness in the medial (vastus medialis) quad muscle, the patella often get pulled laterally over the rim of the groove.  Obviously this is not only painful, but can cause long term wearing away of the cartilage on the underside of the patella.
Increased IT band tension is commonly seen in runners or athletes.  Women are particularly afflicted because of the anatomical width of their hips.
Vastus medialis weakness is quite common with even small amounts of joint edema.  This makes poor patellar tracking quite common post knee surgery (arthroscopic).

A great intervention to help decrease IT band tension is to have a therapist manually massage the structure.  I've also found trigger point needling of the IT band to be quite successful in releasing the tension.  At home exercises include an IT band stretch and rolling of the IT band.  Another treatment for poor patellar tracking is McConnell patella taping.  This is a taping technique that helps the patella sit properly inside the femoral groove, and increases vastus medialis activation.

If you have knee pain, have tried these home exercises and are still dealing with pain, feel free to contact me at: housecallptdc@gmail.com