Pain Around Your Knee Cap
Words can’t explain it. Your knee hurts. It hurts to walk, to climb up and down stairs, to sit at your office desk. You can’t slip on your favourite pair of heels anymore. No more hikes on weekends. No window shopping. Your life as you knew it, is slipping away fast. It’s frustrating.
You’ve asked around, searched on google… according to webMD, you’re probably dying.
A common cause of pain around the knee cap is Patella Maltracking. When you bend your knee or straighten it (such as walking up a flight of stairs), the knee cap (patella) glides in a special groove on the thigh bone called the ‘patellofemoral groove’, controlled by the quadriceps (thigh muscle)
For some reason or other, the patella may stray from this path (usually towards the outside of the knee). When this happens, abnormal stresses are produced on the undersurface of the patella… this may lead to irritation of the soft tissue such as the quadriceps muscle or tendon and cause inflammation (felt as pain, redness and swelling) in the area.
You’re probably wondering by now what you could have done to cause this. Here are a few of the most common causes;
• Tight muscles; the calf and hamstring muscles being the common culprit. Normal daily activities can bring about this tightness such as sitting for hours, playing aggressive sports or gym workouts without proper warm up, wearing high heels, etc.
• Weakness or incoordination in muscles that help maintain normal patella tracking.
• Muscle strength imbalance; If you’ve had an injury in the past, some muscles recover slower than others leading to a muscle imbalance or if you concentrate on a particular set of muscles in your workouts and ignore others, muscle imbalance is a result.
• Altered hip, knee or foot position; Some people are born with these variances though this is quite common following an injury or chronic bad posture.
• Anatomic variations; such as a shallow patellofemoral groove.
What can I do about it?
First off, we need to be sure that this is exactly what’s happening and not some other condition that shows similar symptoms (such as chondromalacia patella or patellofemoral arthritis). Your physician or physiotherapist should be able to help with this. Your physio can carry out a detailed assessment to see whether or not patella maltracking is causing your symptoms or if something else is the problem. Your physio will then choose the best course of treatment based on your symptoms and response to different treatment methods.
Usually several treatment methods are used together. This could include strengthening exercises for your muscles to correct any imbalances and correct the maltracking, Patella taping to improve its tracking, footwear assessment, soft tissue massage and home advice to prevent re-injury.