What it Effects

• Pain at the front of the knee involving the patellofemoral joint

Who it Effects

• People with poor knee biomechanics such as a maltracking patella
• People with Osgood-Schlatter disease prone to this condition
• Common in athletes
• Common in all ages

Mechanism of Injury

• Maltracking patella causing abnormal stress to underside of patella producing pain
• Maltracking of the patella can be caused by the following:
  • weak quadriceps
  • tight structures around the knee (particularly the lateral structures)
  • altered foot
  • knee or hip posture
  • abnormal knee anatomy such as a shallow patella-femoral groove
• Overuse e.g. squatting with weights
• Obesity (puts added stress on the knees)
• Trauma e.g. RTA (road traffic accident)

Signs and Symptoms

• Pain at the front of the knee
• Pain worst when running, attempting stairs and after prolonged flexion, such as sitting
• Possible locking / giving way of the knee
• Visible difference in size of Vastus Medialis compared with your good side. It may be visibly smaller on the bad side
• Crepitus
• End range knee flexion increases pain
• Swelling on the inside of the knee

Treatment

• Stretching exercises for muscles attaching to the knee
• Strengthening of the quadriceps in particular Vastus Medialis (on the inner side of the knee) e.g. straight leg raises and controlled sitting are just a couple of exercises used to treat this common condition (all exercises concentrating on Vastus Medialis contraction)
• Taping
• Ultrasound
• Proprioception exercises

Additional Information

• Vastus Medialis is partly responsible for helping the knee cap track correctly in the patella-femoral groove, if it is weak and does not exert the correct pull on the knee cap and it can maltrack. This stresses the underside of the kneecap and causes pain. Strengthening Vastus Medialis can help to correct this maltracking and therefore resolve the pain

If you have any questions, please use the comment form below or post a thread on the forums.