Patellar Tracking Disorder

The kneecap is its own, separate bone, and is connected to the thigh bone and the shin bone by powerful ligaments and tendons. However, if the kneecap, or patella, becomes misaligned, it can cause pain and discomfort in the knee. This type of injury can usually be rectified with exercises and physical therapy. 

Patellar Tracking Disorder Anatomy

When the kneecap is working as it should, it sits inside a groove, or indentation, at the end of the thigh bone (femur) called the trochlear groove. The kneecap glides backward and forward within the trochlear groove with the movement of the leg.

However, injuries due to sports or overuse can cause the patella to move slightly off its track. It can be pushed to the outside of the knee joint, or to the inside.

Patellar Tracking Disorder Causes

Patellar tracking disorder typically results from high stress on the knee. The twisting motions associated with many sports are especially associated with this disorder. 

However, there are certain structural abnormalities and other conditions that can cause a person to be more susceptible to this disorder, such as:

  • Weak thigh muscles
  • Imbalance in strength between hamstrings and thigh muscles
  • Tendons, muscles, and ligaments that are too tight or too loose
  • Being overweight
  • Knees that turn inward
  • Flat feet
  • Extremely high arched feet
  • Structural problems in the knees or leg alignment, such as a shallow trochlear groove

In nonathletes, this disorder is more likely to occur in women than in men. In athletes, it is equally common for both sexes. It can also occur in older adults due to arthritis in the knee.

Patellar Tracking Disorder Symptoms

Common symptoms of patellar tracking disorder include:

  • Pain in the front of the knee, especially when you squat, jump, run, or walk downstairs
  • Swelling in the front of the knee
  • A popping, grinding, slipping, or catching feeling when you bend your knee

The amount of pain will vary greatly depending on the severity of the disorder. For instance, if the patella is completely dislocated, or separated from the trochlear groove, the pain will be extreme. The leg might appear bent, and walking will be very difficult.

Patellar Tracking Disorder Diagnosis

The symptoms of patellar tracking disorder are similar to several other knee injuries, making diagnosis somewhat difficult. The knee is not always visibly damaged; only in the most severe dislocations will there be visual evidence of the disorder. 

A physical examination of the knee will be necessary in most cases. Your doctor may manipulate your knee into various positions, observe you walking, squatting, or standing from a sitting position.

X-rays and MRIs can be ordered to rule out the possibility of other damage possibly causing your pain. 

Patellar Tracking Disorder Treatment

There are a variety of different treatments for patellar tracking disorder. Generally, doctors will begin with more conservative methods, and only progress to more invasive treatments if absolutely necessary.

Some home remedies that can help relieve the pain of patellar tracking disorder are:

  • Rest or reduced activity level
  • Stretching or strengthening exercises
  • Flexible knee braces
  • Taping
  • Proper footwear
  • Weight Loss
  • Over the counter pain relievers
  • The RICE method: rest, ice, compression, and elevation

Knee taping

Kinesiology tape is a thin adhesive tape that bends in one direction but not in the other. Wrapping your knee in this tape to help stabilize the knee has been reported to reduce pain and symptoms in some athletes. However, there is no conclusive evidence that the tape provides any real improvement.

Physical therapy

A licensed physical therapist will be able to provide you with strengthening exercises that focus on the quadriceps, especially the quadriceps on the inside of the thigh. Strengthening the muscles that control the knee will ideally help the knee remain on track inside the trochlear groove.

Surgery

Surgery isn’t a common treatment for patellar tracking disorders. However, some surgeons might recommend making a small cut in the ligament that anchors the outer edge of the patella, or surgical repair of the ligament on the inner side of the kneecap. This can keep the kneecap from slipping downward.

Patellar Tracking Disorder Prevention

The keys to preventing patellar tracking disorder are:

  • Stretch your legs before and after exercise 
  • Workout to build and keep up the strength in the muscles and knees
  • Maintain a healthy weight
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