Patellar Tracking Disorder: Exercises
Key points
The thigh muscles (quadriceps) help
keep the kneecap (patella) stable and in place. Weak quadriceps increase the
risk of
Reference patellar tracking disorder Opens New Window.
Ligaments and
tendons also help stabilize the patella. If these are too tight or too loose,
you have a greater risk of patellar tracking disorder.
The goals
of nonsurgical treatment of patellar tracking problems are to reduce
symptoms, increase quadriceps strength and endurance, and return to normal
function. Exercises for patellar tracking disorder are not complicated and can
be done at home in about 20 minutes a day.
- Most patellar tracking problems can be
treated effectively without surgery. Nonsurgical treatment may include rest,
regular stretching and strengthening exercises, taping or bracing the knee,
using ice, and short-term use of
Reference nonsteroidal anti-inflammatory drugs (NSAIDs) Opens New Window.
- Quadriceps strengthening is the most commonly
prescribed treatment for patellar tracking disorder. Exercises to increase
flexibility and to strengthen the muscles around the hip can also
help.Reference 1
- Patience and dedication are
essential. The slow progress and improvement can be frustrating. But most
people can be spared a surgical procedure by closely following a conservative
therapy program.
Be sure to stay on your exercise program. You may
not notice much improvement in your symptoms right away, and recovery can take
several months. Problems can come back if you don't keep your strength and
flexibility.
At
first, following an injury or a flare-up of symptoms of patellar tracking
disorder, knee activity should be reduced. Rest your knee by avoiding activity
that increases your symptoms. Exercises should begin as the symptoms
resolve.
Steps you can take to help treat patellar tracking
disorder include:
- Reducing knee activity until pain and other
symptoms resolve.
- Strengthening exercises, especially for the
quadriceps (muscles in the front of the thigh).
- Flexibility
exercises.
- Taping the knee or using a brace.
- Using ice
and nonsteroidal anti-inflammatory drugs (NSAIDs). After 2 or 3 days of using ice, you can try heat to see if it helps.
Test Your Knowledge
-
Surgery is usually needed to treat patellar
tracking disorder.
-
True
This answer is incorrect.
In most cases, nonsurgical treatment including
rest and quadriceps-strengthening exercises done in combination with taping or
bracing the knee and use of ice and nonsteroidal anti-inflammatory drugs
(NSAIDs) will resolve a patellar tracking disorder.
-
False
This answer is correct.
In most cases, nonsurgical treatment including
rest and quadriceps-strengthening exercises done in combination with taping or
bracing the knee and use of ice and nonsteroidal anti-inflammatory drugs
(NSAIDs) will resolve a patellar tracking disorder.
Nonsurgical treatment, especially strength and
flexibility exercises, is usually all that is needed for patellar tracking
disorder. But be sure to seek diagnosis as soon as you notice symptoms,
so that you can begin the right treatment. In general, the longer you have a
patellar tracking disorder, the longer treatment will take.
If a
patellar tracking disorder is left untreated or treated without success, it can
lead to
Reference chondrosis Opens New Window or
Reference osteoarthritis Opens New Window of the knee.
Test Your Knowledge
-
Ignoring the symptoms of a patellar tracking disorder
can have severe long-term consequences.
-
True
This answer is correct.
If a patellar tracking disorder is left
untreated, it can lead to chondrosis, a softening or loss of the cartilage that
covers the back of the kneecap, which can cause pain during activities that
require bending of the knee. It can also lead to osteoarthritis of the knee, a
progressive breaking down of cartilage that is a major cause of disability in
older adults.
-
False
This answer is incorrect.
If a patellar tracking disorder is left
untreated, it can lead to chondrosis, a softening or loss of the cartilage that
covers the back of the kneecap, which can cause pain during activities that
require bending of the knee. It can also lead to osteoarthritis of the knee, a
progressive breaking down of cartilage that is a major cause of disability in
older adults.
Correct diagnosis is of great importance in designing an exercise or
rehabilitation program. The treatment you receive and the exercise program you
use to rehabilitate your knee should be developed specifically for your
condition. Some doctors will recommend using a brace or a taping technique to
keep your kneecap in proper alignment, in addition to an exercise program. Be
sure to closely follow the instructions from your doctor or physical
therapist.
At first, following an injury or a flare-up of symptoms
of patellar tracking disorder, knee activity should be reduced. Overuse and
trauma are common causes of knee pain. And resting your knee will help relieve
pain. Exercises should begin as the symptoms resolve.
Your doctor
or physical therapist should help you decide what exercises to do. He or she
will probably have you start with one or two exercises and add others over
time. Your physical therapist may use biofeedback during some exercises to help
you learn to contract certain muscles, especially the inner muscle of your
quadriceps.
The following exercises may be the first ones that your doctor or physical therapist recommends.
Quad sets
- Sit with your leg straight and supported on
the floor or a firm bed. (If you feel discomfort in the front or back of your
knee, place a small towel roll under your knee.)
- Tighten the
muscles on top of your thigh by pressing the back of your knee flat down to the
floor. (If you feel discomfort under your kneecap, place a small towel roll
under your knee.)
- Hold for about 6 seconds, then rest up to 10
seconds.
- Do this for 8 to 12 repetitions several times a day.
Mini squat
- Stand with your feet about hip-width apart
and 12 inches from a wall.
- Lean against the wall and slide down
until your knees are bent about 20 to 30 degrees.
-
Place a ball about the size of a soccer ball between your knees and
squeeze your knees against the ball for about 6 seconds at a time.
- Rest a few seconds, then squeeze again.
- Repeat 8 to
12 times, at least 3 times a day.
When your doctor or physical therapist thinks your knee is ready for more intensive exercise, he or she may recommend some of the following:
Straight-leg raises to the front
Note: For straight-leg raise exercises, your physical
therapist may have you add light ankle weights as you become stronger.
- Lie
on your back with your good knee bent so that your foot rests flat on the
floor. Your injured leg should be straight. Make sure that your low back has a
normal curve. You should be able to slip your flat hand in between the floor
and the small of your back, with your palm touching the floor and your back
touching the back of your hand.
- Tighten the thigh muscles in the
injured leg by pressing the back of your knee flat down to the floor. Hold your
knee straight.
-
Tighten the quadriceps muscles of your straight leg and lift the
leg 12 to 18 inches off the floor. Hold for about 6 seconds, then slowly lower
the leg back down and rest a few seconds.
- Do 8 to 12 repetitions,
3 times a day.
Straight-leg raises to the inside
- Lie on your side with the leg you are going
to exercise on the bottom and your other foot either up on a chair or flat on the floor in front of your knee.
-
Tighten your thigh muscles, and then lift your leg straight up away from the
floor.
- Hold for about 6 seconds, slowly lower the leg back down, and rest
a few seconds.
- Do 8 to 12 repetitions, 3 times a day.
Straight-leg raises to the outside
- Lie on your side with the leg you are
going to exercise on top.
- Tighten your thigh muscles, and then
lift your leg straight up away from the floor.
-
Keep your hip and your leg straight in line with the rest of your
body, and keep your knee pointing forward. Do not drop your hip back.
- Hold for about 6 seconds, slowly lower the leg back down, and
rest a few seconds.
- Do 8 to 12 repetitions, 3 times a day.
Straight-leg raises to the back
- Lie on your belly.
- Tighten
your thigh muscles, and then lift your leg straight up away from the floor.
- Hold for about 6 seconds, slowly lower the leg back down, and
rest a few seconds.
- Do 8 to 12 repetitions, 3 times a day.
Half squat
- Using your thigh muscles, extend your leg
slowly from 30 degrees to 0 degrees (straight leg) and slowly back again.
- Do 8 to 12 repetitions, 3 times a day.
Remember to limit the bend of your knee to a 30-degree angle at
first. When your knee is bent past this point, your kneecap will have more
contact with the thighbone, causing more pressure, pain, and possible cartilage
damage.
Shallow knee bend on one leg
- Stand on a step, on the leg you want to
exercise. Let your other leg hang down off the step.
- Keeping your
head up and your back straight, lean slightly forward. Hold on to a banister if
you feel unsteady.
- Slowly bend your knee so the foot hanging down
moves down toward the floor, then slowly straighten your knee again. Your heel
should stay on the step, and your knee should not go any farther forward than
your toe.
-
Do 8 to 12 repetitions.
Remember to limit the bend of your knee to a 30-degree angle at
first. When your knee is bent past this point, your kneecap will have more
contact with the thighbone, causing more pressure, pain, and possible cartilage
damage.
Standing quadriceps stretch
- If you are steady on your feet, stand
holding a chair, counter, or wall. You can also lie on your stomach or your
side to do this exercise.
- Bend the knee of the leg you want to stretch, and
grab the front of your foot with the hand on the same side. For example, if you
are stretching your right leg, use your right hand.
- Keeping your
knees next to each other, pull your foot toward your buttock until you feel a
gentle stretch across the front of your hip and down the front of your thigh.
Your knee should be pointed directly to the ground, and not out to the
side.
- Hold the stretch for at least 15 to 30 seconds. Repeat 2 to
4 times.
Hamstring stretch in doorway
- Lie on the floor near a doorway, with your
buttocks close to the wall.
- Let the leg you are not stretching
extend through the doorway.
- Put the leg you want to stretch up on
the wall, and straighten your knee to feel a gentle stretch at the back of your
leg.
- Hold the stretch for at least 15 to 30 seconds. Repeat 2 to
4 times.
Hip rotator stretch
- Lie on your back with both knees bent and
your feet on the floor.
- Put the ankle of the leg you are going to
stretch on your opposite thigh near your knee.
- Push gently on the
knee of the leg you are stretching until you feel a gentle stretch around your
hip.
- Hold the stretch for at least 15 to 30 seconds. Repeat 2 to 4
times.
Iliotibial band and buttock stretch
- Sit on the floor with your legs out in
front of you.
- Bend the knee of the leg you want to stretch, and
put that foot on the floor on the outside of the opposite leg. (Your legs will
be crossed.)
- Twist your shoulders toward your bent leg, and put
your opposite elbow on that knee.
- Push your arm against your knee
to feel a gentle stretch at the back of your buttock and around your hip.
- Hold the stretch for at least 15 to 30 seconds. Repeat 2 to 4
times.
Calf stretch
- Stand facing a wall with your hands on the
wall at about eye level.
- Put the leg you want to stretch about a
step behind your other leg.
- Keeping your back heel on the floor,
bend your front knee until you feel a stretch in the back leg.
- Hold the stretch for at least 15 to 30 seconds. Repeat 2 to 4
times.
Test Your Knowledge
-
The first phase of strengthening your quadriceps
should involve using weight-lifting equipment and bending your knee through a
30-degree angle.
-
True
This answer is incorrect.
After you have adequately rested your knee and
symptoms resolve, the first phase of strengthening your quadriceps focuses on
isometric exercise.
-
False
This answer is correct.
After you have adequately rested your knee and
symptoms resolve, the first phase of strengthening your quadriceps focuses on
isometric exercise.
-
Stretching your hip can help ease a patellar tracking
disorder.
-
True
This answer is correct.
If you have tightness in structures such as
your quadriceps, iliotibial band, or hamstrings, you can develop a patellar
tracking disorder. All these muscles act on both your hip and your knee, so
stretching around your hip can help loosen them and help ease patellar tracking
disorder.
-
False
This answer is incorrect.
If you have tightness in structures such as
your quadriceps, iliotibial band, or hamstrings, you can develop a patellar
tracking disorder. All these muscles act on both your hip and your knee, so
stretching around your hip can help loosen them and help ease patellar tracking
disorder.
For more information about exercises to treat patellar
tracking disorder, talk to:
- Your doctor.
- A physical
therapist.
- An occupational therapist for job-related
activities.
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