Patella maltracking is one of the main causes of knee problems, so it’s important to understand why it occurs. If you have general knee problems, this brief guide will help clarify exactly what patella maltracking is and how it might be responsible for your pain. We will explain what the patella is, why it tracks incorrectly and the problems this can cause, as well as briefly touch on what can be done to relieve pain.
What is the patella?
The patella is what most people know as the kneecap. It is the point highlighted in our KneeStrength.com logo (above), as it is the focal point of our exercises. The movements of areas of the whole body can have an impact on the way the patella tracks over the knee, so the movement of the kneecap can point to different problems. In the immediate area around the knee, we are most concerned with the impact of these quadricep muscles:
What is patella maltracking?
Patella maltracking is an imbalance problem. The muscles in the upper thigh, the vastus medialis (inside) and vastus lateralis (outside) pull on the patella tendon in different directions. If one side is tighter than the other, it will pull the patella out of balance. Demonstrated with this simple diagram, the patella should ideally run smoothly down the middle of the groove between the condyles (the two sides) of the femur, at the end of your thigh bone:
In most cases of patella maltracking, the lateral (outer) quad is overactive and stronger than the medial (inner) quad, which is weak and underused. In these cases, the patella gets pulled out of the groove, to the side, and rubs against the femur, and this is what causes the pain you feel.
When the outer quad is especially tight, it can even pull the patella out of the joint and cause a dislocation. To tackle patella maltracking, therefore, you have to address the tightening of the muscle and the strength imbalance.
What causes the muscle tightness?
There are a number of reasons that the patella movement can become imbalanced, but muscle tightness is caused by an imbalance in strength or through muscles being overworked or used incorrectly. The muscle tightness stemming from improper muscle use comes from an evolutionary survival mechanism. When the muscle is overworked, there is a risk that it will tear and be damaged. In order to prevent this, the body sends impulses for the muscle to contract and avoid overstraining. This contraction forms a permanent knot in the muscle, which shortens the muscle. The shortened muscles then pulls tighter on the joint, causing it to feel stiff. The stiff feeling makes you want to avoid using the joint.
The corrective measures made by your body are well-intentioned, as they may prevent you from performing seriously harmful actions, but these warning signs leave lasting stiffness in the body. The muscle knots causing this stiffness can be removed manually. If you remove the knot, the muscle can be restored to its full length, preventing tightness and alleviating the pain. You can do this, simply, by massaging the knot. This breaks it down, switching off the nervous impulse and releasing the waste products caught in the knot. It also restores blood-flow to the muscle.
How to prevent future knots
Removing the knots treats the symptoms of patella maltracking and knee problems, but to prevent the problems from returning you have to address the strength imbalance. Performing correct body-movement exercises such as squats helps rebalance the muscles and increases strength where it is needed to maintain balanced knee movements. By training yourself to do these exercises in a controlled environment, you will start to move more correctly in everyday life, including in more strenuous situations (for instance when you lift something heavy or do outdoor sports). That trained balanced everyday movement is what will ultimately cure you of patella maltracking related problems for good.
For more information, please read other articles on this site and watch our instructional videos. The LiftAge video providing a brief introduction to correcting patella maltracking is a good place to start.