What Is Patella Maltracking?

Mal Baxter

Patella maltracking, or patellofemoral pain syndrome, is an imbalance in the gliding of the kneecap that aggravates cartilage behind the knee. Rather than gliding vertically as the knee bends, a maltracking patella is pulled to the outward side as it moves upward in the groove. This may result in pain on the outward and front sides of the knee, clicking sounds, swelling, and pain from both activity and long bouts of sitting. Multiple treatments are available, with varying degrees of success.

A person wearing a patellar brace.
A person wearing a patellar brace.

Common causes of patella maltracking include problems with foot alignment and muscle strength. Muscle imbalances in the quadriceps (front thigh) or gluteus maximus (rear) may create gait conditions that aggravate this affliction. Other causes include malrotation of the upper leg bone, or femur, and foot pathology. Treatments include physiotherapy, the use of insoles, and even reconstructive surgery.

Individuals who have a history of knee dislocation are more likely to suffer from patella maltracking.
Individuals who have a history of knee dislocation are more likely to suffer from patella maltracking.

Specifically, patella maltracking is contrasted to patellar tilt, in which the kneecap usually points toward the outer or lateral side; and patellar misalignment, when the kneecap rests too far to the side. Patella maltracking occurs during bending and straightening movements, transitioning outside of its intended groove. The fact that this is a movement condition means that treatment often consists of movement therapies. These might include strengthening of the quadriceps and hamstrings, or using tape or bandages to train the movement of the patella. In some cases, orthotics may be employed to control foot hyperpronation, the inward rotation of foot movement that overextends kneecap movement, to equalize the forces that act upon the knee.

Patella maltracking often strikes individuals who have a history of knee dislocation.
Patella maltracking often strikes individuals who have a history of knee dislocation.

This affliction often strikes people who have a history of patella dislocation, or those who have suffered an injury. Common among adolescent females, it also afflicts those suffering from flat feet or genu velum, knock knees. It may result from ankles turned inward or outward, or even improper footwear. Specialists such as medical professionals, sports physical therapists, or chiropractors assist in proper treatment of this condition.

The patella, also known as the kneecap, is a rounded triangular bone that connects the upper leg to the lower leg.
The patella, also known as the kneecap, is a rounded triangular bone that connects the upper leg to the lower leg.

A common cause of patella maltracking lies with the mechanics of the feet. Improper foot placement rotates the leg inward, which tightens the iliotibial band on the outside of the thigh, drawing the patella outward. With increased pressure at the bottom of the kneecap, friction wears the cartilage down and generates pain behind the knee. Muscle weakness in the gluteus maximus can create overcontraction of the quadriceps, which may also heighten pressure on the kneecap.

Donkey kicks help retrain the legs and feet after patella maltracking.
Donkey kicks help retrain the legs and feet after patella maltracking.

Immediate treatments include stretching, or rest, ice, compression, and elevation (RICE), to reduce swelling and inflammation. Exercise techniques such as side-lying abductions, clamshells, hip rotations, or donkey kicks are sometimes employed in retraining the movement of the legs and feet. Gait correction with orthotics, or braces and insoles, reduces weight-bearing forces and guides movement. Other treatments might include surgery, injections, anti-inflammatory agents, and medications.

A specialist such as a chiropractor can assist in proper treatment of patella maltracking.
A specialist such as a chiropractor can assist in proper treatment of patella maltracking.
A cold compress or ice pack may help reduce the pain and swelling caused by patella maltracking.
A cold compress or ice pack may help reduce the pain and swelling caused by patella maltracking.
Recostructive surgery may be necessary to treat patella maltracking.
Recostructive surgery may be necessary to treat patella maltracking.

You might also Like

Readers Also Love

Discussion Comments

Magnette

I've twice had surgeries on one of my knees - one arthroscopic and the other reconstructive - and I wouldn't wish it on anyone. The reconstructive surgery itself wasn't so bad, but the recovery and physical therapy, were painful and often depressing. My point is to take care of your knees. The last paragraph offers some good treatment and exercise options. If you suffer from patella maltracking, please follow them.

Post your comments
Login:
Forgot password?
Register: