Patellar Balancing Act

In a recent blog, I talked about the importance, and challenges of building a strong thigh muscle when you have a kneecap or patellar problem.

Equally important in maintaining a healthy knee with pain-free kneecaps is certain stretching exercises. It's a real balancing act between strength and flexibility.

The kneecap or patella rides over the lower part of the femur in a groove called the trochlea. It's not a deep joint like the hip, so things are inherently a little unstable, with some kneecaps tending to ride slightly off track and thus prone to problems.

The key to getting the kneecap to ride more centered in its groove is good muscle balance. This is especially true in children and teenagers after a growth spurt where muscles tend to tighten up resulting in imbalances. This is one of the reasons that kneecap problems are so common in the younger age groups. In addition to the strengthening exercises previously mentioned, you should focus on daily stretching of the following muscle groups:

  • Hamstrings (rear thigh)
  • Quads (front thigh)
  • ITB (iliotibial band) / outer thigh
  • Calf muscle

Sometimes a knee sleeve can help. The neoprene sleeve with an open hole in the front (patellar cut out) can help the kneecap ride better in its groove till the muscle balance is restored through exercise. There are special patellar braces for those whose kneecaps really go out of place (i.e. sublux or dislocate). These include either the Shield's or Palumbo patellar stabilizing brace.