These differences, or anatomic variations, are something people are born with. The result is abnormal pressure on the articular surface of the patella.Īnother type of imbalance may exist due to differences in how the bones of the knee are shaped. This tends to pull the patella toward the outside of edge of the knee. People with patellofemoral problems sometimes have problems in the timing between the VMO and the VL. The VL runs down the outside part of the thigh. The VMO is the section of muscle on the inside of the front of the thigh. As mentioned earlier, the VMO is one of these four muscles. There are four muscles that form the quadriceps muscle group. Many patients are confused when their Physical Therapist begins exercises to strengthen and balance the hip muscles, but there is a very good reason that the therapist is focusing on this area.Ī similar problem can happen when the timing of the quadriceps muscles is off. This causes abnormal tracking of the patella within the femoral groove and eventually pain around the patella. Weakness of the muscles that pull the hip out and away from the other leg, the hip abductor muscles, can lead to imbalances to the alignment of the entire leg - including the knee joint and the muscle balance of the muscles around the knee. Weakness of the muscles around the hip can also indirectly affect the patella and can lead to patellofemoral joint pain. In time, this pressure can damage the articular cartilage. This in turn causes more pressure on the articular cartilage on one side than the other. When this happens, the pull of the quadriceps muscle may cause the patella to pull more to one side than the other. ![]() If part of the quadriceps is weak for any reason, a muscle imbalance can occur. The quadriceps muscle helps control the patella so it stays within this groove. One of the more common causes of knee pain is a problem in the way the patella tracks within the femoral groove as the knee moves. Related Document: Endurance Rehabilitation and Wellness Center, PC's Guide to Osteoarthritis of the Knee The patellofemoral joint is usually affected as part of osteoarthritis of the knee. Degeneration may develop as part of the aging process, like putting a lot of miles on a car. Wear and tear can develop for several reasons. The underlying cartilage begins to degenerate, a condition sometimes referred to as chondromalacia patella. Problems commonly develop when the patella suffers wear and tear. This groove is called the femoral groove. This covering helps the patella glide (or track) in a special groove made by the thighbone, or femur. The underside of the patella is covered with articular cartilage, the smooth, slippery covering found on joint surfaces. The patella acts like a fulcrum to increase the force of the quadriceps muscles. ![]() This action causes the knee to straighten. Tightening up the quadriceps muscles places a pull on the tendons of the quadriceps mechanism. Though we think of it as a single device, the quadriceps mechanism has two separate tendons, the quadriceps tendon on top of the patella and the patellar tendon below the patella. The large quadriceps tendon together with the patella is called the quadriceps mechanism. This unique bone is wrapped inside a tendon that connects the large muscles on the front of the thigh, the quadriceps muscles, to the lower leg bone. The patella (kneecap) is the moveable bone on the front of the knee. ![]() What is the patella, and what does it do?
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