The back of the knee cap (pattela) is 'V' shaped. It rubs in a complimentary v-shaped
groove in front of the lower end of the thigh bone. When the pattela runs off-centre, it
rubs firmly on the underlying thigh bone, causing pain in the knee.
(anterior knee pain, chondromalaecia patellae)
Why does it occur?
Who does it affect?
Symptoms
Diagnosis
Management
Outlook
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Why does it occur?
Abnormal biomechanical forces in the leg can cause the knee cap to run off-centre (towards the outside of the leg). This includes problems in the foot/ankle, the knee itself and imbalances in the pelvis/hip/thigh.
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Who dose it affect?
Patella tracking problems are common in adolescents and distance athletes (runners, cyclists). In adults, it is associated with degenerative changes in the cartilage on the back of the knee-cap.
During puberty this pain is commonly referred to as "growing pains".
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Symptoms
Pain at the front, inside, outside or back of the knee.
Pain may be increased by ascending and descending steps/slopes, squatting, kneeling or prolonged sitting (Movie-goers knee).
Giving way of the knee.
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Diagnosis
Diagnosis of the condition and its cause can be made by physiotherapists at Hastings Sports Injury and Physiotherapy Center.
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Management
Physiotherapy treatment may include:
Pain relief
Massage and stretches to structures pulling the knee cap outwards
Strengthening exercises for the structures pulling the knee cap inwards
Taping to center the knee cap
Correction of abnormal biomechanics in the leg
Failure of conservative treatment may necessitate referral to an orthopaedic specialist who may consider several surgical options
However, this is rare if treated when symptoms occur.
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Outlook
Successful non-operative treatment requires adherence to a strengthening and stretching program. Prognosis is very good with conservative treatment.
Hastings physiotherapists will be happy to confidentially discuss any of your concerns. Contact the clinic to make an appointment.

This fact sheet is not designed to replace the advice of your health professional.
FOR FURTHER INFORMATION OR TO MAKE AN APPOINTMENT PLEASE PHONE
HASTING SPORTS INJURY AND PHYSIOTHERAPY CENTER
Phone: (02) 6583 2111
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