The knee joint is one of the body’s simplest at first glance. You can make it bend or you can straighten it out. Easy. Most introductory anatomy course will compare the knee joint, classified as a hinge joint, to a door hinge to help people understand how it works. As with everything else in the body, the knee joint is actually a little more complex. And knee cap pain is common but preventable.
One of the reasons why the knee joint is one of the more unique in the body is due to the patella, known more commonly as the kneecap. The kneecap’s role is primarily to increase leverage from the quadriceps to help produce more force when we squat, run, jump… basically anything where we straighten the knee. It’s a quirky but incredibly useful bit of our body!
The kneecap has its own set of problems, however. Much like the knee as a whole, the kneecap is at the mercy of the hip and ankle to put it in position to succeed. For example, if your knees tend to collapse inward while you’re squatting, the kneecaps will usually have increased pressure on the outer part of the joint. If this occurs often enough, the cartilage in that area can start to wear down. This is all to say that pain under or around the kneecap is usually going to be caused by what’s referred to as a tracking issue.
Think of the kneecap as a train and the femur (the long bone in your thigh) as providing the track and you’ve got the basic idea. The problem is that the femur – the track – can move under the kneecap. Various tendons and ligaments can also pull the kneecap off track as well, and in some cases even dislocate the kneecap. So really it’s a train on a moveable track with a bunch of ropes tugging the train. If the system works well, it’s a really strong and stable joint! When things go wrong, it can be very painful and makes getting around pretty tough. If you’re having pain around the kneecap, here are some things to try:
- Patellar Mobilization – This is a simple to do, but easy to mess up exercise. If you’re knee isn’t fully straight and relaxed, you won’t be able to do it. This is best done seated at the edge of a chair with your leg propped in front of you, but if you’re flexible you can do this sitting on the ground with your legs directly in front of you. Dosage for this isn’t too specific, but 30-60 seconds at a time 2-3 times a day can make a difference.
- Clamshells – Another seemingly simple exercise. The most common mistake made with clamshells is allowing the pelvis to roll backward as the knee elevates. This takes the stress off the glute medius, the muscle we’re trying to work. A cue that usually helps is to take your top arm and reach it forward slightly. The height of the knee isn’t what’s important, it’s that you feel the muscle on the side (not the front) of your hip working. Try working to muscle fatigue for 1-3 sets on each side.
- Balance drills, especially in single leg stance – The emphasis with any balance drill is going to be your body positioning. With whatever balance exercise you choose, the knee should stay over the ankle with the kneecap pointed forward, and your bellybutton should be pointed in the same direction as your toes. Simply standing on one leg is a way to challenge yourself here, but you could always try more dynamic movements like lunges or RDLs. Remember, the issue here is tracking, so keep the train track as steady as it can be.
Kneecap pain can be tricky. There’s a lot of stuff that affects how the kneecap moves. If you’re not seeing the success you want with some basic exercises, see a physical therapist for some help.
Got questions? Feel limited in what you’re able to do? The staff at Limitless Physical Therapy in Eugene, OR can show you how to discover your future without limits.
***The above information, including text, images, and all other materials, is provided for educational purposes only, and not as a replacement or supplement to professional medical advice. Please contact a certified healthcare professional or your primary physician for any personal concerns.