Patellar Tracking Disorder: Exercises

Overview

The thigh muscles (quadriceps) help keep the kneecap (patella) stable and in place. Weak quadriceps increase the risk of patellar tracking disorder.

Ligaments and tendons also help stabilize the patella. If these are too tight or too loose, you have a greater risk of patellar tracking disorder.

The goals of nonsurgical treatment of patellar tracking problems are to reduce symptoms, increase quadriceps strength and endurance, and return to normal function. Exercises for patellar tracking disorder are not complicated and can be done at home in about 20 minutes a day.

Most patellar tracking problems can be treated effectively without surgery. Nonsurgical treatment may include rest, regular stretching and strengthening exercises, taping or bracing the knee, using ice, and short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Quadriceps strengthening is the most commonly prescribed treatment for patellar tracking disorder. Exercises to increase flexibility and to strengthen the muscles around the hip can also help.

Your doctor or physical therapist should will help you decide what exercises to do. You will likely start with one or two exercises and do more over time. Your physical therapist may use biofeedback during some exercises to help you learn to contract certain muscles, especially the inner muscle of your quadriceps.

Things to keep in mind

Correct diagnosis is important in designing an exercise or rehabilitation program. The treatment you receive and the exercise program you use to rehabilitate your knee should be developed specifically for your condition.
At first, following an injury or a flare-up of symptoms of patellar tracking disorder, knee activity should be reduced. Overuse and trauma are common causes of knee pain. And resting your knee will help relieve pain. Exercises should begin as the symptoms resolve.
Some doctors will recommend using a brace or a taping technique to keep your kneecap in proper alignment, in addition to an exercise program. Be sure to closely follow the instructions from your doctor or physical therapist.
Be sure to stay on your exercise program. You may not notice much improvement in your symptoms right away, and recovery can take several months. This can be frustrating. Problems can come back if you don't keep your strength and flexibility.

How To Do The Exercises

First exercises

Quad set

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slide 1 of 2, Quad set,

Sit or lie down on a firm surface or the floor with your affected leg straight. Place a small, rolled-up towel under your knee.
Tighten the thigh muscles of your straight leg by pressing the back of your knee down into the towel.
Hold for about 6 seconds, then rest.
Repeat 8 to 12 times.
It's a good idea to repeat these steps with your other leg.

Wall sit with ball squeeze

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slide 2 of 2, Wall sit with ball squeeze,

Stand with your feet about hip-width apart and 12 inches from a wall.
Lean against the wall and slide down until your knees are bent about 20 to 30 degrees.
Place a ball about the size of a soccer ball between your knees and squeeze your knees against the ball for about 6 seconds.
Rest a few seconds, then squeeze again.
Repeat 8 to 12 times.

More intense exercises

Hip flexion (lying down, leg straight)

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slide 1 of 11, Hip flexion (lying down, leg straight),

Lie on your back with your affected leg straight. You can bend your other leg, if that feels more comfortable.
Tighten the thigh muscles in your affected leg by pressing the back of your knee down. Hold your knee straight.
Keeping the thigh muscles tight and your leg straight, lift your affected leg up so that your heel is about 12 inches off the floor. Hold for about 6 seconds, then lower slowly.
Repeat 8 to 12 times.
It's a good idea to repeat these steps with your other leg.

Hip adduction (lying on side)

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slide 2 of 11, Hip adduction (lying on side),

Lie on your side with your affected leg on the floor.
You can either prop your other leg on a chair, or you can bend that knee and put that foot in front of your other knee.
Keep your knee straight and your leg in a straight line with your body.
Lift your bottom leg up toward the ceiling about 6 inches. Hold for about 6 seconds, then lower slowly.
Repeat 8 to 12 times.
It's a good idea to repeat these steps on your other side.

Keep your kneecap pointing forward.
Don't let your hip drop back.

Hip abduction (lying on side)

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slide 3 of 11, Hip abduction (lying on side),

Lie on your side, with your affected leg on top. You can use your hand or a pillow to support your head.
Keep your knee straight and your leg in a straight line with your body.
Lift your affected leg straight up toward the ceiling, about 12 inches off the floor. Hold for about 6 seconds, then slowly lower your leg.
Repeat 8 to 12 times.
It's a good idea to repeat these steps on your other side.

Keep your kneecap pointing forward.
Don't let your hip drop back.

Hip extension (lying down, leg straight)

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slide 4 of 11, Hip extension (lying down, leg straight),

Lie on your stomach with your legs straight.
Keeping your leg straight, lift the toes of your affected leg about 6 inches off the floor.
Hold for about 6 seconds and then slowly lower your leg.
Repeat 8 to 12 times.
It's a good idea to repeat these steps with your other leg.

Shallow standing knee bend

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slide 5 of 11, Shallow standing knee bend,

Stand with your hands lightly resting on a counter or chair in front of you. Place your feet shoulder-width apart.
Slowly bend your knees so that you squat down like you are going to sit in a chair. Make sure your knees do not go in front of your toes.
Lower yourself about 6 inches. Your heels should remain on the floor at all times.
Rise slowly to a standing position.
Do 8 to 12 repetitions, 3 times a day.

Remember to limit the bend of your knee to a 30-degree angle at first. When your knee is bent past this point, your kneecap will have more contact with the thighbone, causing more pressure, pain, and possible cartilage damage.

Lateral step-up

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slide 6 of 11, Lateral step-up,

Stand sideways on the bottom step of a staircase with your affected leg on the step and your other foot on the floor.
Keeping your head up and your back straight, lean slightly forward. Hold on to a handrail or wall if you feel unsteady.
Use your affected leg to raise yourself up, bringing your other foot level with the stair step. Then slowly bend your knee to lower your foot back down. As you bend and straighten your leg:
Repeat 8 to 12 times.
It's a good idea to repeat these steps with your other leg.

Keep your hips level.
Keep your knee moving in a straight line with your middle toe. Don't let your knee go past your toe.
Keep your heel flat on the step.

Standing quad stretch

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slide 7 of 11, Standing quad stretch,

If you are steady on your feet, stand holding a chair, counter, or wall. You can also lie on your stomach or your side to do this exercise.
Bend the knee of the leg you want to stretch, and grab the front of your foot with the hand on the same side. For example, if you are stretching your right leg, use your right hand.
Keeping your knees next to each other, pull your foot toward your buttock until you feel a gentle stretch across the front of your hip and down the front of your thigh. Your knee should be pointed directly to the ground, and not out to the side.
Hold the stretch for at least 15 to 30 seconds. Repeat 2 to 4 times.

Hamstring stretch in doorway

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slide 8 of 11, Hamstring stretch in doorway,

Lie on the floor near a doorway, with your buttocks close to the wall.
Let the leg you are not stretching extend through the doorway.
Put the leg you want to stretch up on the wall, and straighten your knee to feel a gentle stretch at the back of your leg.
Hold the stretch for at least 15 to 30 seconds. Repeat 2 to 4 times.

Hip internal rotator stretch

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slide 9 of 11, Hip internal rotator stretch,

Lie on your back with both knees bent and your feet flat on the floor.
Put the ankle of your affected leg on your opposite thigh near your knee.
Use your hand to gently push your knee away from your body until you feel a gentle stretch around your hip.
Hold the stretch for 15 to 30 seconds.
Repeat 2 to 4 times.
It's a good idea to repeat these steps with your other leg.

Iliotibial band and buttock stretch

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slide 10 of 11, Iliotibial band and buttock stretch,

Sit on the floor with your legs out in front of you.
Bend the knee of your affected leg, and put that foot on the floor on the outside of the opposite leg. (Your legs will be crossed.)
Twist your shoulders toward your bent leg, and put your opposite elbow on that knee.
Push your arm against your knee to feel a gentle stretch at the back of your buttock and around your hip.
Hold the stretch for at least 15 to 30 seconds.
Repeat 2 to 4 times.
It's a good idea to repeat these steps with your other leg.

Calf stretch

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slide 11 of 11, Calf stretch,

Stand facing a wall with your hands on the wall at about eye level.
Put the leg you want to stretch about a step behind your other leg.
Keeping your back heel on the floor, bend your front knee until you feel a stretch in the back leg.
Hold the stretch for at least 15 to 30 seconds. Repeat 2 to 4 times.

Related Information

Patellar Tracking Disorder

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