What is patellar tracking disorder and how can Pilates help?

What is patellar tracking disorder?

Patellar tracking disorder occurs when the kneecap (patella) shifts out of place as the leg bends or straightens. In most cases the kneecap shifts too far outwards however in a few people it shifts inwards. The knee joint is a hinge that joins the lower leg bones with the thigh bone (femur). The kneecap is held in place in the front of the knee joint by tendons on the top and bottom and by ligaments on the sides. Cartilage lines the underside of the kneecap helping it glide along the groove at the end of the femur. The kneecap can shift or rotate off track if the groove is too shallow or if the cartilage is damaged. Ligaments, tendons or muscles that are too loose or too tight may also lead to a misalignment.  Learn how Pilates can help patellar tracking disorder and get you back to walking and running pain free again.

Causes

• Usually caused by several problems combined.
• Shape of the patella, too tight muscles, too loose muscles and tendons in the leg, foot or hip. Cartilage damage.
• Overuse.
• A severe blow to the inside of a healthy knee can knock the kneecap out of alignment or dislocate it.
• Patellar tracking problems may run in the family.

Symptoms

• If your kneecap is out of alignment there may be discomfort or pain especially when going down stairs or sitting for a long time, standing up from sitting or squatting. This kind of pain is called patellofemoral pain and may be caused by patellar tracking disorder.
• There may be a feeling of popping, grinding, slipping or catching of the kneecap when you bend or straighten your leg. There may be the feeling that your knee is buckling or giving way as though your knee can’t support your body weight. 

Treatment

• If your knee is swollen, dislocated, giving way or causing pain take a break from activities that cause knee pain i.e. squatting, kneeling, running, jumping. Put ice on the knee, use pain medicines.
• As the pain starts to decrease, stretch and strengthen your leg. Strengthening the quadriceps, hamstrings and inner and outer thighs will help keep the kneecap stable. 
• Surgery isn’t usually needed. However, there are many types of surgery that can realign the kneecap and correct the tracking problem in some but you and your doctor can decide what is best for you.

Prevention

• Avoid activities that overload or overuse the knee. 
• Stretch legs and hips before and after activity.
• Reduce stress on knee joints.

Pilates Exercises that can help with Patellar Tracking Disorder

Pilates work on the mat and the reformer combined can be very good for strengthening and stretching the muscles around the knee and helping with patellar tracking order.

Reformer work

• Feet in straps
  • bend and stretch
  • lift and lower
  • leg circles
• Bridge
  • hip rolls or articulated bridge
  • hinge bridge
• Footwork
  • parallel
  • pilates “V” / heels together, toes apart
  • toes wrapped around the bar
  • high half toes
  • lower and lift (heels)
  • running
• Second position
  • parallel
  • laterally rotated
  • medially rotated

Mat work

• Hip rolls / Bridge / articulated bridge
• leg circles
• side lying leg series

These are a sample of exercises that can be done to help strengthen the muscles around the knee. There are many other exercises and variations so Pilates can help patellar tracking disorder.