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1st Sep

2010

Taping for Patellar Pain

Pain stemming from the joint between the knee cap and the underlying thigh bone, the patellofemoral joint, is one of the most common problems of the knee. It is particularly common in sports, making up 14-17% of all reported sports injuries. The pain is felt in front of the knee, and often just below the knee cap, the patella. Although there may be many contributing reasons for the pain, it is believed to most often occur due to a shift in the position of the patella during movements of the knee, creating increased pressure on certain areas of the joint cartilage and its underlying bone.

BRACING AND TAPING

There are various patellar braces available on the market, which aim at keeping the patella in a somewhat central location in its underlying groove in the femur bone, in which it runs up and down. Some of these braces have shown to have the potential to reduce patellofemoral pain.

Patellar taping has perhaps shown even better results, and compelling evidence of its effectiveness has been shown in several research studies. The most commonly used taping technique is the McConnell method.

It was previously believed that the taping worked primarily because it moved a patella which was shifted or tilted too far out to the side, in a direction towards the inside of the knee. More recent research studies have shown, however that taping more than anything reduces the amount of upward motion of the patella, and it increases the patellar cartilage contact area during motion, thereby decreasing the compression force on the cartilage and underlying bone.

EXERCISE FOR PATELLOFEMORAL PAIN

Taping or bracing by themselves may produce only partial and temporary pain relief. Typically specific rehabilitation exercise is necessary to achieve more substantial and long lasting results. Such exercise depends on what deficits or muscular imbalances a person presents with, but a typical program would include quadriceps (front thigh muscle) training, especially of the inside portion called the VMO, while avoiding excessive patellar cartilage compression and pain.

Many people also have hip muscle weakness, especially of hip stabilizing gluteus medius on the side of the buttocks, which creates a subtle buckling of the hip during walking, running and jumping, which in turn changes the mechanics of the patella. Specific weightbearing hip strengthening exercise is therefore important to include for many people with patellofemoral pain.

FOOT ORTHOTICS

Another contributing factor for some people is a foot which overpronates, or flattens excessively during walking and running. This may lead to excessive rotation of the lower leg and thigh as the knee bends and straightens, again affecting the patellar movements. These people may be helped by getting custom orthotics for their feet, or if the pronation is not severe, an off the shelf shoe insert (or support molded to the foot in a shoe store) may suffice.

A combination of some or all of these measures usually helps people with patellofemoral pain return to activities and sports with less knee pain.

Best wishes for continued good health,

Gunnar

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