Avoid Knee Pain – Patella Tracking Exercise Tips

by | Nov 28, 2011 | Exercise and Fitness, Pilates Exercises, Techniques & Teaching Tips, Videos | 3 comments

I posted a video on the Centerworks YouTube channel: Knee Exercises to Strengthen Muscles Around the Patella to Avoid Knee Pain, and it’s been one of the highest viewed videos on my channel.  Thanks to everyone that’s tuned in for this knee exercise tip!  Today, I received a question from a viewer, but was unable to get my reply to send, so I thought I’d post it in a blog and hopefully the person who asked the Knee cap dance questions below will find this, and if there is anybody else out there looking for help with knee pain issues – I hope this blog post will help you too.

Viewer Asks: 

“I just watched your “Knee cap dance”  While having my hands on the tops of my knee I felt a slight crunch on the outside of my right knee.   It didn’t hurt but each time I moved my knee cap it crunched.  The reason I watched your video was account of a slight pain in my knee cap.  It is continually getting better with other stretches that I have found on the web.  Here’s my question, do I keep doing the Knee cap dance to “break up any adhesions” or do I stop this particular stretch?   Thank you.”

Aliesa’s Reply:

Thanks for the question about the knee-cap exercise.  Easier for me to make a judgment call when I have a client in front of me, know their full health history, and can see them move.  When in doubt, or if any exercise you are doing is causing pain – I would immediately stop doing the exercise.

Perhaps there are modifications, or other adjustments that need to be made.  But without seeing you – it’s impossible for me to make recommendations on what else to do in this instance.  If you deem it is safe for you to continue this exercise, you might work in a smaller range of motion to move the kneecap to start and see if you can do the exercise and avoid the crunching that you are talking about.  Also, the knee cap should be gliding evenly, straight up the middle.  If the knee cap is gliding in it’s groove – bending and straightening your knees, or lifting your kneecaps should be a quiet experience!  If it’s pulling off to the outside of your leg as it lifts, you may have some muscle imbalance issues that are contributing to the problem and creating the crunching sounds.

Generally speaking,  a lot of people have muscle imbalances between the front of the thigh (quadriceps) and back of the thigh (hamstrings) in combination with the support of inner thighs, outer thighs, and Glutes can cause the kneecap to track incorrectly.

Test Your Knee Cap Tracking:

Sit in a chair and bend your knees,  put one hand on the top of your kneecap and straighten your leg – if you hear some crackling sounds, it’s because your kneecap is not tracking properly in its groove.  Now test the other leg.  Is there a difference in the sounds that your knees make?  Do they both crunch, or is one worse than the other?  Does your noisy knee correlate to any knee pain or problems you have experienced?

Tracking issues unfortunately are common.  Some folks can get away with this misalignment for a lifetime and have relatively few knee problems.  Other folks end up with multiple knee surgeries, and knee replacements because they never took care to improve their posture, strength, flexibility and change bad movement patterns.  Regardless of how old you are, getting the kneecap to track better is possible and the kneecap dance exercise is one of the exercises I teach that is easy for clients to learn & do at home.

Reasons Why You May Experience Knee Cap Pain:

  • Sometimes if part of the quadriceps muscle (either inner or outer portion) pulls stronger it can pull the kneecap to either the inside or outside of the thigh, which can cause the grinding and miss-aligned tracking issue.
  • If your hips are wider, or your “knock-kneed” the angle from your hip to knee (Q-angle) can make it more of a challenge to maintain good knee alignment.
  • Weak inner thighs (adductors), weak outer thighs (abductors), and weak Glutes affect the stability of the knee when standing on one leg or bending and straightening the knees.
  • If the knee locks when you are standing or doing any type of exercise, the hamstrings are weak, and locking jams the kneecap against the leg bones in not a good way!
  • If you have had serious knee injuries or surgery, scar tissue & adhesions may limit the range of motion for your knee and knee cap.

Recommendations for Strong, Safe, & Healthy Knees

I would recommend that you consider seeing your primary care doctor, a sports medicine physician, or get a referral to a physical therapist to rule out any serious knee issues, and ask them about the exercises you are doing, if they are OK for you, or what other exercises you can be doing to safely improve things.

I’m also a fan of Pilates, since there are so many great exercises you can do in a lesser weight-bearing position on the Pilates Reformer, Cadillac, and Chairs that are excellent for improving functional alignment, strength, and flexibility.  Please keep in mind, if you are having pain or problems with your knees, chances are there’s also a problems at your feet or hips and pelvis that is contributing to the issue.  It’s great to focus on “knee” exercises, but there may be other parts of your body that need to be focused on to ensure your knee pain will completely go away.  If there is a Pilates studio, or well-qualified Pilates teacher in your area – even if you only take a couple of private sessions to have someone help you improve your exercise technique and body awareness for an at-home program it would be a good investment.

Hope this helps you make a wise decision on if the Knee Cap Dance exercise is appropriate for you to help keep your knees safe & healthy!

If you have any other questions about the knee-cap exercise , Pilates, or other health & wellness topics – please let me know.

Have you tried the Knee Cap Dance Exercise yet?   Check it out now!

Aliesa George: Over the past three decades, Aliesa George has helped assist people with their personal health journeys by sharing, teaching, and developing Pilates, Foot Fitness, and other Mind-Body programs.


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