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 Patella Tracking Syndrome
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Patella (knee-cap) Tracking Syndrome is generally defined as knee pain in the front of the knee as a result of an imbalance between the 4 bones of the knee (Femur, Tibia, Fibula and Patella (Knee-Cap)) causing the knee cap to "track" (or move) in an abnormal way. It is called a syndrome because there is no scientific agreement on the exact cause of the injury.

Proposed Causes
Abnormal movement (tracking) of the knee cap is thought to be as a result of:
  • An imbalance of muscle pull (due to muscle, weakness/tightness, muscle damage or history of muscle damage)
  • Mal-alignment of the joints or joint surfaces
  • Mal-alignment of the knee (may be as a result of imbalances of the ankle and foot or hip and pelvis).
  • Excessive use of a joint (or joint loading) causing changes in movement or repetitive strain.

Signs and Symptoms

  • Knee pain (especially behind the knee cap)
  • Pain generally comes on with activities that require bending of the knee (e.g. running) and or forced contraction of the quadriceps muscle (e.g. going up or down stairs).
  • Pain may come on after increasing the duration or intensity of the activity (e.g. after running for 5-10 minutes or with an increase in speed).
  • There may be pain with squatting (or repetitive squatting).
  • Poor mobility of the knee cap (the knee cap sits in a capsule of ligaments and tendons which may be tight in certain areas)
  • Pain may come on with extended periods of sitting with legs crossed or knees bent.
  • Symptoms may not come on until the next day.
  • There may be a feeling of tenderness along the edges of the knee cap.

Osteopathic Diagnosis and Treatment

  • A detailed past medical history and physical examination will assist in determining potential factors that may be causing the patella tracking Syndrome.
  • Your osteopath will do a careful analysis of body movement to look for imbalances, weaknesses and movement abnormalities.
  • Treatment will be focusing on the potential cause of the syndrome and reducing the pain through knee.
  • Your osteopath will also work through potential lifestyle factors that may be contributing to the syndrome.
  • Imaging or referral to a specialist is rarely required for this injury but imaging studies of the knee may be ordered to assist in determining other potential causes of the knee pain.


  • Ice is beneficial in the first 24-48 hours (3 sets of 10 minutes on 10 minutes off - 2 or 3 times per day). Stop using ice with any discomfort or if there is no relief.
  • Anti-Inflammatory/Pain Reliever/Analgesic Medication as prescribed by your general practitioner or pharmacist.
  • Once pain has subsided your osteopath will prescribe specific exercises (stretches and strengthening) to balance to the knee.
  • Strapping: strapping the knee cap (in the short term) may assist in relieving the pain and irritation (your osteopath will assist with this).
  • In many cases patella tracking syndrome develops as a result of a specific muscle weakness. If this is identified through examination specific isolated muscle strengthening (commonly VMO strengthening) will be implemented,
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