Greetings! Spring is almost here, and of course that means you are thinking of all the trigger point self-care you will be doing to enjoy your outdoor activities, right?
Well, you might have a couple other things in mind … but certainly Spring will be more fun if your knees are in good shape! This means you need to know a little bit about your kneecaps.
Your kneecaps (patella bone) are designed for more than just good looks. :-) Their real and very important function is to give added leverage to your Quadriceps muscles (knee muscles in the front of your thigh).
When running, biking, swimming or climbing, you need all the leverage you can get to handle the amazing amount of force that is put through your knees. In fact, because of their importance, kneecap problems can be the unfortunate demise of an athlete’s career.
But you don’t need to be an athlete to experience problems with your patella. Your kneecaps are needed even just to stand up from a seated position, climb up and down stairs and walk around.
In this issue, we are going to look at a condition called “High Riding Patella” and the muscle that can cause it, which goes by the name of Rectus Femoris (erector of the femur/thigh bone).
The Rectus Femoris is the long red muscle in the drawing below. Note that the primary trigger point (‘x’) is located up near front of the hip and the referred pain is right in the kneecap.
Riding High in the Groove
The patella is a “sesamoid” bone, which essentially means it is “floating” within your Quadriceps tendon. When you bend or straighten your knee, the “floating” kneecap slides in a groove (called the trochlear groove) to stay in the best position for leverage, which is right in front of your knee joint.
Due to this constant sliding up and down, the backside of your knee cap is coated in the thickest smooth cartilage of your entire body!
This ingenious system works beautifully in a perfect world. However, when there are trigger points in the Quadriceps muscles, moving your knees may literally not go so smoothly. If the outside Quadriceps (Vastus Lateralis) are too short, the Patella is pulled to the outside causing friction and wear and tear. If the inside Quadriceps (Vastus Medialis) are too short, the Patella is pulled to the inside.
And for our topic this month, if the Rectus Femoris is too short, the patella can ride too high in the groove, causing excess wear and tear on the cartilage and a loss of leverage needed for your knees to support you the way they were designed to!
Symptoms you may experience with kneecap dysfunction include:
- Pain in the front of the knee (see referred pain chart to the left)
- Crunching or popping when you bend or straighten the knee
- Trouble getting up after sitting for long periods (such as in the movies)
- Difficulty fully flexing your knee
- Difficulty extending your thigh
- Pain walking downstairs or wearing heels
- High Riding Patella and other kneecap problems
But not to fear, if the Rectus Femoris is the cause of your high riding patella and kneecap pain and problems, you can apply the same trigger point therapy principles as always to eliminate this dysfunction.
Let’s take a look below at a couple quick tests and self-care tips for a healthy Rectus Femoris and a happy kneecap!
*The information in this article is not intended to diagnose or treat any medical condition and does not substitute for a thorough evaluation by a medical professional. Please consult your physician to determine whether these self-care tips are appropriate for you.
Referred Pain Drawing from Figure 14.1 vol 2, pg 250
Janet G. Travell & David G. Simons Volume 2-Myofascial Pain And Dysfunction, The Trigger Point Manual, The Lower Extremities, Lippincott Williams & Wilkins, Philadelphia, 1993