Squinting of patella

| Advanced Physiotherapy
Squinting of patella

A condition in which the patella appears to be pointing inward when the patient is standing; caused by excessive femoral anteversion.

Factors affecting patellar tracking

Local factors

1) Tight ITB, lateral retinaculum

2) lax medial patellar retinaculum

3) Trochlear dysplasia

4) weakness of quadriceps


1)Common in young adults, high socioeconomic importance.

2) More common in military recruits and athelete.

3) female : male 2:1

Extrinsic factors

1) Excessive duration or frequency of physical

2) Errors in training such as sudden increase in mileage

3) Activities change of training surface.

4) Inappropriate foot wear such as high feels.

Aggravating factors

1) Descending stairs

2) going uphill or walking on incline

3) Standing up from squatting.

Relieving Factors

1) Extension of the knee

2) rest.

Special test

1) patellar tilt test

2) patellar glide test

3) vastus medialis Co ordination test

4) patellar apprehension test

5) waldron's test

6) Clark's test

Investigations include Radiographs,CT scan, MRI, radionuclide scans, CT hip, patella and tibial tubercle


The goals of nonsurgical treatment of patellar tracking problems are to reduce symptoms, increase quadriceps strength and endurance, and return to normal function. Exercises for patellar tracking disorder are not complicated and can be done at home in about 20 minutes a day.

Most patellar tracking problems can be treated effectively without surgery. Nonsurgical treatment may include rest, regular stretching and strengthening exercises, taping or bracing the knee, using ice, and short-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Quadriceps strengthening is the most commonly prescribed treatment for patellar tracking disorder. Exercises to increase flexibility and to strengthen the muscles around the hip can also help.

At first, following an injury or a flare-up of symptoms of patellar tracking disorder, knee activity should be reduced. Overuse and trauma are common causes of knee pain. And resting your knee will help relieve pain. Exercises should begin as the symptoms resolve.

Some doctors will recommend using a brace or a taping technique to keep your kneecap in proper alignment, in addition to an exercise program. Be sure to closely follow the instructions from your doctor or physical therapist.

Be sure to stay on your exercise program. You may not notice much improvement in your symptoms right away, and recovery can take several months. This can be frustrating. Problems can come back if you don't keep your strength and flexibility

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