PATELLA MALTRACKING

http://www.youtube.com/watch?v=nDCnNtbYPd8

People are strange. The one matter that I find constantly surprising is that over time, I will see say, 20 people with the same issue exhibited to the same degree of severity. But in terms of pain, they range along a spectrum. At one end of the spectrum will be an individual who is so crippled with pain that they cannot function well on a bike (and sometimes cannot function without pain off the bike either.) At the other end will be another with the same degree of dysfunction who are so little affected by their problem, that they are not even aware that there is a problem. The rest range somewhere in between. This video is of one of the atypical pain free type problem children.

Click on play and have a look. This is a gent who came in last week for a fit. He had an interesting physique. Extraordinarily broad shoulders combined with narrow hips but carrying 20 kg too much weight that he plans to lose. Functionally, he is a strange combination of general ligamentous laxity and very poor flexibility in the hips and lower back. He has a history of dislocating both patellas with the majority of dislocations being on the right side.  In the video footage above, at rest his right patella sits well outside  the groove that it should run in. Compare it to the placement of the left patella. When he engages his quadriceps as though he is about to extend his knee, the patella pops back towards its normal position but not all the way. On every pedal stroke there was a large amount of side to side patella movement to a degree that I have never seen before. The even more surprising thing is that this has been the case for years without any pain and was not the issue that brought him here. This ‘trick’ patella causes no pain and scans show no wear and tear.

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