Tilted Patella

One significant step along my ongoing (and seemingly never-ending) path to recovery, was seeing x-rays of my knee at a visit to the orthopedist. One of the three x-rays that were taken, showed a view of my knee from what would essentially be the P.O.V. of my foot, with my knee bent about 45 degrees. So basically, I could see the bottom of my patella. What it showed was that my patella was tilted laterally (to the outside of my right leg), instead of being down the groove between my femur (thigh bone) and my tibia (shin bone) where it's supposed to be. Hmmmm....

So great! Now we can see what the problem is! Just tell me what to do and I'll do it! Give me the miracle cure. Surgery? Stretches? Chanting?

Well...guess what? It turns out that there are many possible causes of this condition, including that maybe my patella already had a tendency to be titled before I ever got on a bike. WHAT?!? Seriously?!? In that case, it would seem that taking an x-ray of my left knee would have been in order. Apparently that wasn't what my doctor thought. What do I know anyway?

One prevalent theory seems to be that there is a muscular imbalance at the root of the problem. For instance, my IT band (the muscle that runs all the way from the side of your hip to your kneecap) is tight or too strong, and is pulling my knee laterally (to the outside), while my VMO (Vastus medialus - one of the four muscles that make up your Quadriceps) is weak and not opposing the lateral force and pulling the kneecap back in the other direction, or medially (to the inside).

OK, so all I need to do is strengthen my VMO and loosen up my IT band right? Problem solved!

I only wish it was that simple. I've been down that road for months with little to no positive results. Leg lifts, such as lying flat and raising my injured leg up in sets, along with work with a foam roller to loosen up my IT band have yielded bupkis, even after a lot of work an patience. I'm still incorporating these exercises into my daily PT regiment, but I think they are at best only part of the puzzle, or at worst actually aggravating the problem.

More on some new potential treatments soon.