Another source of knee pain

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.

(2) Quick Self-Tests to Tell if You have Trigger Points in Your Rectus Femoris: Follow the instructions below to test whether myfoscial trigger points in your Rectus Femoris might cause kneecap problems. TEST 1: Heel to Buttocks Test PASS FAIL While lying on your stomach, grasp the top of the foot or ankle with the same side hand and pull the heel straight toward the buttocks. A Passing result is when you can bring your heel to touch the buttocks comfortably. A Failing result occurs when the heel remains further away from the buttocks (as shown). The further the heel is from the buttocks the greater the amount of myofascial dysfunction and trigger points present. TEST 2: Rectus Femoris Palpation As always, palpation (the medical term for pressing, feeling and squeezing to evaluate body tissue) is often the most effective test to identify myofascial trigger points. The Rectus Femoris can be palpated from its origin at the front of the hip down to the kneecap. The landmark to use is the ASIS, which is the bony bump you find as you walk your fingers up your thigh and reach your hip (shown as tan circle in drawing to left). The most important trigger point is shown in red, just below the ASIS. To access this point, you need to have your hip straight, not bent. So, palpation of the upper Rectus Femoris should be done while standing or lying on your back. Press your fingers along the full length of the muscle (shown in green) down to the top of the kneecap, feeling for tender points and taut bands of muscle tissue. Press gently to tolerance.