Did you know that patella alignment can have a huge bearing on knee pain?  The patella (knee cap) is a triangular shaped bone set to the front of the knee joint.  It floats within the patella tendon and moves up and down as your knee bends and straightens.

Relative tightness or weakness in the muscles surrounding the patella can have an impact on just how the patella moves up and down as the knee bends and straightens.  For example iliotibial band (ITB) tightness could create a force shifting the patella laterally towards the outside of the knee which can give rise to knee pain.  Similarly quadriceps tightness can often result in the patella being pulled backwards forcefully into the femur which also gives rise to pain.

Misalignment of the patella over the course of time can give rise to the development of chondromalacia patellae, a condition whereby the under-surface of the patella becomes roughened causing pain to the front of the knee joint. 

For these reasons a comprehensive assessment of knee pain should always include an assessment of patella alignment and of the relative tightness or laxity in the surrounding muscles of the knee joint.  Often longstanding or chronic knee issues can be addressed with a few simple stretching exercises if patella alignment is the issue.