Patellar release surgery -- also known as lateral release surgery -- is used as a last resort to treat patellar femoral syndrome. If you suffer from this condition, your patella, which is also known as your kneecap, doesn't sit neatly against the knee joint. Instead, it slips or tilts outwards, causing pain and stiffness when you move your knee. Strengthening and stretching exercises are usually the first method of treatment and are also used during recovery from surgery. They should only be done in consultation with a medical expert.
Causes of Patella Femoral Syndrome
According to Marc R. Bernier, MPT CSCS, on PhysioRoom.com (References 2), recent studies show that weakness in your gluteus medius muscles, located at the top of your hips, contribute significantly to this condition. These muscles stop your thighs and knees from buckling and turning inwards during weight-bearing activities, such as running. Failure to do so -- usually due to muscle weakness -- is a main cause of patella femoral syndrome. Other causes include a wide angle, of more than about 20 degrees, from your hip to your knee, which is more common in women than men; a weak vastus medialis oblique muscle, located on the inside of the knee; and flat or pronating feet that roll inwards at the ankle.
Knee contractions
This exercise is gentle enough to do in early recovery in order to strengthen your vastus medialis oblique muscles so they can better support your kneecap. Sit with your legs straight out in front of you and a rolled-up towel under the injured knee, with the knee slightly bent. Place your fingers over your VMO, just above your knee cap on the inside of your thigh, and contract your quadriceps to push your knee into the towel. If your VMO is responding correctly, you should feel a strong tightening of the muscle under your fingers. Relax and repeat this exercise, or you can do a more advanced variation sitting in a chair with your knees bent. Contract the VMO on your injured leg and hold it as you slowly straighten your leg then return it to the start position. Try doing 10 repetitions, twice a day, until you can maintain a strong VMO contraction throughout.
Lunges
This exercise also targets your VMO muscles, but is a little more advanced than the VMO contractions. Stand with your injured leg forward and the other one about a stride's width behind you. Keep your back straight as you bend your front knee and drop the back knee down towards the floor then slow rise back to the start position. Make sure you keep the VMO in your front knee contracted throughout the movement. Perform as many lunges as you can, while keeping your VMO contracted, gradually working up to 20 repetitions.
Hip Abduction
This is a good exercise for strengthening your gluteus medius muscles to ensure they can control movement in your hip and, therefore, in your knees. Start by lying on your side so your injured leg is on top and the other leg is resting along the floor underneath. Rest your head on your lower arm and place the top hand on the floor in front of you for support. Slightly contract your stomach muscles then strongly engage the muscles in your top buttock and hip and raise your leg off the floor, keeping your foot parallel to the floor and your toes pointing directly forwards. Lower your leg and repeat as many times as you can while keeping the movement controlled and avoiding any swinging motions.
References
- Sports Injury Info: Lateral Release Surgery
- PhysioRoom.com; Exercises for Knee Pain caused by Patello-Femoral Syndrome; Marc R. Bernier, MPT CSCS
- SportsInjuryClinic.net: Patellofemoral Pain Syndrome
- SportsInjuryClinic.net: Vastus Medialis Oblique - VMO
- Core Performance; Hip Abduction --- Sidelying; Jan. 12, 2009
