Knee pain due to rotation of the Patella and subsequent grinding as it moves in the Femoral Groove beneath. Pain felt in the centre of the knee beneath the patella when extending knee under load, for instance, when climbing stairs.
Typically caused by tightness in the Ilio-Tibial Band (ITB) pulling the inferior corner of the patella laterally at the Tibial Tuberosity and/or weakness in Vastus Medialis Oblique (VMO) allowing the medial superior corner to drop.
Generally, an easy but painful fix with massage to release the ITB and strengthening exercises for the VMO. Taping knee to reposition the Patella enables rehab exercises to be carried out pain free. However, acute cases will require longer to recover owing to the damaged, inflamed tissue requiring time to heal once treatment and rehab commences.
More complex cases are generated by the effects of Short Right Leg Syndrome. The First Cardinal Sign's effect of rotating the left hip to functionally pull up the longer leg binds the left SIJ. Energetic blocking at the SIJ causing spasm and inactivity through gluteal musculature. The Glute Medius stabilising effect is negated and shunts load to the ispilateral TFL and contra-lateral QL. Consequent strain through the left ITB rotating the Patella.
I have sighted three instances of rotation in the opposite direction; the superior medial corner of the Patella being elevated. Resulting from excessive tightness in the VMO due to overuse or impact. Tightness through Gracilis and the VMO, eased with a few minutes treatment. Proved to be relatively quick and easy treatment to release the VMO. Orientation of the Patella returned normal.