The patella provides an extra mechanical advantage to the thigh, helping extend the knee the last 30 degrees.
It guides the knee properly into a flexed position 2. Knee pain is one of the most common complaints of the lower extremities. People of all ages may experience discomfort and injury in the knee. In many cases, the movement of the patella is a primary cause of this discomfort. Treating an inflamed patella patellar tendonitis can be complex.
Any one of countless biomechanical factors could cause discomfort. These factors vary from person to person, making each case different from the next. Generally, a practitioner will start by addressing the most common factors that lead to patellar tendonitis.
These include foot mechanics when walking: posture, hip position, knee angle, and other factors that could lead to stress. Once you find the primary biomechanical weakness, you can continue with the appropriate therapeutic intervention.
Many therapists recommend closed-chain eccentric exercise for patellofemoral pain. The eccentric phase of muscle contractions loads the muscle and tendon without placing excessive force on the knee joint or patella. For example, the Eccentron is a closed-chain, eccentric-only system that gradually loads the entire lower kinetic chain.
Clinicians have long valued the benefit of eccentric exercise and recently, it has gained even more attention for treating weakened or injured tendons. Watch this video to see how the Eccentron can restore strength to deconditioned lower extremities. After repetitive training, the tendon becomes stiffer, and can provide better force control of the patella during walking and running.
Exercise with the correct biomechanics is key to long-term success for patellar tendonitis patients. In addition to the knee, you can also find sesamoid bones in the hand. Most people have five hand sesamoids. The most common hand sesamoids are two small bones that start at the base of the thumb distal aspect of the first metacarpal. Injury to these bones can be difficult to diagnose. Therefore, research articles and case studies rarely feature sesamoids of the hand 3.
Patients with upper extremity injuries or surgery often need multiple therapy sessions to make a full return to function without pain. Start by addressing the isolated movement of the hand and wrist.
Once the patient masters isolated movements, you can then move on to integrating functional tasks to restore normal use. These should focus on isometric contractions and muscle control for the first few sessions.
This led me to further investigation. I wanted to know what sesamoid bones were and what they do, BUT through my research, it appears researchers still do not know exactly what they do or why they exist. The following provides some general themes I found through a small literature search. They are found within tendons primarily in the hands and feet and are seen radiographically. There are sesamoid bones found in other locations as well including the patella and fabella in the knee and the pisiform on the wrist Yammine, In a study done by Yammine , it was found that women often have more sesamoid bones in their hands compared to men.
Fig 1. The presence and function of sesamoid bones still remains unclear; however, there are a few hypotheses that include both functional and phylogenetic ideas. Sesamoids are also believed to assist with joint stability and provide capsular strengthening Yammine, In sum, sesamoid bones are a unique feature to the human body that still remain a mystery as to what they do, why they exist, and why they are more prominent in certain populations.
Koo, B. The treatment of disabling pain in a sesamoid bone is enucleation of the bone. Abstract Three cases of sesamoid bone pathology are presented, including two cases of sesamoid fracture and a case of sesamoid periostitis. Publication types Case Reports.
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