Personal Narrative: Patellar Tracking Disorder

The first patient I witnessed was a 25 year old female. Pertinent patient medical history is anxiety, depression, and sleep dysfunction. The referring diagnosis is Chondromalacia of the right patella, which is also known as runner’s knee, is a condition where the cartilage on the undersurface of the kneecap deteriorates and softens. The physician who referred the patient, Victor N. Egwu, MD, orders the PT to evaluate and treat three times per week for four weeks. Right knee ROM and strengthening exercises should be done to treat patient. The PT evaluation justification history includes 1-2 person factors examination is addressing three or more elements. The clinical presentation is stable. The clinical decision-making is low co-morbidities.

The test has the physician move the patellar back and forth while the patient flexes the knee at 30 degrees (Saladin, 1998, p. 44). This test helps diagnose how severe the patella is dislocated and decide the best treatment option. Another test a physician can do is called the patella tracking assessment where they have the patient single leg squat and then stand (Slamaian). If the “patella that slips medially on early flexion is called the J sign, and indicates imbalance between the VMO and lateral structures” (Saladin, 1998, p. 41). Both of these test help diagnose the correct treatment, the difference is the patellar apprehension test is used for more severe cases but both lead to the best treatment

When I look down, all I observe is the color red on a rugged surface. Thin white lines separate me from my competition. I glance to my left. I glance to my right. I notice the various colored shirts alongside me. They all crave the finish line. I grasp the famous red and blue baton in my hands. No one knows my name or my story, the only article they identify is the number pinned on my Mahwah Jersey. We all restlessly stand in position while hundreds of people fill the stadium. The gun is raised, I look up to the sky and pray for wings on my feet, which is the same wish I have for every race. The gunshot sounds through the air and in a blink of an eye it’s over. It's not when you finish or what towns you beat, it's about, the experience you share with those three other girls waiting on you and the baton.

The bone that is held in place by tendons and ligaments in the knee joint is the patella. The job of the tendons in the knee joint is to attach the bones to the muscles, and the job of the ligaments is to attach different bones together. All these structures help the knees to function and move (Knee). What helps the leg to move forward is when the patellar reflex is initiated and the tapping of the knee bends which then causes the muscles of the quadriceps to contract. This movement is also called the “knee jerk” (Knee Jerk). If there is an issue with the nerves, there could be a decrease or an absence that could be damaged along the chain. Hyporeflexia is what that is called. This is usually seen in individuals who have had an injury in the spinal cord at T5 or above (Automatic). Levels S1 and S2 need to be healthy in order for Matt to have an ankle jerk reflex. To see the contraction of the foot you would have to relax the foot and strike the tendon for it to kick. Hypothyroidism, a disorder or a disease could be an indication of an absence of the reflex. You can assess the function of the motor and sensory pathways by doing those

More than 20 million people in the US and over 100 million people worldwide suffer from knee osteoarthritis. It is one of the most common causes of disability among older adults. The effects of knee osteoarthritis include severe joint pain and reduced bodily motion. In other words, it makes doing everyday physical activities such as kneeling, sitting, and walking up stairs extremely difficult.

This moment was what we had worked for our entire swimming careers. It was exhilarating. It felt like we were on top of the world. I felt as though everything below me was moving in slow motion but, I didn't mind because I wanted this feeling to last forever. I had the medal around my neck and I was smiling with pure joy.

I was always an active person from being in sports to hanging out with friends. I always had something planned, or came up with something on the fly. My junior year in high school was a very tough time for me. I was involved in a lot of activities, organizations, and clubs. I was very active in one organization where I had to be up at school every morning at 7:15 for that meeting. Meaning I would not leave school sometimes until 6:45 to 7:00 in the evening. On the weekends I would have something to do either with friends or family. I would never go a weekend with nothing to do. Either I was out running errands or at the mall buying some new clothes.

Everything had led up to this moment. There were the remaining two finalists at the 2006 Winter Olympic Games, ready to risk it all. I tensed my shoulders, ready to make the final jump that would land me onto the podium. After jumping off the bed and nailing a perfect landing, I was an all American gymnast. I ran toward the makeshift gold medal, a marvelous sight made of a single dollar coin taped to a piece of yard. I looked backwards to see how the other finalist had fared, and every compelling emotion swapped places for a single word: dread. Forty minutes later, we were at JFK’s emergency center, awaiting the results of my brother’s MRI.

It’s safe to say 2016 has been an interesting year for me. I went from college track star to drunken college dropout all in the span of 4 months. In the beginning of January I had everything going for me. Indoor track season had just begun and I was expected to dominate the 200 and 60 meter dashes. However a left knee injury would not allow those plans to happen and would lead to the most destructive 4 months of my life.

Patellofemoral Pain Syndrome (PFPS) is a term that is used when describing pain in the anterior knee and surrounding areas of the joint. PFPS is most prevalent in athletes, women, and young adults but can also occur in other populations as there are several factors that contribute to PFPS such as overuse injuries, which put a great amount of force and stress on the knee and can contribute to patellar misalignment. Activities such as jogging, squatting, and climbing stairs all put increased force on the knee joints. These repetitive motions and force can cause PFPS especially if the activity’s frequency, duration, or surfaces are changed. Skeletal misalignments between the hips, knees, and ankles or muscular imbalances/weakness can lead to abnormal

Beads of sweat slip silently off my skin. I feel my heart steadily thumping, a soft hum, and my stomach clenched in unforgiving knots. Every muscle, tendon and ligament quivers in the stillness of anticipation. Finally, the thundering base of the gunshot sounds, and my body bursts off the starting line. Long strides cut through the air, bouncing off the balls of my feet. My arms pump to keep pace, adrenaline rushing throughout the race.

I was completely overtaken by small, simple things: the slowly setting sun and the intricate shadows it displayed on the bleachers; the feeling of the turf under my legs and back; the scent of the grilling, concession stand hot dogs drifting by every few minutes mixed with the smell of the track; and the coaches and athletes walking around me, always with somewhere to go, people to time, splits to discuss. I just lay there soaking it all in, experiencing life anew, “so concerned with the immediate.” I felt “so childlike, so awakened” like I was rediscovering the beauty of the

It is said to be that early diagnosis of patellar luxation in the absence of trauma and certain breeds support the idea that it results from a developmental misalignment of the whole extensor area. (Patellar Luxation, 2016). Developmental patellar luxation is considered a consequence of a complicated skeletal abnormality that should be dealt with as soon as possible to eliminate the possibility of future issues in a younger animal and pain in a older one. (Patellar Luxation, 2016). Palpation is very useful in the fact that it physically gives the ability to feel the luxation from where it moves to how far it moves and so forth. Taking a radiograph as you can see in figure D, shows where the patella is sitting and at a good view you could actually see the depth of the trochlear groove which makes for a good tool in the process of diagnoses. (Patellar Luxation, 2016). The grading system is based on a scale from 1 to 4 which helps in aiding the severity of the luxation and the pain it may cause. Grade 1 is very mild with minimal clinical signs where the patella can be manually luxated but it returns right back to the groove. (Harari, 2013). In grade 2, the patella luxates while the animal is flexing the joint but is then repositioned during extension. In this grade you may see the animal displaying a skipping lameness as if running on 3

We went to the winner’s circle in a daze. The ring steward put the tri-colored sash around my horse’s neck and then we took a victory lap around the ring. The crowd seemed to be roaring with applause, and I could not believe it was all for us. All of our hard work paid off. It was absolutely worth the blood, sweat, and tears it took to be able to set a goal, work hard, and actually accomplish it.

There are two groups of reflexes in the human body, with two ways to categorize each of them. Reflexes can either be inborn and connected through the nervous system, or they can be learned through practice. Another way to explain a reflexive category would be autonomic reflexes or somatic reflexes. Autonomic reflexes are those which are unaware to us and act on visceral organs of the body, whereas somatic reflexes involve skeletal muscle stimulation. Both types of reflexes are put into effect via the nervous system. (1)