What can I expect in the long run with tilted knee caps?

I have knee caps that track to the outside of my knee. I am a photographer --I carry 20LB of equipment for 8-10 hours at a time --but, only on certain days of the year when I am shooting weddings. My job also requires me to half squat a lot of the time and spend some time on the floor. However, I only have a shoot one or two days of the week and the rest of the time I spend at my computer or running around with my two year old son. I am also thirty pounds over weight with an athletic build.

I have gone to my current Physical Therapist for eight weeks or so and built up my hips and glutes a lot. However, single leg squats are still painful without excessive warming up. I am also on my second Dr. in Austin. The first one wanted to operate right away based on the MRI and X-ray, but was okay with eight weeks of PT. However, the PT that I was doing was not helping --it was a misguided Physical Therapist.

The second (current Dr) wanted to give me eight weeks, but wants to operate at the end of the year if I am not completely satisfied with my knee. I do not have a steady work out program, but have been very diligent with my PT at home and at the Dr. office.

I am open for getting on a work out schedule --in my teens and twenties I was an athlete and this would be a good excuse to dedicate the time to do it again.

My knee is still painful after shooting a wedding this weekend and the end of the year is coming soon. My question to you is what can I expect from my knee if I decide not to have the surgery?

Will I always have some pain.
Will I need to be committed to twenty minutes of PT every day for the next few years?
If I get on a steady run/walk or bike program with moderate weight training what would you expect from my knees?

I guess for most people, is this problem chronic, or does a steady work out program usually provide a healthy knee?


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Nov 12, 2008
tilted patella
by: Bart - SII

It sounds like you are on the right track with your second round of PT and doctors. The hip and glute strengthening is usually the key for conservative therapy to work for patella femoral syndrome. However, even after you address all of the mobility and strength issues, there is sometimes a mechanical issue that cannot be taken care of without surgery.

If you truly have lateral patellar tilt (which your doctor would confirm with X-rays) and you don't see a complete resolution with your symptoms after rehab, then surgery may be an option that would benefit you.

Without surgery, you can still hope to do well, but being diligent with your exercises, especially maintaining a good hip / core strength and mobility program is absolutely necessary to keep your knee from acting up. This is likely something that you will need to continue for the immediate and long range future.

Apr 04, 2011
I can relate
by: Sheila

I have been diagnosed with chondromalachia and tilted kneecaps. I have gone for a long time with no major knee pain. However, recently the knee pain acted up and I started wondering if I will end up needing surgery. I believe certain physical activities I did recently triggered a flare up of knee pain. So, I'm going back to my exercises to strengthen the inner leg muscles, take Advil, and stretch. I find yoga stretches to be very helpful. Also, when the pain acts up, I find heat helps: a hot water bottle helps.I wish there was a magic bullet to end the knee pain for good! One has to be very diligent with the proper exercises, etc. to keep the pain at bay. It can be tedious, but what's the alternative?

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