Musculo-skeletal   [back to the Category]

Patellar Pathology   [read the french version]

Author :   Docteur Anne Thiescé

Disorders of the patella represent about 50% of ballet dancers' knee lesions.

These patellar disorders occur more frequently when there is a misalignment in the lower limbs, such as genu valgum, genu varum or genu recurvatum and / or patellar or femoral trochleae morphological anomalies. Specific reasons for this pathology in ballet can be clarified by kinesiology and an examination of ballet movements.

The turn out:

Basically, this position should be guided by external hip rotation. However, dancers who have trouble mastering this position, or, who have insufficient external hip rotation, turn out the lateral muscles of the lower limb, in particular the vastus lateralis and the biceps femoris.

Contraction of the vastus lateralis leads to lateral patellar traction and increases pressure on the lateral part of the joint surface of the patella. Contraction of the biceps femoris, by forcing an external leg rotation under the femur, drives the patella laterally as well as increasing lateral pressure.

The "plié":

The "plié" is performed using the 3 major articulations of the lower limb, the hip, the knee and the ankle. Alternative use of different muscles in order to rise from the "plié" can assuage the extensor mechanism of the knee, constituted in part by the femoro-patellar articulation. The often predominant action of the quadriceps femoris can, in fact, be substituted, indeed, replaced, by the action of the ankle - foot flexor muscles or the triceps surae, by beginning the movement with the foot and the ankle, by the simultaneous action of the triceps surae and the hamstrings which moves the knee, by the action of the hip extensor muscles. The action of sinking into the "plié" is achieved by continuous contraction of the quadriceps femoris in quadricipital dystonia which presses the patella against the femur. Practising bending-relaxing reduces pressure on the patella.


Except for acute dislocation, all these patellar disorders respond well to specific muscular exercise and require close collaboration between doctors, physiotherapists, kinesiologists and, of course, ballet instructors.

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