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September, 2002, Vol. 02, Issue 09 Sharp Anterior Medial Knee PainBy Ben Benjamin, PhD Question: Where is the medial quadriceps expansion? Answer: At the medial side of the patella. The quadriceps muscles join together into the quadriceps tendon just above the patella. The tendon then passes over the patella in the form of an aponeurosis (or flat-sheet structure) and envelops the kneecap, tucking slightly under the medial and lateral aspects of the patella, fitting like a shower cap. It then continues down to attach to the tibial tubercle. This section is called the patellar ligament.
Treatment is usually fairly straightforward. With the client lying supine, the therapist forcefully pushes the patella medially with the thumb of one hand and applies friction therapy with the index finger of the other hand. The finger is placed under the medial side of the patella and pressure is applied anteriorly (toward the ceiling). The direction of the friction movement is from head to foot. Click here for more information about Ben Benjamin, PhD.
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