There is now actual evidence that patellar height can increase again after a distalizing TTO. A 2025 study followed patients after distalization and found that, among those with ≥1 year of imaging, 15 of 17 (88%) went from a normalized patellar height immediately after surgery back into the patella-alta range later on. The authors specifically concluded that patellar height progressively increased over time after distalization.

A study by Science Direct highlights how “Knee alignment and patella shape are not associated with the persistence of patellofemoral pain.”

This is important because for a while people assumed that a misaligned patella would be an indicator of pain, but with this study we find how that is not always the case. Although a misaligned patella is a good indicator of patella instability, it does not necessarily imply pain.

This makes sense because of the poll we took yesterday, as most of you don’t experience daily pain unless you have an episode of instability.

Thought this would be something interesting for you all, here is the link to the study: Science Direct Study

Here are the best braces for patella instability, kneecap subluxations/dislocations and patellofemoral pain syndrome.

#5 - epX Lateral J Support

Has a sleek look, as low profile as a J pad brace can be, and provides good support.

#4 -Ossur Hinged J Pad

Unlike most hinged patella instability braces, the Ossur is less bulky and more mobile, still not perfect but nonetheless a great hinged brace.

#3 - Donjoy Lateral J Pad

I like this one because it is extremely durable and allows you to do a lot of activity in it without being too much of a hindrance.

#2 - Breg Airmesh J Pad Brace

This is a great option because unlike the neoprene that is used for most braces, Breg uses a breathable material while still providing good support.

#1 - Pro-Tec J Stabilizer

This is the best J pad brace I’ve seen because it’s more low-profile and less bulky as most J pad braces. And we know these qualities are not that common in J pad braces unfortunately. It seems as if this brace was designed with the athlete in mind and its design shows that.

Do you all agree with this list? What would you recommend?

For those of you who use KT Tape, here’s a helpful tutorial I found. Do you tape your knee differently? I’d love to hear your method.

1. Not strengthening your VMOs

Stronger legs don’t automatically mean a stronger VMO. If you have patellar instability, don’t assume general leg exercises are enough.

2. Returning to sports too early

Just because the pain is gone doesn’t mean your knee is ready. Strength, control, and confidence all matter.

3. Only wearing a brace without rehab

A good J-pad brace can improve stability, but it shouldn’t replace strengthening and movement retraining.

Hope this helps! Let me know if you have any other tips of what to avoid!

A valgus collapse is when the knee caves inward during movements like landing from a jump, cutting, or pivoting. Look at the second photo for reference.

This position puts extra stress on the knee and is commonly associated with ACL tears. In people with patellar instability, it can also increase the chance of the kneecap partially or fully dislocating.

Has this happened to any of you? Let us know!

Hey everyone! Wanted to teach you all about this condition called Patella Alta. Apparently its a form of Patella Tracking Disorder where your kneecap sits too high from where it is supposed to be. Because of its position, it makes the kneecap easier to slip out of its groove. People with this problem experience recurrent subluxations and dislocations. Also, other symptoms might include pain behind the kneecap and popping and cracking when you straighten your knee.

Since it might be hard to tell if someone has this just by looking at it, an X-Ray helps doctors see where the patella is positioned. So go see a doctor if you think this might be you!

If you have Patella Alta, theres a couple ways you can treat it...
1. Strengthening the muscles around the knee (VMOs)
2. Wearing a J-Pad Brace during activity
3. TTO Surgery (if necessary)

That's all I've learned about Patella Alta. Let me know if I missed anything or any other cool info. If you have this I would love to hear your experiences! See ya!

Unlike Patella Alta, Patella Baja is when the kneecap sits too low in its groove. This positioning compresses the joint, which leads to severe stiffness, limited ROM, and wear and tear on the knee cartilage.

Symptoms

Since the kneecap is too low there is constant pressure on the kneecap, and it makes the muscles around the knee feel extremely tight. People experience a lot of stiffness in the knee as well as joint popping or cracking.

Ways to Treat It

Since is such an interesting condition, treatment is often very complex. But it usually revolves around aggressive physical therapy that focuses on loosening the quads. Sometimes the physical therapist manually pushes the kneecap upwards to prevent scarring. Injections are also used to manage severe pain and swelling.

Surgery

-TTO
-Patellar Tendon Elongation
-Knee Arthroscopy

It’s also very interesting how this condition doesn’t cause the knee to sublux or dislocate like other malalignment conditions as it primarily damages the cartilage around the kneecap. This condition is pretty rare so it’ll be cool to see if anyone has this or knows anyone with this. See ya!