Wartenberg's pendulum, repose and the ‘gripped’ patella—part 1: quadriceps normotonia

SummaryThis paper, the first of a three part series, explores the principle of least effort applied to the quadriceps. The next installment describes manual therapy of the anterior thigh, in particular, the freeing of benign patello-femoral tension. The concluding installment describes a movement therapy approach aiding the patient in awareness and in the exercise of choice in levels of exertion.Quadriceps contraction is necessary in many activities of daily living, but only in bursts. The need for sustained effort is rare. In fact, quadriceps activity is extraneous in most stationary recumbent, standing and sitting positions. Despite the current belief that it is prudent to conserve resources, uninterrupted yet subtle quadriceps contraction is commonplace. Such effort is easy to learn but difficult to correct. This pattern may be demonstrated using the Wartenberg pendulum test.The test may also be used as a self-awareness procedure for re-training relaxation. For the clinician, valuable information may be gained by observing foot trajectory, shin carriage, extraneous exertion and quality of motion. Inquiry after these features may sharpen diagnosis and improve treatment.