These articles have quotations from film adaptations of J.R.R. Tolkien's novel The Lord of the Rings and related works: 1  The Lord of the Rings.  J.R.R. Tolkien's The Lord of the Rings (1978)
This causes a twisting on the tibia and changes its relationship to your kneecap. This can cause tracking problems as well. If your quadriceps or hamstring muscles are too tight, they also will affect the mechanics of the knee and lead to compensation patterns that cause pain.
Improper kneecap movement may result from: 1  poor alignment due to a congenital condition. 2  weak hamstrings and quadriceps (the muscles in the back and front of your thighs). 3  muscle imbalance between the adductors and abductors (the muscles on the outside and inside of your thighs).