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.
Another form of mal-tracking, associated with a tendency to recurrent patella subluxation is when the kneecap shifts outwards (laterally) as the knee straightens and has to shift inwards (medially) to re-enter the trochlea groove as the knee starts to bend again.