Dislocation > Treatments
In most cases, a dislocated kneecap heals with rest.
Unless you have a congenital abnormality or a previous
history of dislocations, dislocations occur with trauma
or a significant event, not overload or overuse. Following
a kneecap dislocation, physicians usually prescribe
a period of relative rest, followed by stretching and
strengthening exercises that can be performed with the
aid of a physical therapist and at home. Relative rest
lets you stay active, but you still should avoid positions
and activities that put excessive pressure and force
on the kneecap. Running, climbing (stairs or trails),
bicycling with the seat low, and yoga all should be
avoided. This period of relative rest is short. Quadriceps
strengthening and conditioning should begin almost immediately.
Equally important is embracing new routines and activities
that are easier on your knees during daily activities.
In addition, your doctor may prescribe an anti-inflammatory
medicine that may help reduce pain. The majority of
patients feel significant pain relief when doing muscle
strengthening exercises and staying away from activities
that bend the knee more than 90 degrees. Your physician
may prescribe a brace to help support your knee and
keep it from bending too far. Your goal for the first
few months after a kneecap dislocation is to avoid a
repeat dislocation by being smart about which activities
to avoid and to perform, and to be consistent with your
conditioning and physical therapy to keep your muscles
pulling evenly on your kneecap.
Usually, you will be asked to try
a well-supervised rehabilitation program for between
six weeks for a subluxation and up to six months for
a dislocation. In most cases, you will need to continue
the exercises you learn in physical therapy for your
entire life. After a dislocation, the knee is immobilized
for four to six weeks. After a subluxation, motion is
resumed when the pain decreases enough to make it tolerable.
Generally, most people can begin range of motion and
strengthening exercises within a week after a subluxation.
Your physician and physical therapist can help design
a customized rehabilitation program that is best for
you. You will start slowly with range of motion exercises
and proceed to stretching exercises. In most cases,
patients respond to non-operative treatment. Most people
can begin stretching the muscles and tendons around
the kneecap within a week. Physical therapy after a
kneecap dislocation follows a general pattern. It often
involves an elaborate daily stretching routine that
helps ensure muscles pull evenly on your kneecap. When
stretching, try to avoid bending your knee past 90 degrees,
which is roughly the knee angle when sitting in a chair
with your feet flat on the floor. Rehab progresses into
strengthening exercises that focus on the quadriceps
and hamstrings the main stabilizing muscles for
your knee. Physicians suggest you gradually increase
the amount of weight as your leg muscles get stronger.
Strengthening exercises require dedication because results
often take weeks and pain may recur. After about six
to 12 weeks of rehab, physical therapy can become activity-oriented
as you regain the ability to perform complicated movements,
using stationary bikes, elliptical machines, and cross-country
skiing machines. Coordination exercises continue for
months until your kneecap is fully rehabilitated. Physicians
usually suggest that you continue strength training
even after your kneecap has been rehabilitated. Have
your physician periodically check your kneecap for strength
and proper tracking.
strengthening exercises: Kneecap (patella) injuries
Your main prevention goal following
kneecap dislocation should be to strengthen your quadriceps
and hamstring muscles so they are stronger than before
the dislocation. You should try to feel comfortable
that your leg muscles are powerful enough to snugly
keep your kneecap in a normal alignment. Physicians
usually suggest that you wear your knee sleeve during
any activities that may stress your knee. The knee sleeve
by itself may improve the tracking of your kneecap,
however, to prevent kneecap dislocations, your rehab
exercises are ultimately more important than bracing.
Making the strengthening exercises you learned in rehab
part of your regular conditioning routine is the best
way to prevent future kneecap dislocations. Like any
dislocated joint, once the first dislocation occurs,
less force may provoke subsequent dislocations. You
will have to rely much more on muscle strength to hold
your kneecap in a normal position after a dislocation.
Depending on the severity of your dislocation and the
success of your rehab program, your physician may recommend
that you avoid contact sports or risky, high-speed activities.
In general, your kneecap can become healthy and stable
after a dislocation, but you may need to be cautious
of activities that could result in accidental collisions
or falls. Besides the knee sleeve, consider wearing
sturdy kneepads designed for crashes during activities
like in-line skating and padded knee braces during contact
sports. Your physician can recommend the best types
of protective gear for your knees. You may know some
people who seem able to pop their joint in and out of
place painlessly. This should be avoided at all costs.
The more your kneecap is popped out of place, the greater
your chances of arthritis and the higher your risk of
re-injury during activities.