Knee > Kneecap Dislocation > Treatments

    Physical Therapy

Home Recovery

Your physician may prescribe visits to a physical therapist to begin supervised range of motion and strengthening exercises after a kneecap dislocation. Most people make one or two visits to the therapist to learn a home stretching and strengthening program. Your physician may prescribe a brace to help avoid a repeat dislocation by helping the kneecap track properly and preventing the knee from bending too far. Your goal for the first few months after a kneecap dislocation is typically 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. 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. Physical therapy can help train the muscles around the kneecap to pull evenly in all directions, keeping your kneecap in normal alignment. You usually need to stay off your feet for about ten days after a dislocation. The real key is relative rest. This means staying away from activities that put excessive pressure on the knee while strengthening the knee so the kneecap will track properly. It is important to refrain from activities that cause pain. In general, any activity that puts a heavy load or strain on your knees with the knee bent beyond 90 degrees should be avoided. This includes heavy running, bicycling with the seat too low, climbing, yoga, and stretches, like the classic hurdler's stretch, where the heel is brought up to the buttocks.


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.


    Knee strengthening exercises: Kneecap (patella) injuries

Prevention [top]

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.

Knee Sleeve (Bracing)
Physical Therapy
   Home Recovery
Lateral Release
Tibial Tubercle Osteotomy and Distal Realignment
Proximal Realignment

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