Patella (Kneecap) Dislocation
This page has been designed to provide you with the right information about patella (kneecap) dislocation and the rehabilitation that may help you in your recovery.
What is the patella and what does it do?
Firstly, patella is the name for your kneecap. For the rest of this article, we will use the name patella.
Your patella is a relatively small bone that sits at the front of your knee and its main job is to help the quadriceps (front of your thigh) muscles work to straighten your knee.
It is held in place by a number of things including soft tissues (tendons and ligaments), the shape of the groove it sits in and the quadriceps muscle group itself.
It is designed to be a very mobile bone to allow it to do its job properly, in other words it is meant to be wobbly! It is also very normal to hear or feel noises from your patella as it moves; this is normally nothing more than friction and although can sound unpleasant, does not mean that anything is wrong and does not mean you are causing harm to your knee.
What is a dislocation?
Dislocation is a medical term to describe when joint surfaces are no longer in contact with each other. It is a primarily a soft tissue injury as it is normally the ligaments and other ‘soft’ structures (tendons etc.) that are stretched and injured.
Is my patella dislocated?
It is surprisingly difficult to dislocate your patella as it has an amazingly strong support system holding it where it should be.
The most obvious feature of a dislocated patella is a large lump (your patella) sitting to the outside of your knee. Understandably, this is normally accompanied by discomfort.
What should I do if I think my patella is dislocated?
First, try not to worry. As uncomfortable as your knee might be, a patella dislocation is something that can be treated easily.
Normally, a dislocated patella will find its way back into its groove by itself, however if it doesn’t, you should call 999 and request an ambulance as they may need to take you to hospital to help get your patella back in place.
What will they do in hospital to help my knee?
If your kneecap hasn’t gone back in by itself, you should call 999 and request an ambulance.
Once you have been taken to hospital, it is likely that you will be helped to manage the discomfort with some medication and have an X-ray taken. The X-ray may happen before the A&E team try to put your patella back into place or afterwards.
The A&E team may give you a set of elbow crutches to help you walk as it may be sore, and may also give you a knee support to use for a short period. It is very likely that you will be referred or encouraged to refer yourself to physiotherapy to help with your recovery.
I’ve been discharged by the hospital, what should I do next?
It is really important that you start to move the knee as normally as you can, as soon as you can. It is even more important for you to know that doing this is safe and is good to do even straight after a patella dislocation.
It is also important to start taking some weight through the injured leg. It might be sore and you might find your confidence to trust that knee might have reduced a bit, but trying to use the knee normally, including walking, is the right medicine for your knee.
Physiotherapy following a patella dislocation can help you on your road to recovery and you can refer yourself here.
What can I do to help myself?
We’ve pulled together a programme of exercises that are often really useful for trying to help you get your knee moving after a patella dislocation. We’ve also included a selection of strengthening exercises to progress to once the knee feels like it’s moving a bit better.
When should I start these exercises?
Well, it is worth being kind to yourself and allowing your knee to calm down first, which might take several weeks, but you can consider starting work on your knee as soon as you feel confident. Often it is better to start sooner rather than later to help rebuild your confidence and trust in your knee.
What are the exercises trying to do?
Good question and it’s useful to know the answer before you start.
Firstly, the exercises are simply helping you get your leg moving. Your knee is designed to move and although it might be sore to do it initially, it is exactly what your knee needs to start its recovery.
Once the knee is feeling like it is moving a bit better, you may want to explore our strengthening and balance exercises below. The aim of these is to start to improve your muscles in terms of their strength and ability to help support your knee.
Lastly, one of the most important things about all of these exercises, is they are trying to help you regain some trust in your knee. Often, after a dislocation you may feel better quite quickly, but it is the confidence to use the knee normally that requires some time and support.
Will I need to have surgery?
No, not normally.
In the vast majority of cases, people who dislocate their patella do very well with physiotherapy alone. Surgery would only be considered if you were having multiple dislocations and the exercises were not really helping, however this is rare.
When can I get rid of the knee brace?
There can be quite a lot of variety in terms of what people are told about using a knee brace after a dislocation. Sometimes you can be told to wear it for a few weeks or simply until you are confident to take it off.
You should look to wean yourself off the brace when you feel comfortable and confident. This is likely to be different from person to person, but it is worth thinking that the sooner you start to use your knee and trust your knee, the sooner you are likely to move forwards.
How long do have to use the crutches for?
Much the same as the last answer really. There isn’t any set period that you have to use the crutches for and you might be best to use your confidence to guide you.
It is recommended that you don’t rush to get rid of the crutches if you cannot walk easily. Quality definitely beats quantity when it comes to walking.
If you need any help on how to use your crutches, you can find our instructional videos here: Walking Aids
When am I going to be able to go back to normal things like driving or sport?
Frustratingly, the answer is not straight forward. A lot like the previous answers about the knee brace and the crutches, it is varied between people.
For driving, you may find getting back behind the wheel is achievable after only a few weeks, but you must make absolutely sure you are in full control of the vehicle and can perform an emergency stop before attempting to drive.
For sport, it would be sensible to think more in terms of weeks rather than months but probably no sooner than 6 – 8 weeks at the earliest. A lot of people will find that it is their confidence that holds them back in terms of returning to sport. As long as you are confident that you can move normally for your sport and can trust your knee, then you might be able to consider returning. It is always sensible to return in a gradual manner.
Exercise tip:
For the movement exercises, aim to try and complete these little and often throughout the day.
For the strengthening exercises, aim to complete the exercises (as many or as few as you want to) about 3 to 4 times a week.
Each exercise should be completed between 8-12 times (or repetitions) for 3 to 4 sets. Make sure you have about 1 minute's rest in between each set.
In order to change your muscles, you need to challenge them. In other words, you should really feel the effort with each set of exercises and should really not be able to do more than 12 each time around.