PATELLAR (KNEECAP) SUBLUXATION What is a subluxing patella? Asubluxing patella (knoecap) is a temporary, partial lslocation ofthe kneecap from is normal postin in the groove inthe end ofthe thigh bone (eu). This ‘roove slocated between two bump at tend of the thigh bone called the femoral condyles, How does it occur? ‘This temporary dislocation ofthe kneecap asally happens daring force leg straightening, sith the ‘kneecap moving out af the groove to the outer side of the ke. "The ease is usually an abmormaity in the way your legs are built. You may have an underievelop- ‘ment ofthe inner thigh muscle oe an overdevelop” "ment ofthe outer thigh mosele. Your kneecyp may be higher inthe leg than ust. You may’be kaack- [need or have underdevelopment of the oter (later. al) femoral condyle. What are the symptoms? You may fel the kneecap moving out of position You may have swelling and pai behind the knewcap, You may have pain ‘when you bend or straighten your leg. How is it diagnosed? ‘Your healtheare provider wil ask about {your symptoms and examine your knee. Hor she may beable to fel the kneecap slipping tothe outside as you bend and Strvighten your leg. An Xray may show “underdevelopment of the lateral femoral condyle. How isi treated? ‘Treatment may inchude: « puting fe packs on your knee for 20 to ‘sd minutes every 3 to 4 hours forthe first 2 or 3 days or until the pain goes wey ‘elevating your knoe to help any swelling poaway, ‘taking an antiinflammatory medicine (adults aged 65 yeas and older should ot take non-steroidal an-intammatory ‘medicine for more than 7 days without their healthcare providers approval) ‘ wearing a brace prescribed by your healthcare provider to keep your ‘exeocap In place 1 doing exercises tos the inne side ofthe ‘high muscle (quadriceps) Some people need surgery to keep the kneecap from sublining ‘Whule you are recovering from your injury you will nee to change your spor or atvity to one that ‘will not make your condition worse. For example, you may need te biycle instead of run When can I return to my sport or activity? “The goal of rfabiltation sto retuen you t your sport or ativity as soon ass satel possible. I you ‘tur too soon You may worsen your injury, which “could lead to permanent damage, Everyone recovers from injury ata different rae. Return to Your sport or _ativiy will bedetermined by how soon your knee recovers, not by how many days or week ithas been ‘ince your injury occurred, In general, the longer you “have symptoms Before you sar retment the longer ie wil take to get better \TELLAR (KNEECAP) SUBLUXATION ‘Normal Postion of Patan aac) “THE SPORTS MEDICINE PATIENT ADVISOR 205PATELLAR (KYEECAP) SUBLUXATION continued You may sally rtuen to your sport ar activity when, Storing from the tp ofthe list and progeessig o e end, each ofthe following is tue + Your injred nce can be fully straightened and ‘ent without pal, «Your knee an leg have regained normal strength compared tothe uninjured knee and leg. {Your knceis not swollen. “+ You ate able to jog straight ahead without limping. “+ You are able to sprint straight ahene without limping You ate able to do 45-degree cuts + You ate able to do 90degree cuts 1 You are able to do 20-yard figure-ofight uns + You are able to do 10-yard figue-of eight runs, «+ You are able to jmp on both legs without pain and jump on the ijure log withou pal Ifyou develop pin, swelling, ore feng that your kneecap is moving out of place agin, you noed ‘contact your healthcare provider How can I prevent a subluxing kneecap? Acsuiluxing kneecap is best prevented by keeping your thigh muscles strong, especially de group of nscles on the ner sic of the thigh, IPATELLAR (KNEECAP) SUBLUXATION REHABILITATION EXERCISES ‘You may dol ofthese exercises right away. tis important to stretch the muscles inthe back of your leg It is ‘zo important o strengthen the museles onthe top of your thigh so your kneecap won't suDlux again 1. SUNDING HasTRINGSreeTe: Pace he ‘ele your lng ona sto! abut Toinches ‘er, beng ate perl yuo /, Sst ho back of your ih Wake sore you do nto your Should and bon at te wast shen cong is or etch Your omer tock instead Hot he ies or 181 20 sosonce. Fepoat es fr ea. -SHNiNG HASTEN 2. QUADRICEPS STRETCH: Stand an arm's lengths away trom the wal fing (c]), straight anead Brace yours by keeping one Rend against the wal ‘with your other hand, rasp the anile ‘of te opposite lag and pall your hee! toward your buttocks. Don’ arch or {west your back. Keep your knees together Hold this stretch for 15 to 90, "YEE" seconds. Repeat 3 times on each sis. 2 SIDEAVING LEG UT: Lying on your sib, tighten the font thigh mucols on your top log and if that leg 8 to 10 nohes away P| from te otter tg, Keep te eg straight Do sete a 10. 4. QUAD SES: Siting on the lor with one eg straight ‘and your other eg bert. press the back fof your knee of your straight eg into the oor by tahtening the muscles ‘on the top of your thigh Hold this postion 10 ‘seconds, Relax. DO3 ‘018 of 10, |. STRAIGHT LEG RAISE: Li on your back wih your legs night out in font yo. Band ana knee and place the {00 fat an the floor Tajhten up the top of your thigh muscle onthe epporte lag anc it that leg bout 8 inches off the foo, keeping the thigh muscle ‘est tight throughout. tehise Slow lower your log bacie down to te floor Do 3 sets of 10 con each side, ‘thor log comes of the fooe. Lower you lag back to the ‘Foor slot Do 3 sets f 10. «6, sTep.uP: Stand with te foot of ‘one leg ona suppost (ikea block of wood) 3 0 5 inches igh. Keep your othe fot ft ‘onthe floor Shit your weight ‘ont the lag onthe support ‘and staigtten the kneo a the jPATELLA (KNEECAP) SUBLUXAT 2. WALL SQUAT WITHA BALL: Stan with your back, shoulders, ana nead against a wal ana ook sight ‘ahead. Keep your shoulders relaxed and your fet 2 “eat away trom the wall and a shoul ‘er’ with apart. Place soccer or ‘basketbal-sized ball behind your back Keoping your head against te wa, slowly squat down toa 45 degree angle. Your tighs wil not yet be para eto the for, Hold this postin for 10 seconds and then slowly side back up |” the wall Repeat 10 times. Buld upto WAL SUT WITH ASL 8. KNEE STABILIZATION: Wrap a piece of elastic tubing ‘round tho ankle o one le, Tie a knot in the other ‘sd oT the tubing ara close Kn a doe A. Stand facing the door onthe fog ‘without tubing and bend your knee slighty, Keeping your thigh ‘muscles tight. While maintaining this pesitan, move the leg with ‘the tubing straight back behind you. Do 3 sels of 10 ‘8. Tum 80" so tho lag without tubing is closest othe door. Move the leg with tubing away from your body Do 3 sets of 10. (C-Turm 90" again so your back ie to the door Move the lo with tubing straight out infront of you. Bo 3 sats of 10 ee staU2ATON . Turn your body 90° again 20 the log with tubing is closest othe door. ‘Move the log wth tubing aeoss your body. Do 3 sets of 10. Hold onto a cai if you need help balancing. This ‘exoise can be made even more challenging by, 'tancing ona plow whie you move te eg with tng. ‘apr 00 Mek Cope n/n gn ton IN REHABILITATION EXERCISES continued) © RESISTED TERMINAL KNEE EXTENSION: Make @ oop. ‘rom a pleco of elastic tubing by tying a kt in both ‘ends, and closing both krats in a door Step ito the loop so the tubing is aounc the back of one leg. Lit the other foot of the ‘ground. Hold onto a cha for Balance, needed Bend the kee of th lg we tubing about 45 degrees Slowly ‘Straight your lg, Koaping your thigh muscle ight 28 you {0 ths. Do tis 10 mes, Do 3 ‘sets. An easier way todo this sto pertom thie exer- ‘se whl etaning on both esr emunal 198. 10, STANDING cA sraETEH: Facing 2 wall, put your ands agaist the ‘wall at about eye level. Keep one eg tack with the heal on the noe ‘and the other log forward. Turn your back foot sight inward (as you ware Pigeon-toed) as you slowly lean into ‘the wall unl you feel a strat in the back of your caf. Hols for 15 130 seconds. Repeat 3 times. Do ths exercsesoveral tines each day, SADE CAT 11. CLAM EXERCSE: Lie on one sie with your hos anes ‘noes bent and fet together. Slowly rise your top og toward the caiing wre Reoping yout Inet ‘canact with each thar Held fr to Seconds ana lower slow. Co 3 sets of "CAM OSE ‘1Orepettions. 12 IJOTINAL BAND STRETCH: Side bend ing: Cros one lag in font ofthe other leg and lean the opposite direction ‘rom the Font lag. Reach the atv on {he side cf the back leg over you: Read ‘whe youde thie. Hold tia poston for “15 0.50 seconds. Return to the stant {ng postin. Fepect 3 times, ADVISOR 207