Getting Your Kneecap Back in the Groove
What Is Patellar Subluxation?
Patellar subluxation occurs when the kneecap moves slightly out of its groove at the end of the thigh bone and then comes back into place.
– Why Is It Serious?
- Often painful and may lead to actual dislocation of the kneecap.
- Subluxation puts additional strain on certain structures, requiring a person to use the hip and thigh muscles to help control the patella.
This reliance can create further complications if left unaddressed.
– Why Patellar Subluxation Happens
- Sudden trauma (e.g., a fall or a blow to the knee).
- Gradual wear and tear on the knee joint.
Understanding the types of subluxation is crucial to effectively addressing the condition.
Types of Patellar Subluxation
Traumatic vs. Atraumatic Subluxation
There are two types of subluxations: traumatic and atraumatic.
1) Traumatic Subluxation
Traumatic subluxation occurs as a result of a specific incident or accident.
- For example, a direct blow to the knee during sports, a fall, or any other type of impact injury can force the kneecap out of its groove.
- This type of subluxation is usually associated with a noticeable injury, and the pain and swelling can be immediate and intense.
- It is most common among athletes and active individuals who engage in high-impact activities, such as soccer, basketball, or running.
2) Atraumatic Subluxation
On the other hand, atraumatic subluxation is not caused by a specific injury or accident.
- Instead, it tends to develop gradually over time due to factors such as joint laxity (looseness), muscle weakness, or an abnormal walking pattern.
- The atraumatic variation occurs more frequently in women, particularly those who are “loose-jointed” or hypermobile, meaning their joints stretch farther than what is considered normal.
- Other factors that may cause a subluxation include abnormalities in the stride, a wider pelvis and a shallow groove for the kneecap.
While an atraumatic subluxation is possible, subluxation in adults is usually due to a sports injury or overuse of the knee joint for a period of time.
Recognizing the Signs of Subluxation
Identifying the signs of patellar subluxation early is crucial for effective treatment and prevention of further injury.
The symptoms can vary from person to person, but there are some common indicators to watch for:
- Kneecap Pain: Sharp or aching pain around or behind the kneecap, especially during activities like walking, running, or climbing stairs.
- Knee Instability: A feeling that the knee might “give out” or feel weak, due to the kneecap not staying in its groove.
- Swelling: Swelling or tenderness around the knee, often after physical activity.
- Popping or Clicking: A popping or clicking sensation when bending or straightening the knee.
- Limited Movement: Difficulty fully bending or straightening the knee due to pain or discomfort.
- Visible Kneecap Movement: The kneecap visibly shifts out of place and then returns, especially during movement.
- Recurring Symptoms: Repeated episodes of pain, instability, or swelling, especially after physical activity.
Subluxation can be a one-time problem or a recurring situation.
This is especially true if the underlying cause isn’t properly addressed.
Why Does Subluxation Keep Happening?
While an atraumatic subluxation may happen without warning, subluxation in adults is most often linked to:
- Overuse of the knee joint
- Sports-related injuries
- Repetitive strain from activities such as bending, jumping, quick changes in direction
Understanding these causes is key to finding the right treatment approach.
Effective Treatments for Patellar Subluxation
Patellar subluxation can often be managed successfully with a mix of different treatments.
The goal is to reduce pain, improve knee stability, and prevent the kneecap from moving out of place in the future.
Here are some effective ways to treat this condition.
1) Physical Therapy
Fortunately, subluxation is often treated successfully with physical therapy and is one of the best ways to treat patellar subluxation.
A physical therapist will create a custom exercise plan to help:
- Strengthen the Muscles: Focus on exercises that build up the quadriceps and hip muscles, like leg presses, side leg raises, and clamshells, to keep the kneecap stable.
- Increase Flexibility: Stretching the hamstrings, calves, and hip flexors can help relieve tightness around the knee.
- Improve Balance and Coordination: Simple balance exercises can help prevent future injuries by making your movements more controlled.
Many exercises particularly emphasize the hips, because strengthening the hip abductors and hip flexors through pelvic stabilization exercises controls the kneecap better.
How Physical Therapy Can Help
Physical therapy focuses on exercises that target the muscles around the hip and thigh, especially the hip abductors (muscles that move the leg away from the body) and hip flexors (muscles that help lift the thigh).
Strengthening these muscles helps stabilize the pelvis and improves overall knee control, which can prevent the kneecap from slipping out of place.
2) Rest and Activity Changes
Give your knee a break!
Avoid high-impact activities that strain the knee, and slowly return to normal activities when your knee feels stronger.
3) Pain Relief
For pain and swelling, try over-the-counter pain relievers like ibuprofen or acetaminophen. Icing the knee for 20–30 minutes every few hours can also help reduce discomfort.
4) Injections
In some cases, doctors might recommend corticosteroid injections to reduce pain and swelling.
This can provide temporary relief while you continue other treatments like physical therapy.
5) Surgical Options
If other treatments aren’t working, surgery might be an option.
This could include procedures to loosen tight ligaments, reconstruct supportive ligaments, or realign the bones to better support the kneecap.
6) Lifestyle Changes
Making small changes, like maintaining a healthy weight, wearing good shoes, and practicing good posture, can help reduce strain on the knee.
7) Regular Check-Ins
Stay in touch with your healthcare provider or physical therapist to monitor your progress. Regular follow-ups help adjust your treatment plan as needed and keep you on track for recovery.
With the right combination of these treatments, you can reduce pain, strengthen your knee, and get back to doing the activities you love!
Additional Recovery Procedures
Several self-care strategies and interventions can help speed up recovery and minimize pain.
Here’s what you can do to manage symptoms and promote healing:
At-Home Care Tips:
- Elevate the knee by putting a pillow underneath your leg.
- Ice the knee for 20 to 30 minutes every three to four hours for two to three days. Continue this practice for two to three days, or until the swelling subsides. Using ice packs or cold compresses can significantly reduce pain and swelling.
- Wear a brace prescribed by your doctor to keep your kneecap in place. Braces provide additional support to the knee, reducing the risk of movement that might cause the kneecap to shift again.
Personalized Recovery Plan
Importance of a Customized Approach
It’s important to remember that everyone heals at their own pace.
Factors such as age, overall health, and the severity of the subluxation all play a role in how quickly and effectively a person can recover.
A physical therapy program designed especially for you will put you on the road to recovery quickly and safely.
A physical therapist will design a plan tailored specifically to your needs, focusing on strengthening exercises, flexibility training, and other modalities that support your unique condition.
Did you know you have Direct Access* to Physical Therapy? No referral, no problem!
Stay Positive and Proactive
Stay positive and proactive in your recovery journey.
Follow your physical therapist’s guidance, perform your exercises regularly, and listen to your body.
With the right care and dedication, you’ll be on the road to recovery quickly and safely, returning to the activities you love with confidence and strength.
The Jackson Clinics serves 18 locations throughout Northern Virginia.
Find one near you: https://thejacksonclinics.com/locations/
