Patellar instability occurs when your kneecap, known as the patella, slides outside its groove. This condition may develop following direct trauma or over time with everyday activities – and is especially prevalent among young athletes who engage in sports that involve fast movements.
Tissue damage from inflammation can lead to discomfort and necessitate treatment options that do not involve surgery. Nonsurgical therapies offer relief.
Strengthening Exercises
Your kneecap (patella) rests securely within its V-shaped groove on the end of your thighbone (femur). Muscles, tendons and ligaments on the front of your leg pull it upward through this groove when straightening or bending your leg, while muscles pull it downward when bent. If it slides too easily out of its groove during straightening and bending – which could result in pain as well as reduced ability to participate in everyday activities and sports – patellar instability occurs and could limit what activities or sports you are capable of performing.
Patellar instability increases with age, activity level and prior episodes of dislocation. Your physical therapist may prescribe exercises designed to strengthen your muscles and increase knee joint stability, using resistance such as workout machines, free weights or barbells, elastic bands or water (for swimming for instance) or your own body weight as resistance exercises.
Your therapist will teach you a simple exercise that can help make standing and sitting more easy, as well as improving balance. Start with feet hip-width apart facing towards a bench or table; bend one knee slowly towards your bottom while counting three. Return slowly back to starting position after three counts are up; repeat five more times until reaching 10.
An effective strengthening exercise is the squat. Simply stand with legs slightly wider than hip distance and slowly lower yourself into a squat by bending knees until they form 90-degree angles with your feet; return to starting position when done. Repeat 10 times before increasing to three sets of 10 repetitions.
Straight leg raises are another effective strength-building exercise. Simply lie on your bed and extend your top leg before contracting the quadriceps muscles to lift it 12-18 inches off of the floor, according to Michigan Medicine. Because this exercise may put undue strain on your knees, begin slowly with less repetitions until reaching higher numbers over time.
Studies suggest that regular weight training may increase the size of the vastus medialis obliquus muscle, which helps support kneecap stability. Regular training also may lower the chance of dislocations or the need for surgery and reduce dislocation risk.
Flexibility Exercises
Strengthening exercises for patellofemoral instability are necessary, but stretching exercises are just as vital to ensure optimal knee and hip functioning. Tightened muscles can cause the patella to slip out of its groove and into more vulnerable positions – so stretching should always be part of any fitness regime.
Flexibility exercises can increase range of motion in both knees and hips, which may reduce injury or pain. It is best to perform these exercises after an aerobic activity or strength training session in order to warm up and increase blood flow to muscles.
Stretching can help relieve tension from knees, hips and back. Stretch at least once daily – ideally morning and evening – for best results; doing it more frequently will increase flexibility within your body and facilitate its use for other things.
Flexibility exercises can help with patellar tracking disorder in various ways. One common technique involves sitting on the floor with legs stretched out in front of you and holding this position for two to three seconds before slowly lowering them; repeat this for 10-15 repetitions on each leg.
An effective exercise involves standing on the bottom step of a staircase with your affected leg while holding onto either a handrail or wall for support, using handrail or wall grip as support to engage core muscles to control movement and improve knee stability. Studies have demonstrated how both muscle hypertrophy and strength training can increase vastus medialis obliquus size while strengthening knee stability.
As with any exercise, stretching exercises require regular, deep breaths. Mild pulling sensations are normal during stretching sessions; sharp or stabbing pain indicates you have gone too far and should cease the activity immediately. For beginners to stretching, starting off with aerobic activity or strength training may help warm up muscles before embarking on stretching sessions to prevent injuries and avoid potential strain.
Pain Management
The kneecap (patella) is held together by quadriceps muscles of the thigh. Weak quad muscles are one of the primary sources of misalignment of patellar movements and instability of its position. Exercise programs designed specifically to strengthen quads as well as receiving an accurate diagnosis by physical therapy are effective ways to address this problem and avoid future episodes of knee pain.
Normal knee bending and straightening movements should place the patella (kneecap) within a groove known as the trochlear groove on top of your femur bone, moving up and down in response to movement of your leg bones (femur). Should an unstable condition develop over time due to jumping, cutting sports activities, or quickly switching directions when climbing or descending stairs – your patella may slip out of this groove, causing its “train” to go off track and dislocate, either suddenly or gradually over time with repetitive activities involving sudden knee actions like jumping off tracks during movement causing it dislocation – something sudden like dislocations can happen quickly such as when dislocation occurs during patella dislocation events such as when dislocating an unstable patellar dislocation occurs suddenly while gradually over time with activities like jumping or changing direction rapidly while moving between stairs or when walking up/down stairs etc.
People suffering from patellar instability may experience a popping sensation when climbing stairs or bending their knees, with their kneecap slipping out of its groove on either the left or right side. Women, young people and athletes who participate in sports that involve pivoting movements such as soccer, basketball or cheerleading are particularly at risk of this condition.
Physical therapists offer various patellar instability exercises to strengthen quadriceps muscles and ensure better tracking of the patella. Furthermore, they can teach how to change daily activities to lower your risk of knee injury; such as how to walk up and down stairs safely or sit without placing too much strain on knees.
Sit comfortably on a firm surface such as a floor or bed with both of your legs bent, feet flat on the floor, and your injured leg extended, ensuring your lower back has its natural curve. Contract your quadriceps muscle in your extended leg until 12 to 18 inches off of the floor are reached, then hold this position for 6 seconds before slowly lowering back down and repeat this exercise several times each day.
Surgery
Normal kneecap (patella) placement lies within a groove atop your thigh bone (femur). When bending and straightening your knee, the patella slides up and down this groove, known as the trochlear groove. But with patellar instability, your patella gets dislodged from its usual place – either during movement when pulled by muscles and tendons of your thigh, or over time from activities such as running, changing direction quickly in sports games, climbing stairs etc – typically seen more among women and teenage athletes than ever before.
The quadriceps muscle on your front thigh helps hold your kneecap securely in place. In partnership with other tendons and ligaments, this muscle helps support and stabilize the patellar. When this structure becomes loose or too tight, you could develop issues related to patellar tracking disorder – an irregularity in kneecap movement caused by improper tracking disorder.
Your healthcare provider may recommend surgery if your kneecap keeps dislocating out of its groove, dislocates once without relocating itself, or cause chronic patellar instability that leads to pain and other symptoms.
Most surgeons employ an arthroscopic procedure to correct kneecap issues. During this surgery, your physician makes small incisions in your knee joint using a camera as guidance, creating small incisions while making necessary repairs with instruments that could then be put back together again later during physical therapy sessions to strengthen and stabilize it further.
Physical therapy will work to alleviate your knee injury’s pain and swelling by teaching exercises to strengthen quadriceps muscle and other stabilizing muscles, while helping you avoid movements which increase risk of patellar instability (for instance bending your knee past 30 degrees).
Studies have demonstrated the power of exercise to strengthen muscles, tendons and ligaments surrounding your knee joint. One such study observed patients who underwent 8 weeks of either strength or hypertrophy training increased the size of their vastus medialis obliquus muscle – an essential stabilizer.
