A patella dislocation is the dislocation of the kneecap from its slide bearing. The patella has a triangular shape and therefore fits exactly into the condyles of the thigh. This joint is called femoropatellar joint.
The kneecap is a sesamoid bone, i.e. it is a bone that is built into a tendon and serves as a force diverter for the M. quadriceps femoris. The patella is embedded in the patellar tendon and laterally stabilized by the so-called retinacula flexoria. Muscular imbalances, false statics or genetic anomalies can cause the patella to shift in its slide bearing and promote dislocation. Before a patella dislocation occurs, affected patients complain of patellar pain at an early stage. Information on this can be found in the article Patellar Pain.
6 simple exercises to imitate
1 Exercise “Knee Mobilization” 2 Exercise “Hammer” 3 Exercise “Stretch Quadriceps” 4 Exercise “Strike Out” 5 Exercise “Sitting Knee Extenders” 6 Exercise “Squatting Knee “An anatomical change in the leg axis (knock-knees), the shape of the patella (patella dysplasia) or the slide bearing can promote patella dislocation. In extreme cases, such factors can even lead to spontaneous patella dislocation, i.e. a dislocation of the patella without adequate trauma caused by muscle traction or slight pressure. In most cases, the patella can be repositioned/repositioned independently by the affected person.
A patella dislocation is painful and can lead to concomitant injuries of the ligaments or cartilage. Traumatic patella dislocations occur as a result of a twist, blow or violent force being applied to the patella. In most cases, a medical reduction is then necessary.
The injury and overstretching of the ligaments around the patella then increases the risk of a renewed dislocation. Patella dislocation can damage the cartilage in the femoropatellar joint and thus promote retropatellar arthrosis. If patella dislocations occur for the first time, conservative therapy with physical and physiotherapeutic means is usually carried out after reduction.
In cases of severe concomitant injuries to the cartilage and ligaments, or frequently occurring patella dislocations, appropriate surgery can be performed. With a patella luxation, the mobility of the knee joint is usually not restricted. Immediately after the dislocation, however, bleeding or pain can cause the joint capsule and ligaments to become stuck together, which restricts mobility.
The extensibility of the knee should also be checked; here the patella is pressed into its slide bearing at the maximum. 1st ExerciseMobilization of the knee joint can be achieved by final movement. The flexion can be trained very well while sitting.
The knee is lifted while the heel pulls towards the thigh. By lifting the knee, evasive movements are avoided. Both joint partners (thigh and lower leg) are moved in such a way that the joint movement is fully utilized.
It is important to make sure that both buttocks are equally loaded during the exercise. 2 ExerciseThe extension in the knee joint can be improved by using the “Hammer” exercise. From the long seat the patient tries to press the back of his knee into the pad so that the heel (clenched toes) lifts slightly off the floor, the thigh remains on the floor.
The movement comes only from the knee joint not from the hip! If the knee joint does not provide sufficient extension, the exercise can be made easier by supporting the back of the knee with a towel or a small cushion. The exercise is performed in quick succession (20-25 repetitions in 3 sets) so that the heel makes small hammering movements on the floor – hence the name.
For strengthening, the stretched, raised position can be held for a few seconds and then released (10-15 repetitions in 3 sets). Further mobilization exercises for the knee joint can be found in the article Physiotherapy Mobilization exercises. Since a patella dislocation can be promoted by muscular imbalances and incorrect posture, a thorough examination should be performed to uncover these.
Often the medial (internal) muscle and connective tissue is too weak compared to the external. The patella is increasingly pulled outwards and tends to dislocate. Strengthening of the vastus medialis muscle is necessary here.
This part of the quadriceps muscle is especially trained during the final extension of the knee joint.The lateral (outer) apparatus should be stretched additionally. Simple quadriceps stretching is suitable for this purpose. 1st Exercise From a standing position, lift the leg to be stretched and pull the foot towards the buttocks.
The knee should not point forward, both thighs should be parallel to each other. The pelvis is pushed forward, the buttocks are tensed. In order to stretch the lateral components more, you can grip the foot above the ankles with the opposite arm.
In this way an increased tension is exerted on the outer side. The stretch is held for about 10 seconds, then released and repeated 3 times. 2 Exercise Since it is not only a matter of muscular shortening, a fascial roller can also be used to stretch the connective tissue structures.
To treat the left knee, the patient is in a lateral position on the left side. The right leg is placed on the floor behind the left leg for stabilization. Now the outside of the knee is placed on the roll and “rolled out”.
This can be somewhat painful, but this is normal. You can find more stretching exercises in the article Stretching exercises and fascial training. Strengthening exercises play an important role in patella luxation in order to compensate for possible incorrect positioning of the patella by means of muscle traction.
In addition to a possibly indicated leg axis correction, the medial muscles must be strengthened. The quadriceps femoris muscle is composed of several parts, the medial part is also called the medial vastus. The aim is to address this part of the muscle directly through specific exercises.
1st ExerciseThe patient is seated on the floor and adjusts the knees. Now a lower leg is stretched without the knee sagging. Both knees remain at the same height during the entire exercise.
To strengthen the medial parts, the foot is not simply stretched straight upwards but with the inner edge facing upwards. The exercise can be performed 15 times in 3 sets. It can be made more difficult by adding weight cuffs.
2nd exerciseA functional exercise is the knee bend. The knees are directly above the ankles, the patella points straight forward. When standing, the weight is evenly distributed on both feet, in flexion it is increasingly distributed on the heels.
During flexion, the knees do not go over the toes, the lower legs remain firmly vertical. The buttocks are lowered to the rear, as if one wanted to sit on a far away stool. In order to activate the medial vastus more, a pillow/ball can be placed between the knees.
The knees press inward during the knee flexion, but should not reach an X-B setting. 15 repetitions can be performed in 3 sets. Further exercises can be found in the articles Exercises Patellar Tip Syndrome and Physiotherapy Exercises Knees.
Coordination exercises are particularly demanding on the structures in the knee joint. They serve to promote the responsiveness and reaction of the muscles in order to safely stabilize the kneecap in everyday life. 1st exercise Start-stop exercises are recommended.
For example, the patient walks through the room in a lunge and must stop at a sign or change direction. The muscles must react quickly to such abrupt movements. If slow movements work well, such a change of direction or tempo can also be performed from the run or even the sprint.
2. exercise Jumping exercises are also suitable as coordination training for patella luxation. For example, jumping with a ball between the knees on a trampoline and stabilizing the leg axis is an effective exercise. The coordination exercises are varied and should always be tailored to the patient’s goals and needs.
For example, sport-specific exercises to improve coordination can also be useful. Further exercises can be found in the article Balance and Coordination Exercises. Massage exercises are particularly useful shortly after trauma to loosen stuck tissue after an injury caused by bleeding or after pain-related immobilization.
In addition to the use of a fascial roller, manual massage grips can also be useful. The tissue around the patella should be slightly lifted and moved. The best way to do this is to grasp a small fold of skin and push it in front of you with your fingers.
A burning pain may occur in some areas. Points of pain can be treated by circular pressure movements. However, it should never be rubbed directly onto bones, as this can cause the periosteum to become inflamed.Heat treatments and massage with pain-relieving ointments can also be performed. Massage exercises are only to be seen as a supplement to the exercise program and alone cannot help in the treatment of patella luxation.
