Have you ever been walking along and suddenly feltl your kneecap slide slightly out of place as you step? That’s called patellar instability. And it’s more than just an inconvenience.
Patellar instability can cause pain, stiffness, and swelling — and can even interfere with your ability to walk.
We’ll give you all the facts about patellar instability and let you know how you can find relief through several methods, including physical therapy.
- What Is Patellar Instability?
- What Causes Patellar Instability?
- Patellar Instability Symptoms
- Patellar Instability Treatment
- Patellar Instability Physical Therapy – Will PT Help?
- Best Patellar Subluxation Instability Exercises
- How In Motion O.C. Can Help With Patellar Instability
What Is Patellar Instability?
In a normal knee, the patella — or kneecap — is attached by tendons to the thigh bone (femur) and shin bone (tibia). There is an indentation called the trochlear groove at the end of the femur where the patella fits and slides up and down with the movement of the knee.
When the kneecap is able to move outside this groove, that is referred to as patellar instability.
There are two different types of patellar instability:
- Traumatic patellar dislocation — This type of patellar instability occurs when the kneecap is pushed completely out of its groove, often as a result of a knee injury.
- Chronic patellar instability — This type describes when the kneecap only partially slides out of its groove. Joint movement of this kind is also called subluxation.
What Causes Patellar Instability?
The causes of patellar instability include:
- A direct blow to the kneecap as a result of a sports injury, fall, or other accident
- An uneven or shallow trochlear groove
- Extremely flexible joints or loose ligaments
Many women have looser ligaments that can cause the development of patellar instability, but men have to deal with this condition as well.
If you have a health condition that causes loose connective tissue, such as …
- Ehlers-Danlos syndrome
- Cerebral palsy; or
- Down syndrome
… you may be more likely to suffer from patellar instability. You could also be at a greater risk for this condition if you play high-impact sports (e.g., football) or sports where you do a lot of quick pivoting (e.g., soccer, basketball, cheerleading).
Patellar Instability Symptoms
Patellar instability can greatly interfere with your mobility. Its symptoms may include:
- Stiffness, swelling, and pain in the knee
- The feeling of the kneecap moving from side to side or catching on connective tissue
- Popping or cracking sounds when you bend your knee
- Buckling of the knee
- Locking of the knee
- Inability of the leg and knee to support your weight/keep you upright
The affected knee may also develop a noticeable deformity over time. People with chronic patellar instability may not have as much pain as those who have experienced a traumatic patellar subluxation, but it varies from case to case.
Patellar Instability Treatment
If you suffer from patellar instability, you should seek treatment as soon as possible, so you don’t have to deal with pain or immobility. Less severe cases of patellar instability will usually respond to nonsurgical treatment, while others may require surgery.
Nonsurgical Treatments for Patellar Instability
If your kneecap is completely out of the trochlear groove and won’t go back on its own, you’ll need a medical provider to perform a reduction where they gently push the patella back into place. It can be uncomfortable, but the effects can be remedied with pain medication.
For general patellar instability or partial knee dislocation, your treatment options include:
- Use of NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen and naproxen
- Rest, ice packs, and elevation
- Wearing a knee brace to immobilize the joint
- Physical therapy to improve range of motion and strengthen muscles holding the kneecap in place
Surgical Treatments for Patellar Instability
If your patellar instability is the result of an injury, you may have bone fragments or loose cartilage in the knee area that will need to be surgically removed.
Surgical treatments for patellar instability include:
- MPFL (medial patellofemoral ligament) repair — This strengthens the ligaments holding the kneecap in place.
- MPFL reconstruction — The damaged ligament is replaced with a hamstring tendon (from your body or taken from a donor).
- Knee osteotomy — This procedure is also known as a tibial tubercle transfer and realigns the tibia, femur, patella, and connective tissues.
- Knee replacement — This is the most extreme option and may be necessary in the event of recurrent dislocations.
Patellar Instability Physical Therapy – Will PT Help?
Physical therapy is a great, less invasive option to treat patellar instability. With physical therapy, patients suffering from patellar instability may experience:
- Decreased pain
- Increased strength
- Improved knee function; and
- Restoration of proper movement
The physical therapists at In Motion O.C. have a lot of experience treating patellar instability and would love to help you with your condition.
Best Patellar Subluxation Physical Therapy Exercises
There are many exercises that can help restore the overall stability of your knee. Let’s look at a few helpful examples. Each set of exercises should be done three times per day.
To do quad sets:
- Sit with both legs extended in front of you and put a rolled-up towel under one knee to keep it slightly bent.
- Lift your foot off the ground until your knee is fully straightened.
- Hold this position for five seconds, then relax the quad muscles and slowly lower your leg back to starting position.
- Repeat 8–12 times.
Shallow Knee Bends
To do shallow knee bends:
- Stand with your feet shoulder-width apart and your hands resting on a chair in front of you.
- Slowly bend your knees and squat as if you are sitting in a chair, making sure your knees don’t go over your toes.
- Keeping your heels on the floor, lower yourself 6 inches or so.
- Slowly rise to a standing position.
- Repeat 8–12 times.
For the wall slide exercise:
- Stand with your feet about 12 inches apart and your heels 6 inches from the wall. Press your butt and back against the wall.
- Slowly slide down the wall and stop when your knees are bent at about a 45-degree angle.
- Hold for 5 seconds, then slowly slide back up the wall.
- Repeat 8–12 times.
How In Motion O.C. Can Help With Patellar Instability
If you’ve suffered from patellar instability without much relief, turn to the experts at In Motion O.C. We’re the #1 physical therapist in the country on Yelp for a reason! Be sure to check out the reviews and testimonials from others who have been treated at our clinics.
We have helped hundreds of people just like you with physical therapy for patellar instability. If you’re ready for patellar instability to stop interfering with your range of motion — and your life — contact us today and request a free screening.
The content in this blog should not be used in place of direct medical advice/treatment and is solely for informational purposes.