Patella dislocation - from bracing to racing

August 15, 2016

Patella (knee cap) dislocation in young athletes can have devastating effect.  WE have recently beed treating a 23 year old male who first dislocated his knee when playing football as a 14 year old.  This was relocated in A&E.  He had some physio but never regained full trust in his knee and hence didn't return back to sport.

 

He managed day to day until this year when he slipped coming down stairs and once again dislocated his patella.  He was put in a brace for 1 month and unfortunately when he came to see us he had extreme quadriceps and glut wasting.  On isokinetic testing (gold standard strength testing) his non-affected quadriceps were 70% stronger than his dislocating side.

 

So what did we do?

 

With any patella dislocation you have to stop the knee from rolling in during functional activity as this puts the patella into a vulnerable position.

 

The problems we found were:

 

1. reduced ankle bend

 

 2. significant glut weakness - causing the knee to roll in

 

 3. significant quadriceps weakness (isokinetic testing)

 

 

Treatment:

 

we have now increased the quads strength by 50%.  This has been achieved by:

 

1. 30 degree knee extensions (patient unable to do one at initial assessment)

 

2. Glut activation exercises

 

 3. single leg press (starting with 5KG now at 80KG)

 

 

4. Star excursion balance (to improve balance and control)

 

 

Next steps:

 

We are now about to start impact exercises such as squat jumping and ultimately running.

 

The patient reported today "I don't even have to think about my knee anymore, I can't believe how far I've come in such as short period of time"

 

This is music to our ears at the Performance Lab.  If you have any lower limb issues that are stopping you perform daily activities or sports.  No matter how bad you think things are, I'm sure we can help you here at the Performance lab.

 

Give us a ring today for an appointment 01254 457867