Firstly, welcome to Injury of the Month! This is the first injury blog in what will be an ongoing series. The aim of this is to be informative and educational and help as many people as we can. This month we begin with a patella dislocation – this may seem like an odd injury to begin with, however, I have chosen this one for two main reasons. One being because, surprisingly, it is more common than what you may think and secondly because there is a vast amount of rehabilitation that should be applied to the recovery of this injury.
What is it?
As we are all aware, our knee cap (patella) is located in a groove above our femur and if you have ever had a little feel of your patella you will notice that it is in fact quite moveable. The term patella dislocation refers to when the patella is pulled out of its normal alignment and does not return back to its original alignment. A subluxation of the patella refers to when the patella has been pulled out of alignment but immediately returns back to its normal position. Symptoms will include immediate pain, swelling, distortion, reduced range of movement and difficulties weight-baring. Most commonly the patella will dislocate or sublux laterally (outwards) but it is possible to disrupt the alignment medially (inwards) although less common. A dislocation is usually quickly diagnosed but an X-ray may be required to determine the grade of the injury and to locate any bone trauma.
How do you get a patella dislocation?
Such an injury will nearly always be caused by a sudden/acute trauma. This could occur as a direct impact to the patella forcing the knee cap in a certain direction, or it can occur as a result of sharp twisting motion. Out of the two scenarios, a sharp twisting motion is most likely to be the cause. Specifically, the foot is likely to be fixed planted whilst the knee is twisting in a slightly bent position.
Although suffering from such an injury is incredibly unfortunate there are certain factors that could be predisposing yourself to a patella dislocation.
– Type of sports played: Sports involving repetitive sharp turns and agility such as football, netball, basketball, rugby, judo etc.
– History of such an injury can act as a predisposing factor.
– Patella femoral mal-tracking: this is when the patella does not always glide over the femur in perfect alignment meaning the knee cap is already inclined to track in a certain direction. If the soft tissue/ligament structures surrounding the patella are weak or have increased laxity this could result in mal-tracking.
– Shallow femoral groove: this would result in the patella never sitting in a fully secure position.
– Weakness in the surrounding muscles: weakness in the quadriceps especially.
– Lateral tightness: muscles inserting on the outside of the knee share attachments with the patella. A sudden contraction will influence the knee cap position.
Immediate recovery must involve a relocation of the knee cap performed by a health professional followed by physiotherapy. Rehabilitation is a slightly more complex matter and will be covered in our social media blogs throughout this month! Essentially the recovery must be focused around knee stability and strength. Recovery can vary between 8 weeks (subluxation) to 3 months case dependent. Follow us on facebook and Instagram to view our rehabilitation and prehab videos!