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Knee Pain

Patellar Subluxation Exercises

Minute Read

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2 months ago

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by james

Patellar subluxation exercises are the best way to recover from instability, subluxation or dislocation of the patella. This condition is where the kneecap moves out of its usual position. The kneecap is known as a sesamoid bone. This means it is a bone that sits inside the tendon of a muscle. For the patella, the tendon is that of the quadriceps muscle. The quadriceps muscle runs from the top of the femur bone at the front of our hip, with one part of the muscle attaching above the hip joint. At the lower end, the quadriceps attach to the tibial tuberosity with the patella bone acting as a pulley over the bending knee joint.

The patella should sit at the inferior pole of the femur. It has a complementary shape that fits into the intercondylar groove of the femur when the knee bends. There is maximal contact and therefore stability between the femur and the patella at 60-90º of knee bend.

Picture diagram of Patellar Subluxation and dislocation

 

Patellar Subluxation Causes:

  • the patella is flatter in shape on its underside
  • the patella is misaligned or sits too high
  • the surrounding muscles are not strong to provide stability to the patella
  • a change of direction of the knee with the foot planted on the ground
  • there is direct trauma to the knee

Dislocation or subluxation causes a stretch or tear to the medial patellofemoral ligament. When this heals it is often more lax than before, leading to great instability of the patella and a higher chance of repeat dislocation or subluxation.

Exercises for Patellar Subluxation

Exercises to aid recovery and prevent recurrence are based on improving the strength of the muscle around the knee and improving excessive tightness in the surrounding muscles.

The quadriceps is the most important muscle group to strengthen. If is composed for 4 individual muscle that attach around the patella and can stabilise its movements. The control of medial (inward) or lateral (outward) movements of the knee from the gluteal muscles at the back and outside of the hip, and by the adductors along the inside of the thigh. On the back of our leg, our hamstring and lower down our calf, also help to stabilise the knee joint as these muscles cross over the knee joint.

Finally addressing any tight muscles which can affect the movement of the patella in, and the pressure of the patella on, the femoral intracondylar groove.

Here are some of the top exercises for patella instability, subluxation and dislocation. These should be done 3x per week, for 3 sets of 15 repeats.

Inner range knee extension – quads

Sitting with your legs out straight in front of you, put a rolled up towel or small cushion under your knee. Push your knee down into the pillow to straighten your knee, and causing your ankle to lift off the floor. You can place you hand on the front of your thigh and feel that inner part of the quads is also working.

Shallow squats with a band – quads and glutes

Stand with your feet hip width apart and a resistance band around your thighs just above your knees. Keeping your weight on your heels lower your pelvis down and back into a shallow squat, bending your knees to 60º. Keep pressure on the band by pushing your thighs out, this works your gluteal muscles. To return up push your pelvis forwards as you straighten your knees, and repeat.

Hip abduction – glutes

Lying on your side with a resistance band around your ankles. Your bottom leg bent to help keep you stable and your top leg should be straight and in line with your body. Lift your top leg diagonally up and back while keeping you pelvis still. You should feel your glutes working, these are the muscles on the outside of your buttocks. Slowly lower your leg and repeat.

Hip adduction – adductors

Standing on one leg with a band tied around your other ankle and a stable base, such as a table leg. Keeping upright and straight through your body, pull the band inwards and across your body. You can alternate pulling the band in front of your body and behind. Slowly return the band out to the side, and repeat.

Long lever bridge with a band – hamstring and glutes

Lie on your back with a band around your thighs just above your knees. Bend your knees to 60º with your feet hip width apart. Tilt your pelvis backwards to flatten your back against the floor, peel your pelvis off the floor leading with your tail bone. Feel it working your hamstring at the back of your thighs, as well as your glutes. Slowly curl back down as you lower, and repeat.

Stretches for quads, glutes, hamstrings and calf

Hold these stretches for a minimum of 30seconds, this has more of a long-lasting effect on relaxing the muscle. These stretches should be done 3 or more times over the course of the day.

Photo of man stretching hamstrings

Photo of man stretch quadriceps

Photo of man stretching gluteals

Physiotherapy with James McCormack

This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.

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