Patellar instability is a condition that affects the kneecap. It occurs when the kneecap, or patella, moves out of its normal position. The movement can cause pain, swelling, and difficulty in walking or bending the knee. Occasionally, the kneecap may completely dislocate. The dislocation can cause severe pain, swelling, and discomfort.

Patellar instability is more common among young athletes. It can happen suddenly due to trauma or gradually.  Common symptoms of patellar instability include physical deformity, pain, and swelling around the knee. The pain and discomfort associated with the condition can make it difficult for you to perform daily tasks.

When you consult a doctor with symptoms of these conditions, they can perform an assessment and recommend appropriate treatment. Treatments for the condition can include medication, surgery, and physical therapy. Physical therapy is a conservative treatment option for patellar instability. For safe and effective physical therapy services in Las Vegas, CA, you can rely on our expert services at Suarez Physical Therapy.

What is Patellar Instability?

The patella is located in front of the knee joint. The bone moves upward and down in a groove on the thigh bone when the knee bends. The other ligaments, tendons, and muscles keep the patella in the groove. Patellar instability occurs when the patella moves out of its track. It can partially slip out of position or fully dislocate.

A complete dislocation occurs when the kneecap completely dislocates from its groove. If you suffer a complete dislocation, you will need medical attention to return the patella to its original position. The condition can occur once after an injury or become a recurring problem. People who experience repeated dislocations may have underlying anatomical factors. These may include:

  • Shallow grooves
  • Weak quadriceps
  • Ligament injuries

Repeated instability can lead to chronic pain, swelling, and cartilage damage. Patellar instability can be a temporary or long-term condition depending on its cause and severity. It affects knee stability and function. This problem makes activities like walking, climbing stairs, or squatting painful. You can improve the overall outcome and prevent further knee damage by consulting a doctor immediately if you notice the symptoms. Your doctor will assess the condition and recommend the most appropriate treatment.

Causes of Patellar Instability

Common causes of patellar instability include:

Traumatic Injury

Traumatic injuries may result from a direct blow to the knee or a sudden twist to the knee. You can suffer an injury when playing sports such as soccer, basketball, or gymnastics. A fall or collision can also dislocate the kneecap, causing it to become displaced from its standard groove. Injury can stretch the ligaments and soft tissues that hold the patella in place. Such an event could increase your risk of future instability.

Anatomical Abnormalities

Patellar instability is not always associated with an injury. Some people are born with a shallow trochlear groove. Others may have a high-riding kneecap. These conditions make it easier for the patella to slip sideways. Structural differences in bone shape can also cause improper patellar tracking during movement.

Weak or Imbalanced Muscles

The muscles surrounding the patella maintain its natural position. Weakness in the quadriceps can affect the movement of the patella, also known as the kneecap. When the outer thigh muscles are stronger than the inner ones, they can pull the patella outward. Over time, the imbalance can lead to instability. Furthermore, you can suffer a dislocation during bending or twisting motions.

Loose Ligaments

 Some people have naturally loose ligaments or hypermobile joints. The flexibility can make the patella move too freely. Without firm support from the ligaments, the kneecap can shift or dislocate from regular activity.

Previous Dislocation

You are at an increased risk of developing patellar instability if you have suffered a dislocation in the past. When the patella dislocates, the surrounding tissues become stretched or damaged. Dislocation weakens the knee and increases the likelihood of a subsequent dislocation.

Growth and Developmental Factors

Children and teenagers are more susceptible to developing patellar instability because their bones are not yet fully developed. Rapid growth or misalignment during development can affect knee tracking. If growth and developmental issues are not addressed early, they can lead to chronic patellar instability later in life.

Symptoms of Patellar Instability

Patellar instability can cause several noticeable symptoms. They include:

  • Knee pain. Pain around the affected knee is the first symptom you may experience when you have patellar instability. You can feel the pain at the front of the knee when bending, walking, or climbing stairs.
  • Your knee may swell after experiencing repeated episodes of instability. Swelling can cause the knee to become stiff and difficult to move.
  • Kneecap movement. You may feel the kneecap slide or shift out of place in the early stages of patellar instability.
  • The knee may give way. The affected knee may suddenly feel weak or unstable when you have patellar instability. Such symptoms can cause you to lose balance or stumble.
  • Difficulty moving the knee. After a dislocation, you may experience trouble when bending or straightening the knee.

Diagnosis and Treatment of Patellar Instability

When you consult a doctor with symptoms of patellar instability, they will perform several tests to diagnose the condition. A proper diagnosis helps determine the severity of the condition. Additionally, it enables doctors to choose the most suitable treatment. Doctors begin the diagnosis with a detailed physical examination.

During the exam, the doctor will check for swelling and kneecap alignment. The doctor can use imaging tests to identify any structural abnormalities after conducting a physical examination. The imaging tests may include:

  • X-rays. Your doctor can order an X-ray to check bone alignment. Additionally, it can help identify signs of previous dislocations.
  • MRI (Magnetic Resonance Imaging). Your doctor may use an MRI to assess soft tissue damage. This could include injuries to torn ligaments or cartilage.
  • CT Scan. Sometimes the doctor can order a CT scan to create detailed images of the bone structure. The test helps to evaluate the shape of the trochlear groove.

An accurate diagnosis helps determine whether you require conservative treatment or surgery. The doctor may also assess risk factors for recurrence of the condition. The doctor can tailor a treatment plan to your specific needs after making the final diagnosis.

Treatment for patellar instability depends on the severity of the condition and its frequency of occurrence. The goal of the treatment is to relieve pain and improve knee stability. Standard treatment options that your doctor can recommend include:

Rest and Immobilization

After a dislocation or injury, the knee will need some rest. Your doctor may recommend using a knee brace for a few weeks. The brace limits knee movement. Additionally, it allows the ligaments and soft tissues to heal. Occasionally, you may need crutches to keep weight off the injured leg.

Ice and Pain Management

The pain associated with patellar instability can cause extreme discomfort. Your doctor may recommend applying ice packs several times a day to help reduce swelling and pain. Furthermore, you may need over-the-counter pain medicines to manage the discomfort.

Knee -bracing and Taping

You may need a patellar-stabilizing brace to help keep the kneecap in its correct position. The brace will provide extra support to the knee as you perform daily activities.

Surgical Reconstruction

Your doctor can recommend surgery in severe cases of patellar instability. The surgical procedures aim to return the patella to its natural position. Medial patellofemoral ligament (MPFL) reconstruction is a standard surgical procedure for the condition. Surgery reconstructs the ligament that stabilizes the knee. Other surgical options include realigning the bones and tightening loose tissue around the knee.

Physical Therapy for Patellar Instability

Physical therapy plays a crucial role in treating patellar instability. It helps restore knee strength and stability. Additionally, it allows you to move your knee freely after a dislocation or repeated episodes of instability. The goal of PT is to strengthen the supporting muscles and prevent future dislocations. The main components of physical therapy for patellar instability include

Assessment and Planning

Before starting treatment, the physical therapist will conduct a comprehensive assessment. They will search for:

  • Knee swelling
  • Pain
  • Muscle weakness
  • Muscle imbalance

Also, they assess how the patella moves when the knee bends and straightens. Based on the findings of the PT, a personalized treatment plan is created. The plan will start gently and progress as your strength and stability improve. The therapist also teaches you about proper knee movement.

Strengthening Exercises

The primary focus of physical therapy for patellar instability is strengthening the muscles. Weak or imbalanced muscles are the reason why the patella slips out of place. The exercises may include:

  • Quadriceps strengthening. The quadriceps muscles hold the kneecap in its groove. Exercises such as straight-leg raises and mini squats can help strengthen this area.
  • Hip and core strengthening. Strong hip muscles keep the knee aligned during movement. Therefore, your therapist can incorporate strengthening exercises in your treatment plan. The exercises include bridges, clamshells, and hip abductions. The exercises help you maintain balance and proper posture while running or walking.
  • Hamstring and calf strengthening. Balanced leg muscles reduce stress on the knee. Strengthening the hamstrings and calves will help control knee movement.

To make this work, your physical therapist will teach you these exercises. They will be monitored closely to ensure proper tracking of the patella.

Stretching and Flexibility

When the knee muscles are tight, the kneecap can become misaligned. Stretching exercises will enhance flexibility and alleviate tension in the patella. The stretches include:

  • Quadriceps stretch. This involves gently stretching the front thigh muscles. It reduces stiffness and helps the kneecap move smoothly.
  • Hamstring stretch. Flexible hamstrings allow the knee to stretch correctly and reduce pressure on the joint.
  • Iliotibial (IT) band stretch. The IT band runs along the outer part of the thigh. If it is tight, it can pull the patella outward. Stretching this band reduces lateral tension. Additionally, it enhances the tracking of patella movement.

Your physical therapist will recommend stretching exercises to complement strengthening activities and help prevent strain.

Patellar Mobilization and Manual Therapy

Occasionally, the therapist will use hand tools to strengthen patellar movement. The gentle mobilization restores normal motion. Additionally, it reduces stiffness around the knee. The therapist may massage the surrounding tissue to relax areas of tension.

Balance and Proprioception Training

Patellar instability can affect your balance and coordination. The imbalance can make your knees feel weak or unstable when standing, walking, or turning. Therapists include exercises that train the body’s sense of position and movement. Therapists use balance training to address the instability. Examples of balance training exercises include:

  • Standing on one leg
  • Using balance boards or foam pads
  • Performing mini squats on unstable surfaces
  • Step-up and step-down drills

These exercises train the muscles and nerves around the knee to react quickly. Furthermore, they stabilize the joint during sudden movements. When you have improved balance, you can prevent falls and future dislocations.

Taping and Bracing Techniques

Taping is a supportive method used during physical therapy. The therapist applies a sports tape to the knee to guide the patella into its proper position.

Taping reduces pain and improves alignment. Additionally, it provides a sense of stability. The PT can use bracing in early recovery. A patellar-stabilizing brace keeps the kneecap from moving sideways. Additionally, it allows for safe movement while the muscles are strengthening.

Functional and Sport-Specific Training

As the healing process progresses, therapy approaches turn to functional training. You may need to participate in an activity that replicates everyday movements. Functional training is designed to prepare the knee for real-world activities and movements. PT can include exercises like:

  • Lunges
  • Step-ups
  • Light jogging

Your therapist will make sure you perform each move with care to protect the patella.

Education and Lifestyle Guidance

Education is a key component of therapy. The PT will teach you to protect your knees daily and on athletic grounds. You can achieve these objectives by sitting, posing, or performing warm-up exercises. The therapist will also recommend that you maintain muscle balance even after you receive it.

Benefits of Physical Therapy for Patellar Instability

Physical therapy offers many benefits for individuals with patellar instability. These benefits include:

  • Restores strength. Physical therapy strengthens the knee muscles. The muscles involved include the quadriceps and the hip muscles. Strong muscles can hold the kneecap in place and prevent it from sliding out of position.
  • Improves stability. Physical therapy helps strengthen the muscles surrounding the knee.
  • Reduces pain and swelling. The pain and inflammation caused by pattern instability can cause extreme discomfort. Gentle exercises and massage therapy can help reduce inflammation and pain.
  • Improves flexibility. Physical therapy loosens the tight muscles and tendons that can pull the patella out of alignment. Better flexibility allows your knee to move smoothly.
  • Enhances function. Therapy restores normal movement of the knee. Additionally, it helps patients return to regular activity.
  • Prevents surgery. PT improves strength, which lowers the risk of future dislocations. Consistent physical therapy can correct patellar instability without the need for surgical intervention.
  • Promotes long-term knee health. Your physical therapist will recommend maintaining excellent posture even after recovering from patellar instability. Continued exercises keep the knee stable, strong, and flexible.

Prevention of Patellar Instability

You cannot prevent all cases of patellar instability. For example, you cannot avoid the instability that results from structural abnormalities. However, certain habits and exercises can reduce your risk of developing the condition. To prevent patellar instability, you should focus on improving strength, flexibility, and knee control. The following factors can reduce your risk of developing patellar instability:

  • Strengthen your muscles. Strong muscles around the knee improve your stability. Therefore, it is recommended that you regularly train your quadriceps, hamstrings, and hip muscles. You can use exercises like leg presses and squats to build support for the kneecap. Strong muscles hold the patella in place and prevent it from dislocating.
  • Improve your flexibility. Tight muscles around the knee can pull the patella out of alignment. Stretching the quadriceps can improve your flexibility and help you maintain knee balance.
  • Wear supportive gear. Supporting gear could help your knee to stay in place during high-risk activities. Support gear includes knee braces, supportive shoes, or athletic tape.
  • Avoid sudden direction changes. Activities that involve sudden turns can strain your knee joint. Therefore, you should move gradually and maintain control during sports.
  • Maintain a healthy weight. Excess weight can put extra pressure on the knees and cause instability. Therefore, maintaining a healthy weight is essential.

Address early signs. If you experience knee pain or swelling, seek medical attention promptly.

Find a Seasoned Physical Therapist Near Me

Patellar instability can affect individuals at all stages of life. However, individuals who engage in vigorous activities and exercises are at a higher risk of developing the condition. Patellar instability causes pain and swelling in the knee. If left untreated, repeated knee dislocations can lead to long-term damage and chronic instability.

If you experience the symptoms of this condition, please consult a doctor at your earliest convenience. Early diagnosis can help ensure proper treatment before the condition worsens. After a diagnosis, your doctor can recommend different treatment options. The treatments can range from medications to physical therapy and surgery, depending on the severity of your condition.

Physical therapy is a conservative treatment option that can be combined with other therapies. It strengthens the muscles around the knee and improves flexibility. Additionally, it trains proper movement to prevent future injuries. If you are struggling with knee instability or dislocation, you will benefit from our expert services at Suarez Physical Therapy. Contact us at 702-368-6778 from Las Vegas, NV, to schedule your appointment.