Well, I did it again. I dislocated my patella in the first period of my hockey game, on my first shift. I think that I did not warm up enough but I don’t think that could have helped this. I caught an edge on my skate and was hit and pop, but the good thing is that it went back in on its own even before I hit the ice it seemed. I forgot how painful it was! Oh well, this lets me put some things into perspective. I play ice hockey and lacrosse, I am 17 years old and this is the second time this has happened to me. I have the same limited mobility in the ramge of motion as I did the first time. I am going to see a sports doctor tommorow but I am sure that it will be the same as last time, he’ll look at some x-rays and say, “well I dont think theres any major damage to any ligaments. I am gonna call up Tanya our physical therapist and we will get you fitted for an immobilizer in no time.” Then an out of shape 40 year old women who probably doesn’t have any experience in rehibilitating college bound atheletes will show me some stupid towel exercises to do and give me an immobilizer and send me on my way to get another dislocation. I will not let that happen. Christmas is coming up and I am going to ask my parents for 30 sessions with a reputable trainer/rehibilitator to get me ready for spring lacrosse. My question is, what do I look for in these trainers? I am not bashing women and I know that there are probably some very good women trainers out there that know their stuff but I am reluctant to let a woman show me how I can rehibilitate, and train to prevent injury in a sport that she cant even play(I know there is womens lax but they are two totally different sports) Are there any key questions to ask them to find out if they know what they are doing? I jsut dont want to be put on the same program as a 50 year old menapausing woman. I need attention on an individual basis catered towards my needs. Coach Davies, I know that you are probably familiar with some of this so I would greatly appreciate it if you would give your two cents worth. Thank you.
I absolutely have many great associates I could refer to you. Please tell me where you are located and if you prefer to speak in private, feel free to email me. Please fill me in with the doctors report as well. In faith, Coach Davies
Please answer the following questions for a more detailed treatment/rehab plan.
- Where there x-rays or MRI taken for this or the previous injury?
- What where the results of these tests?
- When did this happen?
- How long ago was the first dislocation?
- What was the treatment and rehab like?
- Has there been any trauma to the knee other than the dislocations?
- Have you ever dislocated/subluxed the other knee?
- Is this your dominate leg?
- Did the patella dislocate to the medial or lateral aspect of your knee?
- Did your knee/patella get hit or did you get checked?
- Do you where a supportive sleeve or brace?
- What does your knee look like now?
- What does it feel like?
- How much range-of-motion does it have?
- Are you able to fully weight bear on it.
- Do you have any atrophy in the upper or lower leg? Measuring with a tape will pick up subtle differances between right and left.
- Do you have much soreness on the top, inside edge of your patella?
Answer those questions and I'll have more information to go on. A rehab program will be difficult to give without seeing you or putting my hands on you, but I'll try my best.
Thank you so much for the responses Coach and Stronski. Coach- I live in Orlando, FL and I would appreciate it greatly if you might give me the name of a good rehab/strength-training specialist in my area. As for the questions Stronski here are my answers- 1. Where there x-rays or MRI taken for this or the previous injury?- Yes, I had x-rays and an MRI taken for the first injury. I only had x-rays taken for this one to check if there were any bone fragments. 2. What where the results of these tests? The result of the first x-ray and MRI showed no serious damage that the doctor could see. I may have partially torn my mcl the first time but the doctor said that he thought that it was not torn. 3. When did this happen? I re- injured my knee December 2nd of 2001 and my first injury was last march. 4. How long ago was the first dislocation? About eight months. 5. What was the treatment and rehab like? Basically I was in an immobilizer for a week and a half. I then started to try and get my full range of motion back and that took some time, maybe two months. After I got the range back I started strength training again. I had lost a lot of strength and muscle in my left leg but I seemed to regain it quickly. My rehab program was actually designed by myself and it entailed a gradual reintroduction of full range squats, deadlifts, and other full range multi-joint exercises. I had regaind any lost ground by the end of the summer. 6. Has there been any trauma to the knee other than the dislocations? No, dislocation of my left patella has been my only problem. 7. Have you ever dislocated/subluxed the other knee? No, my right knee has been injury free so far.8. Is this your dominate leg? No, unfortunately this is not my dominant leg. 9. Did the patella dislocate to the medial or lateral aspect of your knee? Laterally. 10. Did your knee/patella get hit or did you get checked? I was checked both times. 11. Do you where a supportive sleeve or brace? No I do not but I am getting fitted for one on Wednesday. 12. What does your knee look like now? It was quite swollen compared to the other but now that has seemed to subside for the most part. There is still a bit of swelling though. 13. What does it feel like? It doesnt hurt to just let it sit but it does hurt if I try to extend it fully or bend it more than a couple of inches. 14. How much range-of-motion does it have? Probably about 4-5 inches. 15. Are you able to fully weight bear on it? Yes I can but it feels weak. 16. Do you have any atrophy in the upper or lower leg? Not yet. Measuring with a tape will pick up subtle differances between right and left. 17. Do you have much soreness on the top, inside edge of your patella? On the lateral side of the patella there is some soreness. Thank you and I appreciate any help you can offer me.
Just so you can see this coach and stronski. thanks
Please email me directly and I can send you a listing of specialists in your area. In faith, Coach Davies
Chris, sorry for the delay in replying. You probably have small occult fractures on the patella and femur. Also commonly called “bone bruises”. I’ve never seen a subluxed or dislocated patella that didn’t have one. The first thing you have to do is restore range-of-motion. Without full motion you’ll get considerable atrophy in no time from calf to glute along with a host of other problems. Try these exercises: Sit on the floor with your knee extended, place your hands on your knee and gently push down trying to extend it further. Placing a rolled up towel behind the knee prevents gradual, comfortable extension. Don’t tighten the quads. Just use your upper body weight to push the knee down. Don’t expect big gains the first time and expect some soreness. Hold it there for five minutes to start. Even if you have to break the five minutes up into five sets of one minute or ten sets of thirty seconds. For flexion, sit on a firm chair. A metal folding chair will work fine. Place the chair facing a wall at a distance where at your foot will touch the wall and you can sit on the chair with your back and hips at the back of the chair. Gently slide your hips forward one half inch so that you achieve gentle knee flexion. Hold it there until the pain decreases and move it further. Slowly you’ll move to the front edge of the chair and you’ll have to reposition it. Again, try for five minutes to start. Straight leg raises in four directions will slow down the atrophy. It won’t prevent it though. If you can tolerate it, you probably can do one leg heel raises. Also, train the opposite leg to get a cross-over effect.