Sports Injuries: Kneecap (Patellar) Dislocation

Sports Injuries: Kneecap (Patellar) Dislocation

Athletes in high impact sports or sports that require a lot of running and jumping are prone to knee injuries.  kneecap dislocations most often happen as a result of trauma, such as when a football player is tackled, or a soccer players falls hard on his knees.

The kneecap, or patella, is referred to as dislocated when it slips out of the groove in the femur (thigh bone) that is naturally sits in. Some patients recover from a dislocation and never experience the condition again. For other patients, however, the patella will chronically dislocate until it is repaired through surgery.

You’ll know you’ve dislocated your knee cap if you feel these symptoms following an incident:

  • Severe pain at the knee
  • Redness and swelling
  • Deformity
  • Difficulty moving the knee at all

While many patients can overcome a patellar dislocation with a physical therapy regimen, severe cases will require surgery.

If the surrounding cartilage and bone are not severely damaged, five to six weeks of rehabilitation should be sufficient.   This includes strengthening exercises designed to rebuild the muscles surrounding the patella, which also will in-turn restore the range of motion that should be enough to recover from the injury.

If surgery is required, an orthopedic knee specialist will reset the kneecap and perform a short arthroscopic procedure to remove any dislodged pieces of bone, and smooth down any damaged cartilage. As with most sports injuries, surgery will also require 6 to 8 weeks of rehabilitation for proper healing.

Dr. Main and Dr. Pick-Jacobs treat athletes with mild to severe patella issues routinely. Dr. Main is an expert in arthroscopic surgery to repair the knee following even the most severe cases of kneecap dislocation.

Preventing Sports Injuries

Preventing Sports Injuries

Exercise is good for the body and with the proper precautions, sports injuries can often be prevented. The quality of protective equipment – padding, helmets, shoes, mouth guards – have helped to improve the safety in sports. But, you can still be susceptible to injury. Always contact your healthcare provider before starting any type of physical activity, especially vigorous types of exercises or sports.

Causes of sport injuries may include:

  • improper or poor training practices
  • wearing improper sporting gear
  • being in poor health condition
  • improper warm-up or stretching practices before a sporting event or exercise

Common sports injuries include:

  • Sprains and strains
  • Joint injuries (knee)
  • Muscle injuries
  • Dislocations
  • Fractures
  • Achilles tendon injuries
  • Pain along the shin bone

How can I prevent a sports injury?

The following are some basic steps to prevent a sports injury:

  • Develop a fitness plan that includes cardiovascular exercise, strength training, and flexibility.  This will help decrease your chance of injury
  • Alternate exercising different muscle groups and exercise every other day.
  • Cool down properly after exercise or sports. It should take 2 times as long as your warm ups.
  • Stay hydrated. Drink water to prevent dehydration, heat exhaustion, and heat stroke.
  • Stretching exercises can improve the ability of muscles to contract and perform, reducing the risk for injury. Each stretch should start slowly until you reach a point of muscle tension. Stretching should not be painful. Aim to hold each stretch for up to 20 seconds.
  • Use the right equipment or gear and wear shoes that provide support  and that may correct certain foot problems that can lead to injury.
  • Learn the right techniques to play your sport.
  • Rest when tired, Avoid exercise when you are tired or in pain.
  • Always take your time during strength training and go through the full range of motion with each repetition.
  • If you do sustain a sports injury, make sure you participate in adequate rehabilitation before resuming strenuous activity.
Dislocations

Dislocations

What is a dislocation?

A dislocation happens when extreme force is put on a ligament, allowing the ends of two connected bones to separate. Ligaments are flexible bands of fibrous tissue that connect various bones and cartilage.

Ligaments also bind the bones in a joint together. Stress on joint ligaments can lead to dislocation of the joint. The hip and shoulder joints, for example, are called “ball and socket” joints. Extreme force on the ligaments in these joints can cause the head of the bone (ball) to partially or completely come out of the socket.

Illustration of types of joints
Click Image to Enlarge

The most commonly dislocated joint is the shoulder.

Dislocations are uncommon in younger children because their growth plates (area of bone growth located in the ends of long bones) are weaker than the muscles or tendons. Instead, children are more prone to a fracture than a dislocation.

What are the symptoms of a dislocation?

The following are the most common symptoms of a dislocation. However, each child may experience symptoms differently. Symptoms may include:

  • Pain in the injured area
  • Swelling in the injured area
  • Difficulty using or moving the injured area in a normal manner
  • Deformity of the dislocated area
  • Bruising or redness in the injured area
  • Numbness or weakness in the injured area

The symptoms of a dislocation may resemble other medical conditions. Always talk with your child’s healthcare provider for a diagnosis.

How is a dislocation diagnosed?

The healthcare provider makes the diagnosis with a physical exam. During the exam, the healthcare provider obtains a complete medical history of the child and asks how the injury happened.

Diagnostic procedures may help to evaluate the problem. Diagnostic procedures may include:

  • X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. An MRI is only likely to be done if your healthcare provider is considering surgery.

Treatment for dislocation

Specific treatment for a dislocation will be discussed with you by your child’s healthcare provider based on:

  • Your child’s age, overall health, and medical history
  • The extent of the injury
  • The type of injury
  • Your child’s tolerance for specific medicines, procedures, or therapies
  • Expectations for the course of the condition
  • Your opinion or preference

All dislocations need immediate medical attention since fractures can also happen with dislocations and neglected dislocations can lead to serious problems.

Initial treatment of a dislocation includes R.I.C.E. (rest, ice, compression, and elevation). Dislocations may reduce spontaneously, meaning the bone ends may go back into place by themselves. However, for those dislocations that do not go back into place, your child’s healthcare provider will need to place the joint back into its proper position so it will heal. Your child will receive sedation to help him or her remain comfortable before the procedure. Sedation will also help the muscles around the dislocated joint relax, so the joint can be put back into place more easily.

Your child’s healthcare provider may recommend any of the following to help reduce the dislocation or promote healing afterwards:

  • Splint or cast, which immobilizes the dislocated area to promote alignment and healing. It protects the injured area from motion or use
  • Medicine (for pain control)
  • Traction is the application of a force to stretch certain parts of the body in a specific direction. Traction consists or pulleys, strings, weights, and a metal frame attached over or on the bed. The purpose of traction is to stretch the muscles and tendons around the bone ends to help reduce the dislocation.
  • Surgery (especially for dislocations that happen again and again, or if a muscle, tendon, or ligament is badly torn)

Additional recommendations may include:

  • Activity restrictions (while the dislocation heals)
  • Crutches or wheelchair (to enable your child to move around during healing)
  • Physical therapy (to stretch and strengthen the injured muscles, ligaments, and tendons)

Long-term outlook after a dislocation

While dislocations are rare in younger children, they do happen more often among adolescents. It is important that the child stick to the activity restrictions and/or stretching and strengthening rehabilitation programs to prevent reinjury.

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