The Role of Physiotherapy in Managing Acute Patella Dislocation

A patella dislocation (dislocated kneecap) is a common injury of the knee and is typically a result of trauma. This injury requires urgent follow-up to ensure the individual is given the best chance to return to sport and normal function, and physiotherapy plays a crucial role in the recovery process.

This injury tends to affect young active individuals with adolescent females and athletes at a higher risk, however it can occur in anyone involved in activities that put stress on the knee joint.

What Causes Patella Dislocation?

Patella dislocations are most commonly caused by:

1. Trauma or injury: A sudden blow to the knee, a fall, or a twisting motion can force the kneecap out of place.
2. Weak or imbalanced muscles: Weakness in the quadriceps, hamstrings, or hip muscles can make the knee more prone to dislocation.
3. Anatomical factors: Some individuals have an inherent anatomical predisposition that makes their patella more likely to dislocate, such as shallow femoral grooves or loose ligaments.

What symptoms you may experience?

1. Audible pop
2. Intense knee pain
3. Clicking and/or catching
4. Joint effusion (swelling)
5. Bruising

The Role of Physiotherapy in Recovery

After the initial treatment of a patella dislocation, including prompt reduction of the dislocation, ice, analgesia and NSAIDs to reduce pain and swelling, physiotherapy is typically recommended to help the knee heal and prevent future dislocations. At Hiya Health, our physiotherapist will work with the individual to restore range of motion, strengthen muscles, and improve joint stability to facilitate return to function and goals.

Early Stage Rehabilitation

In the early stages of recovery, the focus is on reducing pain and swelling, as well as restoring mobility.

• Restoration of range of motion: Gentle exercises to gradually increase the knee’s flexibility without stressing the joint are essential.
• Pain management: Techniques such as cold therapy (ice packs) or heat therapy, along with manual therapy (gentle massage), may be used to reduce swelling and relieve pain.
• Isometric exercises: These exercises, where muscles contract without joint movement, help to engage the quadriceps (the large muscle at the front of the thigh) and prevent muscle atrophy while the knee heals.

Strengthening Phase

Once the pain and swelling have been controlled, physiotherapy focuses on strengthening the muscles around the knee to stabilize the patella and prevent further dislocations.

• Quadriceps strengthening: Strengthening the quadriceps is crucial as it helps control the movement of the patella. Exercises such as banded knee extension and wall sits are commonly recommended.
• Hamstring and calf muscle strengthening: The hamstrings and calves also play a role in stabilizing the knee. Strengthening these muscles helps support the knee joint and ensures balanced muscle development.
• Hip strengthening: The hip muscles, particularly the gluteus medius, play an important role in knee stability. Exercises such as clams and hip abduction help reinforce these muscles and contribute to overall knee control.

Proprioception and Balance Training

Proprioception refers to the body’s ability to sense its position in space. After a patella dislocation, patients often experience a loss of proprioception, which can lead to instability or future injury. Physiotherapists incorporate balance training exercises, such as standing on one leg, to improve proprioception and restore the body’s awareness of knee position.

The Importance of Physiotherapy in Patella Dislocation Recovery

Physiotherapy is a cornerstone of rehabilitation after a patella dislocation. Through a combination of strengthening exercises, flexibility training, proprioception drills, and muscle balance exercises, physiotherapists help individuals recover fully and return to their daily activities. By addressing the underlying causes of dislocation, physiotherapy also plays a crucial role in preventing future knee injuries.

If you’re recovering from a patella dislocation, it’s essential to follow a structured physiotherapy program. At Hiya Health, you will be able to consult and collaborate with one of our physiotherapists to create a personalised treatment plan to follow. Proper rehabilitation will help you regain strength, stability, and confidence in your knee, ensuring a smooth recovery and reduced risk of re-injury.

Author: Anna Wu, Physiotherapist – Paddington

Anna Wu

Physiotherapist

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References

Flores, G.W., de Oliveira, D.F., Ramos, A.P.S. et al. Conservative management following patellar dislocation: a level I systematic review. J Orthop Surg Res 18, 393 (2023). https://doi.org/10.1186/s13018-023-03867-6

Hayat Z, El Bitar Y, Case JL. Patella Dislocation. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538288/

Samelis, P. V., Koulouvaris, P., Savvidou, O., Mavrogenis, A., Samelis, V. P., & Papagelopoulos, P. J. (2023). Patellar Dislocation: Workup and Decision-Making. Cureus, 15(10), e46743. https://doi.org/10.7759/cureus.46743