# More Knee Stuff...(Dislocated Patella)



## kneecapper (Dec 9, 2010)

First off, hello everyone - new to this forum and returning to the sport after 5 or 6 years off. 

So while deciding last fall to return to cycling in 2011 after several years off spent running and rock climbing and well, not cycling, I ended up dislocating my patella the day after Thanksgiving. 
It relocated itself on the way to the hospital, and the MRI showed small fracture of the patella itself, and a slight tear to the Medial Patellar Reticulum, as well as a whole boat load of fluid and swelling. The good news is that there is little pain, I'm in a brace, and progressing well through 8 weeks of PT (on week 2). 
Basically, I am looking to see if anyone else has had this injury, what their recovery was like, and if I am totally out of my mind to think that I could still do a racing clinic in April and perhaps race in May. (I am in good shape, just not cycling shape, but thankfully that fitness likely prevented the injury from being worse).
Thanks all!


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## Daren (Jul 25, 2008)

I dislocated mine in August of '06 and spent 18 months riding my couch. Mostly that was due to lazy setting in. I didn't do PT, but when I finally got back to cycling and decided to race, weight training really helped. Also, if there is pain on the bike, go get fitted, or re-fitted, lowering my saddle 0.5mm helped a lot too.


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## Kerry Irons (Feb 25, 2002)

*Loss of leg strength*



kneecapper said:


> First off, hello everyone - new to this forum and returning to the sport after 5 or 6 years off.
> 
> So while deciding last fall to return to cycling in 2011 after several years off spent running and rock climbing and well, not cycling, I ended up dislocating my patella the day after Thanksgiving.
> It relocated itself on the way to the hospital, and the MRI showed small fracture of the patella itself, and a slight tear to the Medial Patellar Reticulum, as well as a whole boat load of fluid and swelling. The good news is that there is little pain, I'm in a brace, and progressing well through 8 weeks of PT (on week 2).
> Basically, I am looking to see if anyone else has had this injury, what their recovery was like, and if I am totally out of my mind to think that I could still do a racing clinic in April and perhaps race in May. (I am in good shape, just not cycling shape, but thankfully that fitness likely prevented the injury from being worse).


The odds are that you will have lost significant leg strength if you were locked into that brace. Otherwise, pain is your limiter and you likely should be OK for an April racing clinic unless you have a lot of pain that prevents you from staying/getting in shape. Was your dislocation due to trauma, or do you have an unstable knee/patella? If the latter, then make sure your PT includes exercises to stabilize the knee.


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## PigmyRacer (Oct 3, 2007)

I agree with the previous post. You should be able to race by April. "Should" meaning that most people with your injury would and "race" meaning that you will probably be able to complete the course but you might not be in real fighting shape. Kerry Irons makes a good point about muscle strength and soft tissue stability. Not much you can do about the leg strength so long as you're in the brace but a good physical therapist will have you doing stability exercises, if not now, within the next few weeks. You might consider getting some weightless exercise maaterials like therabands, a medicine ball, etc... so that you can do your exercises properly at home.


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## kneecapper (Dec 9, 2010)

Thanks guys. I was lucky to a degree in that I was only in the full brace for a week and managed to get myself taken to Mass General in Boston at the time of the injury, which somehow got me into their sports med clinic and access to some world class PT guys as well. Its week three and I have had a few PT sessions already. I'm walking normally in a hinged brace, and doing flexibility, stretching and even some light VMO strength work. This is at home with three sessions a week at the therapy Gym. They know my goals, and we have a plan now, so I'm feeling pretty good about things. Light (and I mean VERY light) spinning will kick in this weekend, as most of the swelling is gone - now its about rebuilding that stability and strength - the feed one another. And yeah, when I said racing, I was not thinking "competing" but rather finishing and staying with the pack as long as possible. Patience is going to be important. The feedback is awesome though and much appreciated. Nice forum here as well. I will keep you posted. Thanks again!


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## kneecapper (Dec 9, 2010)

*Follow up for Kerry*

The injury itself was a slow dislocation with no trauma as the cause - I was climbing in a gym, about 30 feet up on a 5.9 and high stepped with my right foot. As I was weighting the foot, and moving for my right hand hold, my foot slipped a bit on the chalky hold and due to the angle of attack, my core weight was directly over the outside of my already straining right knee - it was as if I was in a dislocation machine - clean, no impact, and no prior instability. Just really bad luck leading to a very bad position on the wall on what was a semi-high risk move anyway. FYI - I don't recommend this injury - its the most pain I have ever felt.


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## JCavilia (Sep 12, 2005)

From your description, it sounds to me like your patella may have been unstable before the injury, even if you didn't know it. Stresses even at odd angles, without impact to the kneecap, shouldn't normally cause dislocation. But even if there was no prior instability, there likely will be after, from the damage to the connective tissue. You'll have to deal with that.

I speak from a bit of experience because I dislocated my left patella just stepping over something in the house (this was about 45 years ago, at age 15 or so). The kneecap just slipped to the outside. Putting it back (with family members getting instructions over the phone from the doctor) hurt like hell. The subsequent swelling was massive, and one draining session extracted an impressive volume of thick bloody gunk.

My knee was immobilized for about 6 weeks, and the muscles atrophied a lot. It took a long time to regain the strength. Sounds like you're getting more modern advice and help, with the PT starting so soon.

My knee was unstable for years after, and I had to learn to deal with it. Full dislocation hapened only a couple more times, and I learned to put it back together on my own. None of the subsequent dislocations were anywhere near as painful as the first one -- in fact, they seemed to do almost no damage. I guess things were pretty loose.

Eventually I could sense when it was starting to go, and instinctively take the weight off it (even if that meant collapsing) and thus avoid full dislocation. Strengthening of the muscles (mainly through cycling) has reduced the instability to almost insignificant levels. With some kinds of impact or pressure I can still feel it start to move out of the track, but I quickly correct, and I haven't had any significant problem in years.

I think you'll do nicely, as long as you pace it and don't aggravate the injury. Remember that you injured connective tissue, which heals much more slowly than muscle. Build up muscle strength without traumatizing anything, and back off when anything feels weird. Racing (carefully) in May seems like a reasonable goal.


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## JSutty (Jun 24, 2011)

*Hi*

Hey kneecapper,
Apologies if this post wasn't quick enough, or if it's useless, but I thought I'd share, as people were kind enough to help me as I went through a similar experience..

You're right, patellar dislocation is bloody painful! Mine sounds pretty similar to yours - no trauma, nothing torn, just lots of swelling and a whole world of pain. I did mine running (actually, I was just finishing running and slowing down). Surgeon popped it back in after about 1 hour (thanks for making me wait!), and then I was in a brace for a week, followed by a cast for about 6 weeks, by which time I pretty much had no thigh muscle left. Then physio after another week's wait. 

At the time I was most concerned that I wouldn't be able to run again, after a few weeks' physio I did some light spinning and numerous people recommended cycling as a step to getting muscle, mobility and fitness back. Although I have gone back to running too, this really got me into cycling and I haven't looked back. 

So in answer to your question, within about 6 months I was cycling for 2-3 hours, up hills, at a good pace. This level of cycling was something I hadn't even contemplated before, and if my life permits I plan to do the etape/marmotte one day.

If you've gone through most of your life without dislocating, and it really was a freak accident then you should be ok to return to what you did before. I'm still pretty tentative when it comes to tennis/football etc... but i'd say cycling should be top of the list when it comes to safe things to do. Just make sure your bike is set up perfectly.
Also, if I have tempted fate here, I apologise, but if it's any consolation I've heard that the second dislocation is far less painful!

Hope this helps!


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