A 17 year old student developed frequent right knee medial patella or kneecap dislocation. This is very painful.
The initial incident was in May 2018 and it reccured 5 times in the following 3 weeks.
She consulted Jennifer Casemore, chiropractor, here at SalisburyChiroPhysio in November 2018 presenting with oedema or swelling and tenderness under her right patella. After full examination, Jenny referred on to Andy Cook our sports therapist and personal trainer, to focus on exercises to improve the strength and condition of the knee in preparation for surgery. This was scheduled for February 2019, having already seen a consultant orthopaedic surgeon and having had an MRI scan in the months following the initial dislocation.
Her right knee was very painful on the initial visit to Andy Cook on 28/11/19 as she had suffered another dislocation that day.
Action A: progressive exercise programme was started a week after the initial visit. This aimed to improve the strength, condition and proprioception (joint position sensation) of the soft tissues (muscles and ligaments) acting over the knee which initially were poor.
Action B: Kinesiology or elastic K Tape was also used to help stabilise the patella and support the lateral structures. The exercises were carried out at home on a daily basis along with regular rehab sessions at the clinic.
As the weeks went by and symptoms improved the exercises progressed accordingly. Dislocations became far less frequent and surgery was postponed in order to see if conservative treatment would be successful.
After an 8 week period this year, without any incident of dislocation, it appeared that conservative management was working well. Unfortunately an apparent random dislocation, whilst asleep recently, has potentially altered the current thinking and a surgical intervention may still be required. Despite this she has done extremely well to improve the overall condition of her knee and will no doubt benefit from the hard work she has put in.