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Patellar (Knee Cap) Dislocation: What You Need To Know. Surgery??

hi I'm Bob Shrum physical therapist red

iron if you are too handsome together we

have the most famous physical therapist

on the internet at our opinion of course

hey Brad today we're going to talk about

if you dislocate your kneecap or your

patella

you know what you need to know and are

you going to need surgery

sure so quite often what happens the way

a person dislocates their kneecap here

by the way I have a kneecap of a

Bonaparte or bonehead what you ever you

call them right now and the kneecap

actually many of you don't know this but

when your D is bending and straightening

the kneecap is actually moving up up and

down in this groove here can you see

that Lonnie the femoral groove yeah so

that's moving up and down in there now

what happens is if you have your knees

slightly bent and a lot of times turn in

like this yeah what we call valgus that

puts your knee at a more risk for for

dislocating the kneecap and the kneecap

almost always dislocates to the outside

this way yeah very weird the only way it

goes in is actually if you've got some

defect or if someone maybe hit it with a

helmet in football or something sugar or

medical that way so it's going to

dislocate this way and what happens when

it does that it actually can tear some

structures here so Brad is going to

actually show that because this is this

is one of the indicators if they if your

VMO the muscle here your vastus medial

BBD also bleakest that's part of your

quadricep kind of that teardrop right

here if that gets torn really bad as a

defective it they probably are going to

do surgery or this is a mouthful here

too medial patellofemoral ligament this

is the link that helps hold the kneecap

in place so it goes from here over onto

the femoral bone here helps hold it in

place if that's got a big defect in it a

big you know gap in it they're probably

going to do surgery right the other

indication for doing surgery right away

is if a little piece of bone fragment

gets broken off and it's sitting

underneath the surface I mean you're

just not going to be able to survive

with you know you

grinding it you saw can't have a floater

in there nope you can't have a floater

other reasons

if the kneecap is is you know subluxed

ER or out of place and they can't get it

back in place or it's really prone to

doing that you're going to probably do

surgery if it's I know we're talking

about people this has happened to the

first time if it's happened more than

once you're more than likely going to

need surgery sure and the last reason

why you might have surgery is if you

really are involved in sports with high

athletic demands so if you're a you know

high end football player and you're

going to do your running back right

professionals yeah you know if you're in

high school you just may not do this

burden you know right exactly so all

right um basically for the vast majority

of people though conservative treatment

is going to be the first issue of choice

right so they're going to try some

physical therapy they're going to keep

you immobilized for probably two or

three weeks and during that time when

there's a leg brace me Brandi brace they

kind of brace that has made just for

this problem and then they'll start

doing some strengthening where the

through trying to strengthen the VMO

especially quadricep most and we're

gonna do a video on that we're going to

show you three exercises you can do to

strengthen the VMO now what are the

things that might put you at risk for

dislocating your knee I thought we just

go over a few of those one the shape of

the groove here which you can't control

that that's genetics yeah

- if you are especially at women you

have a hot what we call a high angle cue

angle that it's just a natural angle

here between your knee they might call

that knock-kneed yeah exactly the knees

come together before your this angle

right here women it's a normal angle of

17 degrees if you're a lot above that

you're going to be an

it just makes it a lot easier for the

muscles to pull the patella right out of

the Greg and we don't that's just the

way it is women are having a higher Q

angle than men yeah

they know that if you're flat-footed it

just changes the whole biomechanics of

the D and it can make you more at risk

if you are flat-footed that is something

you may want to get some type of

orthotics so that you're not flat-footed

to help hold it the arch up so that

you're less likely to have problems

that's another video yeah if your

patella or your kneecap tends to run a

little bit high and we can tell by

looking at it I tell by looking at

someone whether or not their kneecaps

high it doesn't stay in the groove as

much and it's more likely to dislocate

and what's the name of it but tell the

alte but they'll all dummy my Alta

mental but all ties all Tamizh all right

so if you again you're going to have

like I said we're going to do a video

now on on the three exercises for the

VMO and these are the exercises you do

after you've been immobilized for two or

three weeks before that all you're going

to be doing is what we call quad sets

where you're tightening the muscle or

you might be doing a few straight leg

braces right so you got that brace on it

needs time to start the scar tissue in

the right area needs to immobilize and

heal so all right watch I'll link up to

the second video to here so and then

subscribe because we got more videos

like this and some of them are really

good and some of them are boring but we

try our best or keep on guns and I

remember we can fix just about anything

Brad except for a broken heart

but we're working on it Thanks