What to Do If You Dislocate Your Kneecap «

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What to Do If You Dislocate Your Kneecap

The kneecap is under that brown tendon.

by James Hubbard, MD, MPH

A dislocated kneecap is another one of the multiple knee injuries you can get. And you won’t be going far until it’s fixed. It’s painful, most of the time there’s a lot of swelling, and your knee can’t straighten.

Obviously you have to get to a doctor as soon as you can to make sure nothing else is injured and to put it back in place. Often, the doctor will also drain some of the blood off that’s accumulated around it (which can ease the pain dramatically).

But if getting to a doctor is impossible, here are some things you can try.

Why You Shouldn’t Always Put It Back in Place

Treatment depends, to an extent, on what sort of injury we’re talking about. Beware of bad breaks.

Sometimes it just takes twisting wrong to dislocate the kneecap. Other times there’s an added bump to one side of the kneecap. (For instance, you hit the side of a table while you’re twisting, and the kneecap dislocates to the opposite side of where you hit it.)

When the dislocation comes from something like either one of those scenarios, you can pretty well assume you didn’t break anything. Maybe a there’s little crack in the kneecap or tibia (lower leg bone), but there’s no big break that’s going to dislocate too.

The more forceful the hit, the less you can assume there’s no broken bone. So if there’s been major trauma, just splint the knee in the position it feels best and get off of it (or use crutches). Then get to a doctor as soon as you can.

For those minor bumps and twists, it’s best to try to put the kneecap back in place right away (if you can’t get to a doctor) before more swelling sets in and makes it harder to do.

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How to Relocate a Dislocated Kneecap

Here’s how to put a dislocated kneecap back in place:

  1. If possible, ask someone to help. Your leg will need to flex and straighten, and it’s best to have someone do that for you. Straightening your leg on your own requires contracting the quadriceps muscle in your thigh. That tightens the tendon that connects to your kneecap. The tighter the tendon, the harder it is for the kneecap to move back into place.
  2. Flex your hip by sitting. If you’re lying down grab around your thigh and pull it toward you about 30 degrees or so. This relaxes your quadriceps muscle a bit, which loosens that tendon I mentioned in step 1. (If you don’t know what I’m talking about, read the “Anatomy” section of my post on Osgood-Schlatter disease.)
  3. Have someone slowly straighten the knee while the hip is bent. Or do it yourself if no one is available. Apply gentle pressure to the side of the kneecap to try to tease it back in place.
  4. Go slowly. You can try several times, but never force it since you could break something or make an already broken bone much worse.

After the kneecap is back in place:

  1. Wrap it with an elastic bandage or use a knee brace. This does little or nothing to keep the kneecap in place, but moderate compression can keep the swelling down.
  2. Stay off of your injured leg if you can and apply ice packs, if available, for 10 minutes at a time intermittently. Use a cane or crutches.
  3. Get to a doctor as soon as possible for further evaluation to see what is torn or broken.
  4. Expect it may happen again—maybe not right away, but somewhere down the road. If it dislocates over and over again, you’re going to need surgery to keep that from happening.

Has anyone ever had a kneecap dislocate? Painful? Scary? How did you get it back in place? How’s it doing now?

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  • Alicia Jansen

    ok this is weird as i have dislocated my knee heaps, but three times that it wouldnt just go back in the last time it happened it was so painful the ambos and hospital knocked me out almost completely then when they tried to put it in i still screamed in pain, but once it was in felt nothing nothing at all it didnt swell there where no breaks chips nothing i was sore the next day but could put prussure and bend the knee straight away????? Thats not normal is it?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Have you seen an orthopedist for a good check up of why this is happening and what can be done to prevent. it?

      • Alicia Jansen

        I have it because the outside mussel is much much stronger than the inside they said that even if they were to surgically fix it it could cause other problems so just strengthing. But no one can tell me why there has been no swelling, pain but nothing like the other times and I can bend it??

  • Brittany

    I had this happen. A good physical therapist can evaluate the leg structure and strengthen the surrounding muscles so that it won’t happen again. It’s apparently pretty common to have an imbalance in the leg muscles. If you catch it early enough, then you can avoid surgery.

  • Megan Baumann

    3 weeks ago I was getting into my car which was parked on a hill as I got in I slipped in mud into my car and my leg went one way and my knee went the other and it popped right out of place which hurt really bad. I popped it right back in but I couldn’t walk on it at all for about 3 days then I put a knee brace on it and I can walk on it but now lately it pops out daily multiple times and makes me fall with the knee brace on and it hurts worse. I cannot put much weight on it nor can I straighten my leg out. I have not seen a doctor either because I thought I’d be fine after a week or so, I thought wrong. Should I go and will I need surgery since it pops out daily?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Yes, you should go to the doctor who will check you and customize your treatment. It could be a splint, crutches, physical therapy, or something else. With time, if you don’t get better, it could include an option of surgery.

  • Megan

    3 weeks ago I was getting into my car which was parked on a hill as I got in I slipped in mud into my car and my leg went one way and my knee went the other and it popped right out of place which hurt really bad. I popped it right back in but I couldn’t walk on it at all for about 3 days then I put a knee brace on it and I can walk on it but now lately it pops out daily multiple times and makes me fall with the knee brace on and it hurts worse. I cannot put much weight on it nor can I straighten my leg out. I have not seen a doctor either because I thought I’d be fine after a week or so, I thought wrong. Should I go and will I need surgery since it pops out daily?

  • Jane

    Hi Doctor. My 15 yo old daughter dislocated her patella 3 days ago playing netball. At the time of dislocation she suffered severe pain through her back and neck. Is back and neck pain common with this type of injury? Paramedics were not too concerned. No x-ray was undertaken. Should I seek an x-ray to rule out any other issues?
    Thank you for your help

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Jane, she should see a doctor for a good exam and possible Xray, and to suggest how long to keep on the brace, how much activity should be done and when, and exercises (maybe physical therapy) to build the muscles back up and, hopefully, keep her from doing it again. Neck and back pain are not usually part of a dislocated patella unless the same injury that caused the dislocation injured those areas also. So, if those areas are still bothering her, they should be checked as well.

  • Kaitlyn

    Hi Doctor,
    I am almost positive I dislocated my knee cap this morning and it popped back into place right away, but I’m scared to go to the hospital. Is it true they will try and drain blood from the knee? I’ve been icing for 15 minutes on/off since this morning and still can’t move it, should I be going to the hospital?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      The type of treatment would depend on their exam. I’m sure some knees that are swollen from blood may need to be drained but I’ve never had to drain one. An option from the hospital is an urgent care clinic.

  • diamond

    I think they went back in place on their own. This was over 10 years ago but now i cant jump or run without my knees feeling like they will dislocate . I happened on more than one occasion in a squatting position. What can i do

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Have an orthopedist check you out. If he/she agrees, go through some PT to learn proper exercises. If that doesn’t work, the ortho might recommended surgery.

  • Shahana Khan

    Hi Doctor!
    When I was about 6,my knew cap used to just come out at any time,even when I used to walk simply.Then after whn I was 12my knew cap once popped out when I was in my room.I was screaming and suffering when my mom just placed it back.It swelled a lot and I could walk.I wen tto the doctor and had an X-Ray and he said that wth the side of my cap there are two bones in which 1 is small so this is why it keeps coming out.he told me some exercises but I am still scared.He told me and operation but I was too scared to do it.Sometimes I feel pain and it feels like it could come out any time.Any tip you could give me?

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Make sure you do the exercises properly and as often as recommended. If you’re not sure, possibly ask for some physical therapy teaching visits. It’s your best change to have it not recur. But, if it does anyway, you may require surgery.

  • Thomas

    Hey Doctor,
    I have awkwardly fell on my foot last Friday and have dislocated my patella. I remained on the ground until medical help has arrived. It fell back on its own surprisingly after about an hour. It was on the way to the hospital. My xrays were negative and I am awaiting an MRI. I have been immobilized since Friday, icing it on and off and have experienced no pain at all pretty much unless I would apply major pressure on my leg or bend it extensively (I am not attempting). I can slide my heel to about 45 degree angle without pain. The knee is swollen a little bit (enfusion), but not discolored. I have played sports for about 15-20 years on collegiate and professional level and have never had any knee injuries. I am also pretty fit and been working out 3-4 times a week. Really random accident, but it happens. Do you see a hope of no ligament tear? I know it is hard to tell, but I thought I would ask. Please advise.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Thomas, sure, there may be no tear. But the doc who examined you would give you a better idea on the odds.

  • Leo Ramirez

    Hi Doctor.
    First of all, let me just say Im very thankful to come across this website and yourself mostly. I gotta tell you everything since the beginning so that you can get a better understanding of my question and why I’m so concerned.

    I just came from the general hospital traumatologist but he was very rude, impatient, wouldn’t trust my questions and pretty much took off my splint and sent me on my way…free healthcare is an abomination. Well I luxated my left patella to the right (my left) one night I jumped a 1ft. high border crossing the street (jaywalking) and my weight couldn’t take it I suppose. I tried to walk it off right afterwards but, just as the moment when I fell, it pretty much felt like the femur bone jumped out of place to the left (my right) of the tibia bone…that’s how painful it was! They got me to the ER but because it was a pay clinic close by, all they did was put a splint on and sent me off. And then it happened yet AGAIN that same night after a bad choice of position even though I had the splint on and I wasn’t really supporting myself on my ankle. Well nobody told me the possibilities of luxation and the dangers of not relocating it so I didn’t even know what was goin on and I just rested.

    So for more than two very long weeks I didn’t know anything until I was fed up with not being able to walk. So about a week ago I had an x-ray done and an ER doctor finally relocated it…or so I’m hoping. Cuz when he did, it didn’t hurt as much as he said he would, and quite frankly I didn’t feel much movement. Just him pushing and pushing it back and I felt SOME pain. But shouldn’t it have been MORE difficult and painful? After two weeks, don’t bones usually tend to glue back together even if they’re crooked? Well I kept insisting he make sure it was ok and many nurses told me so as they put a new heavier splint on sooooo I guess I can’t be too annoying and I just had to trust. Anyway, he told me to stop using crutches and get a walker, then gave me a one week apointment for the traumatologist. Well he said the traumatologist might even put a cast on. Regardless, I kept pushing the kneecap in a little bit throughout the week cuz I was afraid some of my movements might mess it up again (I swear, going to the restroom is the hardest thing to do right now). Sleeping has been AWFUL. Even WITH the splint on, if I rest the leg on any side, it feels heavier from the knee below and it causes a slight throbbing pain on my right side of my knee (your left). Well a week later, here I am. I did EVERYTHING as the ER doc said: I got a walker, only used crutches for stair hopping, no ankle support whatsoever, and I hardly took off the splint (only to tighten up). Well the trauma doc told me to just FORGET what the ER doc told me. He checked me out, felt my knee, assured me the patella was still in place, and told me I have to start excercising it, even though the swelling is still very notorious. I also got some pills, but I highly doubt that will help.

    Well here’s where I start to get paranoid. He said I’m ok now cuz I can bend it and straighten it even though not completely. But when I told him that even BEFORE I got it relocated I could also bend it and straighten it a little bit as well, he got all defensive like I was lying or something, BUT IT’S TRUE. And several people have told me it might also be broken ligaments and that if that’s the case I’m pretty much screwed for life…is that true? Well when I asked the doc about that, he said it would heal as long as I excercise it to relieve the swelling, even if it might swell up even more in the process. He took away my splint, told me to stop using the walker and from now on only crutches (even though I’m fat and I live on a SECOND FLOOR for God’s sake) and told me to start supporting my weight little by little on my ankle. At first I was fearful but as soon as I got out of his office, I did so and yes, it hurts less and I’m supporting it on my ankle just enough to walk without having to lift myself up with my arms as much…is that a good sign?

    Well that’s pretty much the story…but here’s my million dollar concern: IT STILL REALLY REALLY HURTS when I bend it or straighten it to a certain point. I honestly think something else is goin on down there, it’s just that the doc told me not to start make-believing something that could eventually confuse me or mind-suggest me into something worse…is that even possible? Like hypochondria?! And by the way, shouldn’t I still need a splint, at least for when I’m sitting down or something? Could walking with it be dangerous or what…I don’t get it? Or is that evidently not necessary anymore? I mean, is ONE WEEK truly enough for the patella to glue back after it got relocated and I can start relying on it again so soon??? Let me tell you how my knee feels like when I try bending it further then it lets me: like a squeaky door when you don’t oil it up, but even OLDER…a door that just won’t budge further unless you oil it up. THAT’S what it feels like. Like my knee joint is rusty and bending it more hurts all around, especially that one throbbing point I told you earlier on the right side of my left knee (your left).

    So I don’t know…should I just trust the specialist, even though he was kind of a jerk about it? Should I just keep bending it back and forth little by little even if it huuuuurts like hell? I mean I don’t even trust myself to make ANY kinds of excerises…what kind would you suggest? If I slowly support on my left foot more and more every day, how long do you think it will be before I can FULLY depend on it again? I’m just soooo scared and the doc was very unwilling….maybe he was just too cocky cuz he knows he’s right, perhaps? Ugh I don’t know. Most important question, does the pain that I described to you, the rust-like pain, sound like something normal to you in my situation? Will the ligaments heal if they are broken? What kind of pain would I have if evidently I DO have broken ligaments? IS THIS PAIN NORMAL? What else would you suggest me to do? What other kind of doctor might have to be involved if it isn’t just a kneecap issue? I need answers please doc. If I sound paranoid, that’s because I AM. I’m sorry to be so annoying but I really need to work and I fear if I push trying to get better I might end up worse or possibly crooked for the rest of my life and I don’t have money for surgeries. Help. Yours, truly and now fan, Leo.

    • http://thesurvivaldoctor.com/ James Hubbard, MD, MPH

      Leo, just because a physician comes across as a jerk doesn’t mean he’s not giving you good advice. Perhaps you should follow up with a good family doctor or an orthopedist in a clinic. Or, at least, ask the one you’ve seen if going to a physical therapist would be helpful. They could make sure you do the exercises properly.