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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  • 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.

  • Jack

    Hi doctor, today I dislocated my knee playing five a side football, it was caused by a sideways impact from someone else. Anyway when I got to A&E I straightened my leg whilst in a wheelchair and it moved back in the correct position. The doctor I saw was fairly useless to be frank, and just put me in a splint and told me to do physio. I was just wondering, how long will I have to use crutches/have a splint for? When should I start the physio and is this by myself or with a therapist? And finally I’m really scared about this happening again now I’ve found out it usually does – it was the most painful experience of my life… Is there any way I can stop it happening again? Thanks doc :)

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

      You should follow up with a family doctor or orthopedist. The times depend on the specific injury, if anything was torn, the stability of the kneecap. Generally, crutches are recommended for 1-2 weeks and splint for about 4. Physical therapy can also be a big help in strengthening back the injured muscles.

  • jemma

    i was sledding and it came out or something and now there is a bone sticking out should i be scared

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

      Hopefully, you’ve had it checked.

  • Lonna

    Hi Doctor, My knee cap has dislocated many times over the years. 3 years ago I had a patella realignment surgery and had high hopes for it’s success. I have only had a dislocation a handful of times since then, the last one 6 months ago and it was rather quick and felt fine the next day. 3 weeks ago I suffered the worst dislocation yet, it just wouldn’t go back on for over a minute then came right back off. My knee instantly swelled up worse than ever before and I couldn’t put any weight on it. After an afternoon in the ER and some x-rays I was sent home immobilized with the R.I.C.E treatment. 2 days later I was seen by my physician who brought in Ortho during my appointment. My knee cap is not in the proper position (it’s much higher than it should be), the MRI shows major strain to the MCL, tears to the meniscus and irreparable damage to my previous surgery. I bruised from above my knee to my ankle within the first week and the swelling has gone down but is not gone. I have noticed that I am still bruising. I have a new bruise today on the arch of my foot and another just in front of my ankle bone. I still have bruising down the entire front of my shin which is now turning black again where it was yellow/green just a few days ago. My leg is very weak, I have been wearing a brace while I wait to see the Sports Medicine Doctor. Should I be concerned about the new bruising?

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

      See the section on “What if Only the Bruise is Swollen,” at this link http://www.thesurvivaldoctor.com/2012/02/21/bruises-and-blood-clots/

      In general, any bruise is caused from bleeding in the tissue. Deep bruises may take a few days to become visible, and the blood from many leg bruises travels down with gravity. Blood from, say, an injury to a knee may end up in the foot. It doesn’t mean there is a new injury, just that the blood has migrated. But, if you think this is not the case, or the leg is swelling a lot more despite elevation, or the foot is getting numb or cold, you should see a doctor. It wouldn’t be a bad idea to call yours even if you don’t go in.

  • Sarah

    Hi, I suffered a patellar dislocation a little over a week ago and I have been trying to straighten fully and bend my knee. Could I be causing more damage by doing this? I am just tired of being useless. The ER dr said to stay on Crutches for at least 2-3 weeks. But if I feel fine, is this necessary? It is still sore and very tender, but I just want to go back to normal.

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

      You should follow up with your regular doctor, an orthopedist, or an urgent care clinic. Since every injury can be a little different, they’ll check you and see where to go from here. In general, you have to stay in an immobilizer (with your knee straight) for an average of about 3 weeks, gradually increasing activity, and, finally physical therapy to get the muscle strength back.

  • Giana

    Hi doctor. The first time I fully dislocated my knee cap was ten month ago, and then I did the same thing last week, The first time I did it was after slipping and falling on my back, and I had to push the patella back into place after straightening my leg. It was an awful two month of recovery, with a huge knee that stayed inflamed for about a month, and lots of physical therapy. This time, the same thing with the same knee happened, but the cap went back into place as soon as I straightened my leg without any extra force. Does this mean it wasn’t as severe? It became big quickly, and I couldn’t walk well or bend my knee in any way. This time I started electric stimulation quickly and often at my chiropractor’s office, and one week later it is so much better. It is mostly deflated, less bruised, and I’m walking near normal. I can even bend my knee to 90 degrees, but any more than that is impossible because of the pain. Last time I went to the hospital and had an MRI and discovered I tore a couple of ligaments. I was told to get another MRI, but since I already had this injury I don’t think I need to go spend money to do that when I probably tore the same ligaments as last time. Do you think this is necessary with my improvement over just a week with electric stimulation? I am starting physical therapy as well. I was also told that the only surgery I could get was to repair the ligament if it wasn’t going to be able to on it’s own, since my problem is that the area that holds my patella is flat, so it slides around easily. Is there something else that surgery could do for me?
    Thank you.

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

      It sounds like your best choice to keep this happening again and again is surgical repair–an appointment with an orthopedic surgery who deals with recurrent patella dislocations and get specific advice on your options.