Chronic Subluxated Patella

Medical Q&A [Moderated]
1

Alright guys, another question/issue. 2-3 years ago, when I weighed 280+ and before any sort of strength training, I was working on something and kneeled down on my right knee for a period of time. When I pushed up with my left leg to get up, my left knee popped and felt like it bent outwards and down I went. Possibly the most pain I’ve ever been in. I laid on the floor for several minutes like that episode of Family Guy where Peter hurts his knee. After many minutes I got up and was able to hobble over to and sit on the couch for a while. Afterwards, I could walk on it, it was a little sore/stiff but nothing bad. I figured I pushed up wrong or something, especially since I was really fat, and I brushed it off as something I only experienced once. Fast forward to now and it’s happened 3-4 more times, all while trying to stand up from a crouching/kneeling position. Every time is super painful when it happens, depending on how badly it happens, and it’s stiff and sore a little bit for a couple of days. I can actually see the knee cap move off to the side and then snap back into place. This is still occurring after losing 40 lbs, going through LP and continuing to strength train. It’s never given me issue in the gym. I’m now pursuing getting an MRI and talking to a specialist to see how to fix this. To my #uneducatedself, it seems that crouching/kneeling stretches the tendons and muscles in the area and this is allowing my patella to subluxate when I try to push to get up. With all that in mind, I have a couple of questions:

  1. Barring any MRI anomalies such as something being torn or a deformity, is more strengthening able to fix this? Knees sound like complicated joints, but I’m seeing things like “unstable knees”, which just sounds like blowing out your knee or putting a disc out of place.

  2. I feel that it’s common to recommend “strengthening the knees”. Are there actually some specific exercises outside of squats and deadlifts that would just focus on knee strength? Wouldn’t improving my lifts just do that anyway?

Thank you! It’s hard to find a Doctor that you know is good and that also subscribes to the same pain and treatment theories that you guys do.

2

Have you ever had to manually re-locate your patella?

Have you ever had significant knee swelling after one of these episodes?

3

No I haven’t to either of those.

4

Interesting.

It’d be a bit unusual to have recurrent subluxations or dislocations in the absence of any structural abnormalities (or risk factors, like a shallow trochlea). I do think the orthopedic evaluation is in order here before moving forward. If the evaluation shows nothing, then I’d carry on with training, as strengthening the supporting musculature is probably our best bet at reducing the recurrence rate of this issue for you.

5

Hmm…ok, that is interesting. I really appreciate the follow up and will update as I go further. Specialist is about a month away for one that is well reviewed so it’ll be a little bit before I know. Thank you!