Patellar Instability with Spontaneous Patella Disclocations

Hi all,

I think I have a pretty good grasp of the BBM approach to pain and injuries, but my partner is suffering some issues with her patellar instability, and we’re struggling to find the right entry point given her current situation and history. I’ve reviewed what I can of the knee rehab template and I don’t think she is a great candidate for it.

The background is she suffered her first dislocation in middle school in a gymnastic accident. In the 20 years since she has dislocated it another 40 or so times according to her best estimate. This is normally the result of something trivial, typically just ADLs, with no obvious incident causing it. As you can imagine, there is quite a lot of anxiety tied into this now given the pain of each incident and how trivially it has occurred. They havent been able to give me a great history, but they did tell me there were scans performed after the original dislocation (not sure what though) and they were not told of any damage to any other part of the knee so we’re working on the assumption that is still true.

She hadnt experienced any issues for about 2 years and was in the most consistent exercise schedule she’d had since middle school. The situation now though is that about about a week ago, after no obvious incident, she started feeling some pain on the medial of the knee and by the end of the day was having trouble putting her weight on it or fully extending it. It is experiencing that textbook “catching” sensation whenever she moves it and she’s now paranoid its about to pop out at any moment.

We hoped a couple of days of careful rest would see whatever was going on would calm down, but a week later it hasn’t so we’re guessing we have to be a bit more proactive to improve this situation. So I guess the questions we have are 1) does this sound like it needs medical examination before we get her back into doing some form of exercise? 2) If not, how do we go about finding that entry point that accommodates the fact that even normal ambulation is painful, and she’s dealing with genuine anxiety, bordering on PTSD, over it popping out yet again.