Patellar Dislocation (Non-Operative)
Non-Operative Treatment of Patellar Dislocation
Rehabilitation Protocol
Phase 1 – Maximum Protection (Wks 0-6)
0-4 Weeks:
• Brace locked in full extension for 6 weeks
• Partial weight bearing for 2 weeks
• Ice and modalities to reduce pain and inflammation
• Range of motion – none
• Begin submaximal quadriceps setting
• Begin straight leg raising progression as tolerated
• Blood Flow Restriction Therapy to build/maintain muscle mass and activate quad
• Lower extremity stretching – hamstrings and calf
Weeks 2-4:
• Weight bearing as tolerated; progressing off of crutches
• Continue with inflammation control
• Soft tissue mobilization quad, ITB, calf, hamstrings, gluts
• Range of motion – none
• Implement open and closed chain multi-plane hip strengthening
• Core strengthening and lower extremity stretching program
Weeks 4-6:
• Full weight bearing
• Patellar stabilizer brace under brace
• Range of motion and brace setting:
• 0* to 30* week 4 (both passive and active)
• 60* week 5
• 90* week 6
• Full following week 6
Phase 2 – Progressive ROM and Early Strengthening (Wks 6-12)
Weeks 6-8
• Gradually progress to full range of motion
• Normalize gait
• Foam roller and soft tissue mobilization
• Begin bilateral closed chain progression with stability brace – strong emphasis on alignment
• Implement gradual step-up progression
• Hip stabilization program
• Begin stationary bike
• Initiate deep and shallow water pool program
Weeks 8-12:
• Wean out of stabilization brace as tolerated for strengthening
• Progress bilateral and unilateral closed chain program
• Add basic gym program (leg press and hamstring curls)
• Increase intensity on stationary bike
• Add treadmill walking program and elliptical as tolerated
Phase 3 – Progressive Strengthening (Wks 12-16)
• Advance closed kinetic chain and gym strengthening
• Begin impact and plyometric progressions
• Increase intensity on bike, treadmill, and elliptical trainer
Phase 4 –Advanced Strengthening & Return to Sport (Wks 16-20)
• Liner running progression progressing to multidirectional as tolerated
• Bilateral progressing to unilateral plyometric progression
• Sports test for full clearance Revised
• Flexion – continue with end range heel slides
• Bilateral squat progression – focus on proper alignment
• Multi-plane open and closed kinetic chain hip strengthening
• Step-up progression – focus on proper alignment
• Hamstring activation with bridge on floor, ball or box
• Progress to unilateral heel raise off the floor then off a step
• Proprioception drills
Cardiovascular Exercise
• Stationary biking
• Treadmill/outdoor walking with focus on proper gait mechanics
Recommended Loading
• ROM: 2-3x/day
• Strength: 1x/day open chain; 3x/week closed chain
• Cardiovascular: 20 minutes/day with low intensity
RETURN TO ACTIVITIES
Running: 4-5 months when functional criteria are met
Golf: Short irons at 4 months, full swing with long irons at 5 months.
Delay 4-6 weeks if lead leg.
Pivoting/cutting sport: When functional criteria are met and cleared by surgeon, typically
6+ months at earliest