Cruciate ligaments :

Patellar manipulation - - Posted by murtaughdog (murtaughdog), 29 December 2004

I had a new PT today because the lovely girl who usually tortures me is on vacation.  The new PT was very concerned that my patella was to "stiff".  He said everything else was great, but kept stressing over my patella "stiffness".  How important is this, and how do I get my patella to catch up with the rest of my rehab?

Thanks, and I can't wait for my PT to get back!

Rgr
Posted by hmaxwell (Heather M.), 30 December 2004

Patellar mobility is crucial to healing well, especially if you had an ACL reconstruction with patellar tendon graft.  That's because the patellar tendon can get scarred up by the taking of the graft, and this can lead to ongoing issues with pain and stiffness.

Use the search feature to look up patellar mobilizations (aka patellar mobes).  Focus on the soft tissue healing problems section as well as the 'struggling with pain and rehab' section.  The goal is to keep your operated kneecap and patellar tendon as mobile and flexible as your good knee.  Tread the kneecap like a clock, and move from the static position out to each 'number' and back.  Also, be sure to massage, lengthen, mobilize, and do cross friction work on the patellar tendon.  Professional massage (myo-fascial release and/or ROLF massage) can be very helpful, but only if your PT and/or OS clears it--mine did not for over 8 weeks.

There are several posts, a couple of them recent, that give details on how to do patellar mobilizations.  Your PT should be able to show you how to do them...also, it is better if you can get someone to do the mobes for you.  That's because when you bend forward to grasp the edges of the kneecap, your hamstrings tighten and your quad kind of locks the kneecap down.  So it's best if you can sit with your legs stretched in front of you, relaxed, while someone else does the mobes.  Failing that, it's better to do them on yourself than not at all.

Heather

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