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Author Topic: Patellular subluxations  (Read 1788 times)

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Offline dancer44644

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Patellular subluxations
« on: December 01, 2006, 11:16:10 PM »
heillo, i just found this site and thought it might help me. my daughter is a dancer and has been dancing for five to six years, she is now 15. Starting about 6 months ago, she starting feeling pain in her left knee, and then her right knee. We went to a chiropractor and he said it was tendonitis and adjusted her knee once a week. After each adjustment, she told me her knee felt worse. Recently, we decided to switch over the an orthepedic surgeon, he has now diagnosed her with patellular subluxations, and made her quit dance. She is also wearing two knee braces during school, and is starting physical therapy 3 times a week to strengthen her VMO.
I would like to know what a little bit more about this since I know nothing about it. Will the physical therapy work for sure? The orthepedic surgeon also mentioned surgery... which scared my daughter. Is this surgery ok to do while she is still growing? I am worried about this becoming a longterm injury that will cary into her adult years, and I want it to be fixed now. Any suggestions, comments, and past experiences would be well appreciated! Thank you
Concerned Parent

Offline pjbaker

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Re: Patellular subluxations
« Reply #1 on: December 02, 2006, 01:52:27 AM »
Hey I was in your daughter's situation not too long ago. I had danced for about 10 years and started having problems when I was 14. It just began with knee pain, but then it soon started to sublux and eventually dislocate. I tried PT and did it for months with the know help. I also tried bracing and taping, but it didn't help. PT isn't a guarantee, but it does help some people so I would try it first and it well help to strengthen her VMO. Also try the bracing and taping first before you start considering surgery because this does help other people. I am now 18 and have since had 4 surgeries on my knees (3 on Left, 1 on Right). I had a LR on each of my knees which didn't help and I later found out that a LR is more for a tilted kneecap than for subluxations. The last surgery I had was a Fulkerson Osteotomy (TTT). I am now about 6 weeks out and can honestly say there is a huge difference. I do not have the pain I had before the surgery from the subluxations and dislocations. The recovery from this type of surgery isn't easy, but I can already tell such a huge difference. I can now see where my knee was supposed to track and it is a great feeling. My OS has even said that I will be able to return to dance after I am completely healed. I don't know if this helped, but I hope it did.

PJ
Chronic Dislocations since 14.
August 2004 - Right LR
November 2004 - Left LR
October 27, 2005 - Left VMO Advancement
October 20, 2006 - Left Fulkerson TTT SUCCESS!!!!
May 11, 2007 - Right Fulkerson TTT

Offline dancer44644

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Re: Patellular subluxations
« Reply #2 on: December 02, 2006, 02:23:21 AM »
Thank you so much for your advice. I hope you can soon return to dance because i know how much joy it can bring to people, like my daughter. We will definently try physical therapy first, and strengthen her VMO. Just one more question... her knee has popped out, or rather dislocated twice within the last two weeks. She describes a loud popping noise, that is very painful and then it will slide back in and swell up. Is this frequency normal? I would like to get an opinion from another person, not a doctor, because sometimes their answers and kind of unclear, in my experience.

brianne

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Re: Patellular subluxations
« Reply #3 on: December 02, 2006, 02:37:46 AM »
I have had dislocation such as the ones your daughter is having as frequently as every day.  I am 5 weeks out from a TTT on my right knee.  It has helped me greatly as well.  Hopefully PT will help your daughter.  It helped me for quite a long time.  I had a few nasty dislocations that remained out of place when I was 12-14.  After PT I was able to return to dance, swim team, track, and cross country.  It wasn't until about 4 years ago that my knees started acting up again.  Definately push the VMO strengthening.  If the PT can solve the VMO weakness then that should help things a lot.

Offline pjbaker

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Re: Patellular subluxations
« Reply #4 on: December 02, 2006, 03:17:24 AM »
Hey I had situations where it pop out at the frequency or worse, but then there were times when it wouldn't. For me the decision to have my last surgery was fairly easy because I was in constant pain and I was starting to have many subluxations daily and started having more dislocations. I wasn't able to do much with my family and friends. I couldn't go to the movies or even enjoy going out to dinner with my boyfriend. I really hope that PT can strengthen your daughter's VMO because like Brianne said it will help a lot. Good Luck. If you have anymore questions I can try to help answer them.

PJ
Chronic Dislocations since 14.
August 2004 - Right LR
November 2004 - Left LR
October 27, 2005 - Left VMO Advancement
October 20, 2006 - Left Fulkerson TTT SUCCESS!!!!
May 11, 2007 - Right Fulkerson TTT

Offline dancer44644

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Re: Patellular subluxations
« Reply #5 on: December 02, 2006, 04:55:21 AM »
Thank you for all of your help, I am so glad I found this wonderful website! I came up with another question, it will probably sound lame, but all of this knee stuff is new to me. Where is the VMO (inner or outer knee) and is it a muscle? How does strenthening the VMO help patella subluxations? Anyway, thanks again for all of the help, my questions and worries will be more frequent im sure when PT gets rolling.

brianne

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Re: Patellular subluxations
« Reply #6 on: December 02, 2006, 05:16:39 AM »
The VMO is the inside muscle of the Quad group.  Strengthening it helps pull the patella back into proper alignment.   When the outer quad muscles are stronger than the VMO it puts additional pull on the patella increasing the subluxations and dislocations.

Offline dancer44644

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Re: Patellular subluxations
« Reply #7 on: December 03, 2006, 03:04:33 AM »
Hello again... i meant to mention this earlier, but i forgot. When my daughter was first diagnosed with patellular tendonitis, about two months ago from our OS, who then changed the diagnosis to patellular subluxations, i researched that yoga was good for tendonitis. I know a yoga instructure who specializes in alignment and Anusara yoga. However, i don't know if she really has tendonitis now... My daughter was an extremely active kid dancing about 10 hours a week, and now that she can't dance, she is really bored and somewhat depressed. So, I was hoping to start her in yoga to occupy her time but i want to make sure that it won't further damage her knees since she now has subluxing patellas. The OS said she can do anything as long as it doesn't hurt, but he wasn't very clear on the specifics. Also, I would like to know if any of you all have suggestions as to what activity you think she can do... right now we have her not climbing stairs, and riding the elevator at school (her high school is very large, about a 1/2 mile long!) Also, she is still wearing two braces all day and is taking celebrex for her pain that is pretty constant. Some advice would be great! Thanks

brianne

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Re: Patellular subluxations
« Reply #8 on: December 03, 2006, 03:31:38 AM »
I don't know much about Yoga, but I know that Pilates is pretty good and fairly easy on knees.  It really focuses on strengthening muscles.  I would recommend checking into anything like that before she starts doing something...just in case.

I can remember being 13 years old and so mad and depressed that I couldn't dance or run anymore because of my knees.  It can be so heartbreaking when you are your daughters age to not be able to do the things you want to do.  It was at that time that my mom encouraged me to get into art, acting, and writing.  I grew to love those activities and they we not limited by my knee injuries.  In fact, getiing into writing is what lead me to what I currently have my degree in now.  This will be a difficult trial for your daughter, but encorage her to use it as a time to explore new options and learn new things about herself.  When one door closes, another opens.

As I stated earlier, PT really helped me when I was 12-14.  I was able to resume my favorite activities and was not limited in what I could do.  Let your daughter know that it is possible to get back into the things she loves.  It wasn't until I was 20 that my knees started acting up again, and if I hadn't dislocated them again when I was 20, I might be okay still today.

Offline dancer44644

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Re: Patellular subluxations
« Reply #9 on: December 05, 2006, 10:50:14 PM »
Ok, so there is a new problem.... her right knee has popped out twice and her left knee once, and now her knees hurt constantly. She says it is a sharp pain, not an ache, and is in the middle of the knee cap and above the knee cap. Is this normal, or is there something else wrong. I put a call into her OS, but i got an answering machine.. I will try again later. Any suggestions in the mean time would be great.

brianne

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Re: Patellular subluxations
« Reply #10 on: December 05, 2006, 11:06:22 PM »
When you say that her knees have popped out, do you mean a full dislocation where they remain out of place until put back in place?  (this is very painful)  Or do you mean her knees have just been subluxing?  My knees always ache this way after they sublux or dislocate.  I don't know if it is normal or not.  When does she start PT?  Do you have another appointment with her OS soon?  Have you gotten more than one opinion?  All of the OS's I saw were in agreement with what my problem was, but it took a few OS's to come up with the best treatment plan.

I wouldn't worry too much right now, but definately get back with her OS just to be sure.

I really hope that your daughter can solve her knee problems.  Its no fun to have painful and problematic knees.


Offline dancer44644

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Re: Patellular subluxations
« Reply #11 on: December 10, 2006, 03:00:19 AM »
Hey, thanks for the reply. When I saw popped out, I believe I mean sublux because that is what the OS kept saying. She is now wearing her braces all day and takes them off when she is in bed, this has helped her knees not sublux. Also, the OS prescribed Celebrex for her constant pain, but it doesn't seem to be working. The OS said if it was working, that her pain would be relieved right away. Also, she has been getting bad headaches and feeling dizzy since taking Celebrex, so I think we are going to stop it.

As for PT, we have started it, and she is doing stretches to work on her quadricepts, especially her VMO. The OS prescriped this treatment, and the PT and chiropractor agreed, so I think we are heading in the right direction. HOwever, yesterday, I noticed something interesting on her right knee... I know, if it's not one thing, it's another.... Anyway it was a little bump right below her knee cap. At first I thought it was a bug bite, but it doesn't itch, and it is an oval shape. It hurts her when I push on it, and it is pretty small. Got any ideas? I am just a mother, with no knowledge of knee, although I am starting to learn now, so I have no clue what this bump could be. I would like to hear from any of you out there before I bug the doctor again. We see him about every 3 to 4 weeks, and my daughter doesn't like me worrying about everything, so I have come to you guys for answers! Thanks so much for the feed back!

Offline doublespresso

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Re: Patellular subluxations
« Reply #12 on: December 10, 2006, 05:25:04 AM »
The bump below her knee could be a sign of Osgood Schlatter Disease (http://www.nlm.nih.gov/medlineplus/ency/article/001258.htm). It's usually more common in teenage boys, I think, but I've known high-school girls who had it too. Hope that helps!















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