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agdavis
Oct 24, 2010, 10:05 PM
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Registered: Jan 7, 2009
Posts: 310
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After dislocating one knee, my wife learned that she has a condition known as "patella alta." It took 5 doctors to figure this out (ridiculous), and she was in pretty good condition after about a year of rehab. Presumably the reason that the rehab took so long was because she was originally incorrectly told to immobilize the knee, which caused the muscles to weaken and further decrease knee stability.
Last week, we were climbing at j-tree and while she was stemming, her other (non-injured) knee dislocated. She described it as the same exact injury as the previous one.
Now, I have two questions:
1) does she have any hope of ever being able to stem?
2) does anyone have experience of climbing with patella alta, and if so, how have you coped with this?
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onceahardman
Oct 25, 2010, 10:31 PM
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Registered: Aug 3, 2007
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agdavis wrote: After dislocating one knee, my wife learned that she has a condition known as "patella alta." It took 5 doctors to figure this out (ridiculous), and she was in pretty good condition after about a year of rehab. Presumably the reason that the rehab took so long was because she was originally incorrectly told to immobilize the knee, which caused the muscles to weaken and further decrease knee stability. Last week, we were climbing at j-tree and while she was stemming, her other (non-injured) knee dislocated. She described it as the same exact injury as the previous one. Now, I have two questions: 1) does she have any hope of ever being able to stem? 2) does anyone have experience of climbing with patella alta, and if so, how have you coped with this?
Depending on your wife's specific presentation, it may well not be all that "ridiculous" that only the 5th doctor made the call on patella alta. Very few GPs would have any idea. Even many orthos tend to look for things they can effectively treat.
Anyway, patella alta patients tend to have unstable patellae, since the patella is riding "high" (or more precisely, "proximal") relative to normal. This causes patellar motion to not have the bony constraints which normally limit lateral tracking of the patella. Also, patella alta patients tend to get an articular cartilage problem called chondromalacia, or softening of the articular cartilage on the deep surface of the patella, due to the lower than normal compressive forces on that cartilage.
(patella baja patients, on the other hand, tend to have very stable patellae, but are very prone to DJD/osteoarthritis of the patellofemoral joint /raises hand/)
Treatment rationale is to:
1) increase VMO strength, which is difficult (without also increasing strength of the other quads, it might even be impossible)
2) stretch lateral structures which attach to lateral patella, especially IT band, which can be effectively stretched with a foam roller.
3)Medial taping of the patella, combined with a lateral abutment neoprene sleeve can improve stability as well.
Any hope? I don't know. Did she dislocate on the very first stem she ever attempted? If not, there is some hope.
I don't have patella alta, so I can't really help with your second question directly.
(This post was edited by onceahardman on Oct 25, 2010, 10:36 PM)
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