The patella (or kneecap) is a bone that is located in a shallow groove (called the trochlea) at the bottom of your thighbone (femur). This important anatomical structure connects to both the quadriceps muscles (via the quadriceps tendon) and the tibia bone (via the patellar tendon) and plays an influential role in the knee’s ability to bend and straighten.
Occasionally, restriction in patellar movement can alter the range of motion and function of the knee joint and cause this treatment to become necessary.
This article will provide details on patellar mobilization, including its potential uses and benefits.
What Is Patellar Mobilization?
In a properly-functioning joint, the patella is pulled upward in the trochlear groove when you straighten or extend your knee. Along the same lines, your knee cap moves in a downward direction in the groove when the leg is bent or flexed. If this patellar mobility is altered, however, the knee may not function properly and joint movement may be diminished.
Patellar mobilization involves the application of pressure or force on the kneecap in an effort to restore the normal up and down movement in the trochlea. Side-to-side mobilizations may also be utilized if the kneecap is not tracking properly in the groove.
The movements that a therapist applies on the kneecap can be either rhythmic and gentle or more forceful and sustained, depending on the goals of the mobilization and the causes of the impaired mobility.
This treatment is also frequently coupled with exercise in an effort to sustain the benefits after the therapy session.
What Is It Used For?
Patellar mobilizations can be a valuable treatment for a wide variety of musculoskeletal knee conditions. This is particularly true if pain or stiffness in the joint is impairing your ability to function.
Recently had knee surgerySustained an acute knee injuryCongenital hypermobility or laxity in your joints
Here are several specific scenarios where this technique has proven to be helpful.
Post-Operative Rehab
Following surgery on the knee or the surrounding structures, your joint is typically left swollen and stiff for several weeks. During this time, your normal knee movements are altered and patellar mobility can quickly become impaired.
As a part of your post-operative physical therapy, joint mobilizations are commonly used to combat this patellar limitation and to restore your knee range of motion. This technique may be utilized when rehabbing from a variety of surgeries including:
ACL or other ligament reconstructions Partial or total knee replacements (arthroplasty) Meniscal repairs Partial meniscectomys Microfracture procedures
Knee Osteoarthritis
Knee osteoarthritis causes the smooth, slippery cartilage that coats the end of the bones in the knee to thin and degenerate over time. As this occurs, the joint can become stiff and range of motion may gradually diminish. Patellar mobilization can help to restore some of this lost movement.
The treatment has also been found to increase function and reduce pain when included in the therapy regimen of people with this common diagnosis.
Injury
An injury to the knee can also frequently cause swelling and inflammation and may hinder the mobility in your joints.
During physical therapy, patellar mobilizations commonly play a role in regaining any range of motion that has been lost. By restoring normal patellar mobility in the trochlear groove, movements like bending and straightening your knee become easier, and overall daily function improves.
This is true for many types of injuries, including ligament sprains, muscular strains, and patellar fractures. It is always advisable, however, to have your injury assessed by a physician before beginning this type of treatment.
What to Expect
Early on after an injury, surgery, or flare-up of arthritis, patellar mobilizations are typically gentle in nature. Your therapist will commonly glide your kneecap into the tight direction and then relax theirpressure.
The mobilizations will continue to oscillate between a stretched and relaxed position for several minutes at a time. Passive stretches of the knee are also typically incorporated into your rehab to help increase the joint’s overall range of motion.
As your condition improves, the therapist’s mobilizations may get more forceful or may be sustained for longer periods of time. This can vary depending on your individual diagnosis and the goals of the rehab treatment. While you may feel stretching or strain during this hands-on technique, patellar mobilizations should generally not cause pain.
Exercises
Along with the hands-on mobilization of your knee, exercises are typically issued to continue your progress moving forward.
Self-patellar mobilizations can be performed at home with your leg extended in front of you on a bed or sofa. In addition, knee flexion or extension stretches are commonly suggested to maintain any gains in joint motion that were achieved during in-clinic mobilizations.
Finally, strengthening exercises like leg raises, squats, or step-ups are typically issued to improve the muscular support of the affected joint.
Benefits
Patellar mobilizations have been shown to have a number of specific benefits.
This treatment can be helpful in achieving full knee extension early on after an ACL reconstructionsurgery.
In addition, the treatment has also been shown to positively affect pain levels and overall function in people with patellofemoral pain syndrome, especially when the mobilizations were paired with strengthening activities.
The same benefits have been seen in individuals with knee osteoarthritis, with better self-reported function and lower amounts of pain in people who were treated with patellar mobilizations.
Summary
Patellar mobilization is a hands-on treatment where pressure is applied to the kneecap. This technique helps to restore mobility in this bone and can lead to improved knee range of motion, increased function, and decreased pain.
This type of mobilization is used in physical therapy for many conditions, including osteoarthritis, knee injuries, and post-operative therapy. It is typically administered along with other strengthening exercises and stretches.
A Word From Verywell
A stiff or painful knee can significantly limit your daily function and make each step you take seem labored and difficult. Fortunately, patellar mobilizations may be of benefit. If you are dealing with a restricted range of motion or soreness in the knee itself, be sure to speak to your healthcare provider. After a thorough examination of your leg, they’ll be able to better advise you on whether this hands-on treatment is appropriate for your situation.
