Specialista in Ortopedia Pediatrica
Post-patellar dislocation
Home Exercise Program
Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.
1.Quadriceps activation
Global quadriceps recovery is the basis of patellar control
Seated with leg extended, small rolled towel under knee. Press knee down (squashing towel) while slightly lifting heel off floor. Hold 5-10 seconds. Aim for a full, even contraction of the whole quadriceps, without trying to isolate a single portion of the muscle. In the early phases it is one of the most used exercises, because it reactivates the quadriceps safely; progression is based on pain control and contraction quality, not on repetition count.
3 × 15-20 repetitions, several times daily
2.Straight leg raise (SLR)
Quadriceps strengthening without bending knee
Supine, healthy leg bent, leg to treat straight. FIRST: contract quadriceps and "lock" knee in extension. THEN: lift entire straight leg 20-30 cm. Hold 2-3 seconds, lower slowly. Key is NOT to bend knee during movement. If leg bends, reduce height.
3 × 15-20 reps, 2-3 times daily
3.Controlled mini-squat (0-30°)
Limited range squat to protect patella
Standing with back to wall or holding support. Descend ONLY 20-30° knee flexion (very shallow squat). Patella is under more stress at greater flexion degrees, so limiting movement is protective. Rise slowly. Feet shoulder-width, weight evenly distributed.
3 × 10-15 reps, slow movement
4.Lateral step-up
Strengthens lateral patellar control
Standing sideways to low step (10-15 cm). Step up with affected leg, then lower controlling movement. Observe that knee doesn't "collapse" inward during rise. If it does, lower step. Progress to higher step only when control is excellent.
3 × 10 per leg, progressive height
5.Gluteus medius and maximus strengthening
Glutes control hip rotation that influences patella
CLAMSHELL: lying on side, knees bent, open knees keeping feet together. GLUTE BRIDGE: supine, lift pelvis. HIP ABDUCTION: on side, lift straight leg. Weak glutes allow hip to internally rotate, bringing patella outward and predisposing to dislocation.
3 × 15 for each exercise
6.Proprioception and balance
Recover knee position sense
PROGRESSION: Level 1 - Single-leg balance, hard floor, eyes open. Level 2 - Eyes closed. Level 3 - Cushion, eyes open. Level 4 - Cushion, eyes closed. Focus on keeping knee slightly bent and WELL ALIGNED (not inward). Progress when stable for 30 seconds.
3 × 30 seconds per level
7.Motor control with visual feedback
Learn to control knee during movements
In front of mirror, perform squats, step-ups and lunges checking that the knee stays aligned over the 2nd toe throughout the movement. Knee must NOT "collapse" inward. If it does, actively correct or reduce range of motion. This motor-control retraining is one of the elements associated with a lower risk of recurrence and is a useful criterion before return to sport.
Integrate control into ALL exercises
8.Quadriceps and lateral chain stretch
A tight lateral retinaculum and iliotibial band push the kneecap outward
QUADRICEPS: standing with support, pull the heel toward the buttock keeping knees together and pelvis tucked, 30 seconds. LATERAL CHAIN: standing, cross the affected leg behind the other and lean the trunk to the opposite side, feeling the stretch along the side and outer thigh. You can add foam-roller self-massage on the outer thigh, avoiding the painful area of the kneecap.
3 × 30 seconds per exercise, daily
9.Controlled landing and progressive plyometrics
Most recurrences happen on poorly controlled landings and changes of direction
Only from the advanced phase (usually after 10-12 weeks) and with specialist clearance. Start by stepping down from a low step and landing on two feet with soft knees, aligned over the feet and silent. Progress to: hops in place, forward-backward jumps, lateral jumps, single-leg landing. If the knee collapses inward or a feeling of instability appears, go back to the previous stage.
3 × 8-10 reps per level, 2-3 times a week
10.Gradual return to sport
Protected progression toward sports activities
PHASE 1 (6-8 weeks): No sport, only rehabilitation. PHASE 2 (8-12 weeks): Straight running, cycling, swimming. PHASE 3 (12-16 weeks): Running with turns, light plyometrics. PHASE 4 (16+ weeks): Gradual return to specific sport. Each phase requires no pain or swelling. Sports brace recommended on return.
Indicative timing - personalized plan with specialist
RED FLAGS - When to stop and contact the doctor immediately
Stop the exercises immediately and contact the specialist (or go to the emergency department if severe) if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- Fever, redness or warmth of the joint, or inability to bear weight
In case of doubt, always prefer a check-up over continuing the exercises.
Dott. Daniele Priano
Ortopedia Pediatrica - ASST Gaetano Pini-CTO
ortopediaevolutiva.com • 26/08/2026
Versione Web
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MioDottoreBefore You Start
Who is this guide for?
Adolescents recovering from patellar dislocation or post-surgery. Progressive rehabilitation program is essential.
What you need
Clear floor space, mat or soft surface, comfortable clothing. Some exercises may require resistance bands or supports.
Suggested frequency
According to specific rehabilitation protocol. Usually daily with gradual progression.
Common mistakes to avoid
- •Performing exercises too quickly without control
- •Pushing beyond the pain threshold
- •Skipping days or doing occasional very long sessions
- •Not warming up before strengthening exercises
⚠️ Red flags — when to stop and contact the doctor immediately
Stop exercises immediately and contact the specialist if any of the following occur:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
Detailed Exercises
- 1
Quadriceps activation
Global quadriceps recovery is the basis of patellar control
Seated with leg extended, small rolled towel under knee. Press knee down (squashing towel) while slightly lifting heel off floor. Hold 5-10 seconds. Aim for a full, even contraction of the whole quadriceps, without trying to isolate a single portion of the muscle. In the early phases it is one of the most used exercises, because it reactivates the quadriceps safely; progression is based on pain control and contraction quality, not on repetition count.
3 × 15-20 repetitions, several times daily - 2
Straight leg raise (SLR)
Quadriceps strengthening without bending knee
Supine, healthy leg bent, leg to treat straight. FIRST: contract quadriceps and "lock" knee in extension. THEN: lift entire straight leg 20-30 cm. Hold 2-3 seconds, lower slowly. Key is NOT to bend knee during movement. If leg bends, reduce height.
3 × 15-20 reps, 2-3 times daily - 3
Controlled mini-squat (0-30°)
Limited range squat to protect patella
Standing with back to wall or holding support. Descend ONLY 20-30° knee flexion (very shallow squat). Patella is under more stress at greater flexion degrees, so limiting movement is protective. Rise slowly. Feet shoulder-width, weight evenly distributed.
3 × 10-15 reps, slow movement - 4
Lateral step-up
Strengthens lateral patellar control
Standing sideways to low step (10-15 cm). Step up with affected leg, then lower controlling movement. Observe that knee doesn't "collapse" inward during rise. If it does, lower step. Progress to higher step only when control is excellent.
3 × 10 per leg, progressive height - 5
Gluteus medius and maximus strengthening
Glutes control hip rotation that influences patella
CLAMSHELL: lying on side, knees bent, open knees keeping feet together. GLUTE BRIDGE: supine, lift pelvis. HIP ABDUCTION: on side, lift straight leg. Weak glutes allow hip to internally rotate, bringing patella outward and predisposing to dislocation.
3 × 15 for each exercise - 6
Proprioception and balance
Recover knee position sense
PROGRESSION: Level 1 - Single-leg balance, hard floor, eyes open. Level 2 - Eyes closed. Level 3 - Cushion, eyes open. Level 4 - Cushion, eyes closed. Focus on keeping knee slightly bent and WELL ALIGNED (not inward). Progress when stable for 30 seconds.
3 × 30 seconds per level - 7
Motor control with visual feedback
Learn to control knee during movements
In front of mirror, perform squats, step-ups and lunges checking that the knee stays aligned over the 2nd toe throughout the movement. Knee must NOT "collapse" inward. If it does, actively correct or reduce range of motion. This motor-control retraining is one of the elements associated with a lower risk of recurrence and is a useful criterion before return to sport.
Integrate control into ALL exercises - 8
Quadriceps and lateral chain stretch
A tight lateral retinaculum and iliotibial band push the kneecap outward
QUADRICEPS: standing with support, pull the heel toward the buttock keeping knees together and pelvis tucked, 30 seconds. LATERAL CHAIN: standing, cross the affected leg behind the other and lean the trunk to the opposite side, feeling the stretch along the side and outer thigh. You can add foam-roller self-massage on the outer thigh, avoiding the painful area of the kneecap.
3 × 30 seconds per exercise, daily - 9
Controlled landing and progressive plyometrics
Most recurrences happen on poorly controlled landings and changes of direction
Only from the advanced phase (usually after 10-12 weeks) and with specialist clearance. Start by stepping down from a low step and landing on two feet with soft knees, aligned over the feet and silent. Progress to: hops in place, forward-backward jumps, lateral jumps, single-leg landing. If the knee collapses inward or a feeling of instability appears, go back to the previous stage.
3 × 8-10 reps per level, 2-3 times a week - 10
Gradual return to sport
Protected progression toward sports activities
PHASE 1 (6-8 weeks): No sport, only rehabilitation. PHASE 2 (8-12 weeks): Straight running, cycling, swimming. PHASE 3 (12-16 weeks): Running with turns, light plyometrics. PHASE 4 (16+ weeks): Gradual return to specific sport. Each phase requires no pain or swelling. Sports brace recommended on return.
Indicative timing - personalized plan with specialist
Frequently Asked Questions
How long does recovery take after a patellar dislocation?
Full recovery generally takes 3-6 months. First 2-4 weeks involve brace immobilization, followed by progressive rehabilitation. Return to sport only when strength and stability are fully recovered.
Can it happen again?
Unfortunately yes, recurrence risk after first dislocation is significant (15-40%). Global quadriceps recovery, hip strength and neuromuscular control are essential to reduce this risk. In some cases surgery may be indicated.
When can I return to sports?
Return to sport depends on strength recovery (at least 85% compared to healthy leg), proprioception and motor control. Generally not before 3-4 months. Pivot and contact sports require longer times. Decision should be made with specialist.