Patellar Instability

Explanation of Diagnosis

Specific Work Modifications

• Avoid frequent stair climbing and take breaks if stairs trigger shifting or pain
• Minimize kneeling, squatting, and lifting with the knees bent; use a step stool or height-adjusted work surface instead
• If your job involves standing, alternate positions every 20 to 30 minutes and avoid long periods with knees locked
• Choose chairs with good back support and keep the knees from staying deeply bent for long stretches
• Wear supportive footwear with a stable sole; consider a patellar-stabilizing knee brace during higher-risk tasks if your clinician recommends it
• When turning or reaching while carrying items, pivot with your whole body instead of twisting the knee

Specific Activity Modifications

• Limit deep knee bending, jumping, and quick directional changes (cutting/pivoting) until symptoms calm down
• Avoid running on uneven ground; choose flatter surfaces and reduce speed and volume
• Temporarily reduce activities that combine knee bend with twist, such as soccer/basketball drills, singles tennis, or dance spins
• Choose lower-irritation workouts like cycling with appropriate seat height or an elliptical with smooth, controlled motion
• Use a longer warm-up and start with shorter, easier sessions before progressing
• If you feel shifting, catching, or giving way during an activity, stop and switch to a lower-stress option the same day

Recommended Supplements

• Omega-3 fish oil, 1,000 to 2,000 mg per day: may help support a less inflammatory environment that can calm joint irritation
• Vitamin D3, 1,000 to 2,000 IU per day (or follow bloodwork guidance): supports bone and muscle function, especially if you are low
• Collagen peptides, 10 g per day: may support connective tissue and overall tendon/ligament health during rehab
• Curcumin (turmeric extract), 500 to 1,000 mg per day: may help with minor inflammation-related aches in some people

Recommended Nutrition and Hydration

Diet Recommendations

• Focus on a balanced diet with enough protein from lean meats, fish, eggs, beans, or dairy to support tissue repair
• Include a variety of colorful fruits and vegetables daily to provide antioxidants and micronutrients
• Choose healthy fats (olive oil, nuts, seeds, salmon) and limit added sugars and heavily processed foods
• Get calcium-rich foods (milk, yogurt, fortified alternatives, leafy greens) to support bone health
• If you have high body weight, slow, steady weight reduction can reduce stress across the kneecap over time

Hydration Tips

• Aim for regular water intake throughout the day; consider extra fluids around workouts
• If you sweat a lot, include electrolytes through food (salty soups) or a sports drink used sparingly as needed

Home Exercise Prescription

Do these exercises about 3 to 5 days per week, focusing on good control and staying in a pain-free or near-pain-free range.

1. Quad set (isometric): Sit or lie with the leg straight, tighten the thigh muscle and press the knee gently toward the floor; hold 10 seconds, repeat 10 times
2. Straight leg raise: Tighten the thigh, then lift the straight leg about 12 to 18 inches (or as far as you can without pain or shifting); do 2 sets of 8 to 12 reps
3. Side-lying hip abduction: Lie on your side, keep toes pointing forward, lift the top leg a few inches without rolling your body; do 2 sets of 10 to 15 reps
4. Glute bridge: Lie on your back with knees bent, lift hips until your shoulders and knees are roughly in line, then lower slowly; do 2 sets of 8 to 12 reps
5. Clamshells: With hips and knees bent, keep feet together and open the top knee without letting your pelvis roll; do 2 sets of 10 to 15 reps
6. Supported single-leg balance (only if stable): Stand near a counter, balance on the affected leg, and keep the knee tracking over the middle of the foot; hold 20 to 30 seconds, repeat 2 to 3 times

Helpful Books

• "Explain Pain" written by David Butler and Lorimer Moseley
• "Becoming a Supple Leopard" written by Kelly Starrett
• "Strength Training Anatomy" written by Frederic Delavier