This is not my patella, I was fortunate enough to have mine pop back into place before there was an opportune kodak moment.  However, it can give one an inclination of what happened.  

What bothers me about the incident is that I cannot isolate the cause, so as to prevent it from future occurrence.  To add further perplexity, my physiologist tells me I have tight, healthy knees.  I was not performing a complicated maneuver, I did not have a ski twist my leg, I simply overshot the balance beam and was trying to dismount on the opposite side.  The move we were working on is called a "staller" (sp?): hop onto the beam in a straddle position, legs pointed parallel to the ground in a V position, weight supported on your hands between your legs (see picture below).

From this position I fell over the side of the beam, which was only about lower rib cage height, and when my left leg touched the floor and was weighted . . . snap, crackle, pop.  I could feel popping and tearing, then a pop back into place when I hit the ground curled up in a fetal position.  It hurt immediately, the kind of hurt I haven't felt in years (possibly ever?).  I hollered repeatedly at the top of my lungs until I could get my wits about me, then did my best to breathe through the pain.  My brain wanted to implode, and I could feel shock settling in.  My fellow gymnasts noted I was a pale green color.

Fortunately Coach Kari is well-trained, and there is also a great nurse in my class.  They recommended ice, ibuprofen, and a trip to the local sports physio clinic first thing in the morning.  They confirmed my suspicion that any trip to ER would result in a few hours sitting uncomfortably in a waiting room, an x-ray to confirm nothing was broken, and a recommendation for physio.  A couple gentlemen from class carried me out to the car to be chauffeured home.

After a handful of ibuprofen, a couple bags of ice, and a 2 oz hot butter rum toddy I could feel the tension ease from my mind & body, and was able to sleep not too badly.  The pain was almost non-existent by morning, unless of course I tried moving it.  At the physio clinic my knee was probed (ACL felt intact, thank goodness), and they confirmed that I had indeed experienced a dislocated patella.  The soft tissue on the inside of my knee, which normally keeps it in place, were ripped and swollen.  

 The prescription: full leg brace at ALL times for 1 week (do not even get up to answer the phone without it), ice for 20 minutes of every hour, followed by 2+ weeks of a hinged limited range-of-motion knee brace, and physio sessions twice per week.  Not having any benefit coverage for this type of thing, I was happy to hear that health care covers my first three visits!  Unfortunately, once you have dislocated the patella, like a shoulder, it is HIGHLY likely it will continue to happen.  My doc claims that the key to preventing this is counterintuitive, you need to build up some scar tissue which will help hold the patella in its proper place.  The key to the "right amount" of scar tissue is the right amount of usage.  Too little use and the scar tissue may not build enough, or it may be "clumped", too much use and I could build too much scar tissue, and the soft tissue could stay loose.

My physio sessions consist of cold whirlpool soaking, ultrasound and shock treatment to stimulate healing, and a few simple, controlled contraction of isolated muscles around the knee.  Four full days later, I can almost bend my knee 70 degrees, very slowly.  Thanks to the leg brace I can walk without pain, although awkwardly & slowly.  I was even able to do a "Barbara" WOD today, minus the squats.  The hot tub with snowballs within easy reach make for some nice hydrotherapy in the backyard.

I expect to be fully recovered before the snow is gone, and I'm not expecting a late spring.

Update: Sporting my new piece of leg jewelry.  After a week and a half, the swelling dropped significantly for a couple days, then flared up again.  A nice yellow bruise has appeared that covers most of my lower leg.



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