Patella Subluxation

Hi

Yesterday I had another Patella dislocation or subluxation, the last time I had one was around october last year. I have had a number of these dislocation types in the passed and always thought it was just a knee dislocation, but the last time I had one I went to a physio and it was diagnosed as a patella subluxation.

The first time I had one was around 8-10 years ago when i stood on my right leg when climbing over a fence and I think I turned and felt my knee go, it was the worst pain I felt and felt like my shin bone was popping out of my skin. I managed to wedge my foot in between the fence and straighten my leg out causing the dislocation to go but leaving and excruciating pain. I went to A&E got bandaged up etc, and from what I remember I was told it was a knee dislocation not patella.

Since then I had a few more episodes over the years where I turned my leg and felt something pop out, straightening my leg fixed the problem but again left some pain, not as bad as the first time it happened but still very uncomfortable.

I was never advised by the doctors to see a physio to rehabilitate the problem and strengthen the area.

The last couple years I started to attend the gym regularly, and last year took up a combat grappling sport. Everything was fine until a training partner put weight on my knee or leg causing my knee to dislocate, it popped back in straight away, im not sure if this cause I do it out of instinct or it just pulls back, it feels like the knee its popping out but when I went to emergency and physio I was told it was the patella.

I was told the usual, rest for weeks, strengthening exercises etc, but after a few days the pain subsided a lot and I felt ready to go back and train my combat sport lightly, and do weights at the gym, focusing on the area around the knee and the muscles the physio told me to work. I didnt really stick to the exercises i was given, which I should have but still focused a lot on legs and the area around the knee.

I wasnt sure, but I felt cause of the previous weight training I did prior to dislocation whilst grappling, helped the area and why it felt better after a day or 2.

Then yesterday it popped again, at first it was bad pain but subsided fairly quick, now I am just getting sharp pains on the inside of my knee that come and go. Nothing as bad as previous times.

Is this down to my knee becoming worse and each time it happens its just stretching more and more and becoming looser?

I have a lot of exercises I am focusing on, the main one being the VMO muscle and isolating that.

Other ones include the upper legs muscles and hip muscles.

I have a lot of exercises that focus on these muscles, but any recommendations for the hip?

I know the physio told me the VMO and one of the hip muscles on the outer side of the leg near the glute keeps the patella in place or holds it tight, but I cant remember which one.

I probabily should attend a physio but i know whats wrong and I know how to rehabilitate it, I was concrned that the MPFL was going to be looser but my knee cap still seems how it was before, maybe tighter.

Also any excercise that really isolate the VMO or other muscles that aid in keeping the patella from subluxation would be great.

I know the back/wall hold squats, ball in between knees, lunges, step ups/downs, peterson step ups, leg raises/extentions, split squats.

Sorry for the long post, just thought a bit of history might help, also any other help or recommendation would be great.

Thanks