Orthopedics Physical Therapy What Is Patellar Mobilization and How Does It Work? By Tim Petrie, DPT, OCS Tim Petrie, DPT, OCS LinkedIn Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade. Learn about our editorial process Published on March 23, 2022 Medically reviewed by Oluseun Olufade, MD Medically reviewed by Oluseun Olufade, MD LinkedIn Twitter Oluseun Olufade, MD, is a board-certified orthopedist. He teaches as an Assistant Professor of Orthopedics at Emory School of Medicine in Atlanta, Georgia. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Definition Uses What to Expect Frequently Asked Questions Patellar mobilizations are a hands-on treatment used to address movement limitations in the knee joint. 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. Sunlight19 / Getty Images 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. Risks Speak to your healthcare provider before undergoing patellar mobilization if you have:Recently had knee surgerySustained an acute knee injuryCongenital hypermobility or laxity in your joints 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. 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. Frequently Asked Questions What are patellar glides? Patellar glides are another name for patellar mobilizations.This treatment involves pressure applied to the kneecap, either by a therapistor using your own hands. The bone is repetitively moved or stretched in one ofseveral directions in an effort to improve its mobility in the trochlear grooveof the femur. Which mobilization technique is best for increasing knee flexion? When the knee flexes or bends, the patella responds by moving downward in the trochlear groove of the femur. Because of this, mobilizations are generally performed in the downward direction (moving the knee cap toward the foot) when the goal is to increase the amount of bend in the joint. This hands-on technique is usually performed at various angles of knee flexion and accompanied by stretches. How long does knee mobilization take to show results? Improved symptoms in the knee have been seen after patellar mobilization sessions lasting as little as 5 minutes. It is typical, however, for these benefits to be relatively short-lived. Because of this, patellar mobilizations are rarely performed in isolation. Instead, this treatment is usually coupled with longer-lasting interventions like stretching or strengthening to ensure the benefits are sustained. 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Academy of Orthopaedic Surgeons. Patellofemoralpain syndrome. Cavanaugh JT, Powers M. ACL rehabilitationprogression: where are we now? Curr RevMusculoskelet Med.2017;10(3):289-296. doi:10.1007/s12178-017-9426-3 Aseer PAL. Content validation of total knee replacement rehabilitation protocol in Indian population. JCDR. Published online 2017. doi:10.7860/JCDR/2017/27528.10137 Sit RWS, Chan KKW, Zou D, et al. Clinic-based patellar mobilization therapy for knee osteoarthritis: a randomized clinical trial. The Annals of Family Medicine.2018;16(6):521-529. doi:10.1370/afm.2320 Michigan Medicine. Patellar tracking disorder: exercises. Jayaseelan DJ, Scalzitti DA, Palmer G, Immerman A, Courtney CA. The effects of joint mobilization on individuals with patellofemoral pain: a systematic review. Clin Rehabil.2018;32(6):722-733. doi:10.1177/0269215517753971 By Tim Petrie, DPT, OCS Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit