Month: July 2025

Knee Dislocation: Causes, Prevention, & Treatment

soccer player holding his knee

Reviewed by Richard Nauert M.D.

At first, the term knee location might not sound like a big deal, but it is not to be taken lightly. Understanding knee dislocations is crucial for athletes, active individuals, and anyone seeking to maintain healthy knees. In this article, we provide an in-depth look at knee dislocations, including their causes, prevention methods, and treatment options, featuring expert advice from Dr. Richard Nauert a orthopedic surgeon and fellowship-trained sports medicine specialist at TSAOG Orthopaedics & Spine in San Antonio, TX.

What is Knee Dislocatiohttps://www.tsaog.com/about-us/who-we-are/\n?

The clinical definition of a knee dislocation is injury to three of the four major ligaments surrounding the knee. The four major ligaments are the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), and the fibular collateral ligament (FCL), occasionally called the lateral collateral ligament (LCL). Of course, there are many more stabilizing structures of the knee, including the separate bundles of the individual ligaments and the structures in the postero-medial and postero-lateral corners (PLC/PMC).

What Causes Knee Dislocation?

The energy required to cause a knee dislocation is typically very high, and often there are other associated injuries. An example would be a motor vehicle accident with a direct forceful blow to the knee or a significant twisting event. They can also be present in sports such as football, speeding down the hill, and hitting a tree while skiing. An example of a knee dislocation happened during a University of South Carolina vs University of Tennessee football game when highly regarded NFL prospect Marcus Lattimore sustained a knee dislocation.

How to Prevent Knee Dislocation

  • Strengthen the muscles around your knee: Focus on exercises that target your quadriceps, hamstrings, and hip abductors. Strong muscles help stabilize the knee joint and reduce the risk of dislocation.
  • Improve your flexibility: Stretch regularly to maintain good leg flexibility, particularly your quadriceps, hamstrings, and calf muscles. Tight muscles can pull on the knee joint, increasing the risk of dislocation.
  • Use proper technique during activities: Be mindful of your technique when participating in sports or other physical activities. Avoid sudden twisting motions or changes in direction, as these can put stress on the knee joint.
  • Wear appropriate footwear: Choose shoes that fit well and provide adequate support for your feet and ankles. Doing so can help maintain proper alignment and reduce the risk of knee dislocation.
  • Use protective gear: During high-risk activities like contact sports, wear protective gear such as knee pads or braces to help stabilize the knee joint and reduce the risk of injury.
  • Address any existing knee problems: If you have a history of knee injuries or conditions like patellar instability, work with a specialist to develop a treatment plan that addresses these issues and lowers the risk of future dislocations.
  • Avoid overtraining: Gradually increase the intensity and duration of your workouts to avoid putting too much stress on your knees. Allow adequate time for rest and recovery between training sessions.
  • Practice balance and proprioception exercises: Incorporating balance and proprioception exercises into your routine can help improve your body’s ability to sense and control the position of your knee joint.

Knee Dislocation Treatment

When knee dislocation is suspected, emergent evaluation by a physician is a must. An injury to the nerves and blood vessels of the lower leg can require immediate surgical intervention.

Many of these ligament injuries are diagnosed using the clinical exam. However, x-rays are a must, and a magnetic resonance imaging (MRI) study is needed as well. The X-rays provide information regarding the status of the bone, any fractures, the position of the bones, and overall bone quality. An MRI, on the other hand, provides much greater detail regarding the soft tissue structures, such as the cartilage surfaces on the bones, the medial and lateral menisci, and the ligament and muscle conditions surrounding the knee.

At times, the MRI will show that the MCL or FCL is intact and without an abnormality, but clinically, during the exam, there is laxity to these ligaments. This is especially so in chronic cases. Stress x-rays with manual force on the knee will then give objective evidence of any increased laxity as you compare the normal side to the injured side. These techniques are needed to determine injuries to these areas of the knee.

Unfortunately, knee dislocations, the vast majority of the time, require surgical intervention. The type of reconstructive surgery required would depend on the severity and type of knee dislocation and associated knee injuries. Anatomical reconstruction would be the goal in most cases. The subtle injuries to the posterolateral corner can often be missed if a careful clinical and diagnostic workup is not performed, which would set any reconstructive surgery of other ligaments up for failure if not recognized and dealt with. These injuries can be devastating and not only end the career of an athlete, but if there are injuries to the blood vessels at the time of the injury, they can at times even lead to loss of the limb. Thus, these injuries should be taken very seriously.

Get Help From TSAOG

At TSAOG Orthopaedics & Spine, our mission is to be trusted for patient care based on our experience and traditions. Dr. Richard Nauert, a key member of our team, is an orthopedic surgeon and fellowship-trained sports medicine specialist who is dedicated to helping patients overcome knee dislocations and other orthopedic challenges. With appointments available at our Ridgewood and Quarry Area locations, Dr. Nauert and the TSAOG team are ready to put their expertise to work for you.

Don’t let a knee dislocation keep you from the activities you love – schedule an appointment with a specialist at TSAOG today.

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References:
https://www.tsaog.com/services/sports-medicine-service/
https://www.tsaog.com/physicians/richard-nauert-md/
https://www.tsaog.com/find-physicians/?docSpec=Sports+Medicine
https://www.tsaog.com/about-us/who-we-are/
https://www.espn.com/college-football/story/_/id/8564561/marcus-lattimore-dislocated-knee-saturday-south-carolina-gamecocks-coach-steve-spurrier-says
https://tsaog.radixhealth.com/dash/self/?scct=f51f195c-b53c-4bec-b329-0b73e0b0bddd#/

Why Work for a Physician-Owned Physical Therapy Practice?

TSAOG Staff Photo

When choosing where to practice, physical therapists often weigh the merits of various clinical settings. Physician-owned physical therapy services (POPTS) stand out as environments where therapists can thrive through integrated care delivery and specialized focus. In this guide, we discuss the compelling perks of physician-owned settings that make them attractive career destinations for physical therapy professionals, and share the perspectives of physical therapists on our team.

“The number one reason for working in a Physician-owned practice is Direct Access to the Physician/Surgeon. That access facilitates relationship, communication, trust, and understanding of each Physician’s preferences and needs.” — TSAOG Physical Therapist

What Are Physician-Owned Physical Therapy Services (POPTS)?

Physician-owned physical therapy services are a healthcare delivery model where physicians own the physical therapy services. The physical therapy services may be housed within the same facility as the physician’s practice or in a nearby location under the same ownership umbrella. POPTS vertically integrates services so physicians can expand their scope of care beyond traditional medical treatment. The model typically involves orthopedic surgeons, sports medicine physicians, physiatrists, or other specialists who frequently prescribe physical therapy as part of their treatment plans.

In POPTS arrangements, physicians maintain clinical oversight throughout the entire treatment continuum. For example, an orthopedic surgeon who performs knee replacement surgery can directly supervise the subsequent rehabilitation process by having the patient receive physical therapy from therapists employed within their practice. Surgical intervention and rehabilitation are seamlessly connected, with the physician maintaining visibility into all aspects of the patient’s recovery journey. The POPTS model has gained particular traction in specialties with high rehabilitation needs, where close coordination between medical treatment and physical therapy can significantly impact recovery outcomes. It reflects a broader trend in healthcare toward comprehensive service offerings under unified management structures.

“I work alongside the doctors who are next door and are easily accessible. If ever, I need to discuss a case with a referring MD, I can just go next door and talk to them directly or text him or her personally to collaborate about the continuum of care for their clients to optimize their outcomes.” — TSAOG Physical Therapist

Physician Owned Physical Therapy vs Independent Physical Therapy Clinics

Physician-owned physical therapy services and independent physical therapy clinics are two different models for delivering rehabilitation care.

In physician-owned models, the physical therapy practice operates under the direct ownership of physicians, typically specialists such as orthopedists or physiatrists. The therapy services are often co-located within the physician’s medical practice or nearby, creating an integrated care environment. Physical therapists in POPTS settings typically function as employees of the physician practice, working under the clinical direction and practice philosophy established by the physician owners.

Independent physical therapy clinics, by contrast, operate as separate business entities without physician ownership. These clinics are typically owned by physical therapists themselves, by non-physician entrepreneurs, or by larger healthcare corporations. Independent clinics receive patient referrals from various physicians and medical practices without the referring physicians having financial interests in the therapy services. Physical therapists in independent settings generally exercise greater autonomy in clinical decision-making and treatment protocols.

6 Benefits of Working for a Physician-Owned Physical Therapy Clinic

Continuity of Care

Working within a physician-owned model allows therapists to participate in truly integrated care delivery. Therapists can follow patients from pre-surgical conditioning through post-operative rehabilitation and long-term recovery, with consistent oversight that improves treatment outcomes. With continuity, therapists can build stronger therapeutic relationships with patients and better understand their recovery journeys.

“I feel that we as a company really take patient centered care to the next level. With easy communication with the Doctors, their PA’s, and their staff, we can all stay on the same page and notify each other of progress or lack thereof.” — TSAOG Physical Therapist

“I think too the patients take comfort in knowing that we are able to communicate directly with the Physician to handle any concerns effectively & efficiently.” — TSAOG Physical Therapist

Professional Development Opportunities

Physical therapists’ close association with physicians creates unique learning opportunities. Therapists can observe surgeries, attend physician-led clinical rounds, and participate in joint case reviews that enhance their clinical knowledge.

Practice Stability and Referral Security

The built-in referral network from physician owners typically provides a more stable and predictable patient flow. Referral security can translate to more consistent scheduling and potentially greater job stability compared to independent clinics that must constantly develop new referral sources.

“It’s a system that works best for all parties involved because it’s time efficient care.” — TSAOG Physical Therapist

Advanced Resources and Technology

Physician practices, particularly larger specialty groups, often have greater capital resources to invest in advanced equipment, technology, and facilities. Physical therapists can access state-of-the-art rehabilitation technologies, specialized treatment equipment, and robust electronic health record systems that improve treatment capabilities.

Specialized Practice Focus

Working with physician specialists allows therapists to develop deep expertise in specific clinical areas. For example, therapists in orthopedic-owned practices become highly specialized in post-surgical rehabilitation protocols for joint replacements or sports injuries, developing mastery that can advance career opportunities.

“The other great advantage is [POPTs] allows for the PT to Specialize in a particular area, e.g. Orthopedics.” — TSAOG Physical Therapist

Participation in Research and Innovation

Physician-owned practices may engage in clinical research and innovation projects. Therapists may have opportunities to participate in research studies, contribute to developing new treatment protocols, and co-author professional publications.

“One more unique advantage of TSAOG is ‘BRIO‘ which is an absolute Phenomenal Benefit for any PT/OT interested in Research!” — TSAOG Physical Therapist

Explore Physical Therapy Careers in Texas with TSAOG

Are you ready to experience the professional advantages of a premier physician-owned practice? TSAOG offers physical therapists a unique opportunity to advance their careers in an integrated, collaborative environment recognized for excellence.

Our welcoming, inclusive culture has made us a San Antonio employer of choice, earning “Best Places to Work” recognition for multiple years. Physical therapists at TSAOG benefit from direct collaboration with orthopedic specialists, access to cutting-edge resources, and clear paths for professional advancement.

With a vision “to be trusted for patient care, based on our experience and traditions,” we’ve built a practice where therapists can deliver exceptional outcomes while developing specialized expertise. Our award-winning services, including “Best Physical Therapy” recognition in 2022, reflect the quality of care our team provides.

Explore our job openings!

10 Helpful Tips for Diabetic Foot Care

man suffering with foot cramp

Reviewed by Cory Moczygemba, DPM

For people with diabetes, taking proper care of their feet is crucial to prevent serious complications. Diabetes can cause nerve damage (neuropathy) and poor blood circulation, which can lead to foot problems that, if left untreated, may result in severe consequences. At TSAOG Orthopaedics, our foot and ankle specialists understand the importance of diabetic foot care and are committed to helping you maintain healthy feet. In this guide, we share tips to help you care for your feet and prevent complications related to diabetes.

Inspect your feet daily for any cuts, blisters, sores, swelling, or redness.

Use a mirror to check the bottoms of your feet if needed. Diabetic neuropathy can cause numbness, making it difficult to feel injuries. Catching problems early prevents them from worsening. If you notice any issues or have trouble examining your feet, ask a family member for help or consider using a long-handled mirror to check hard-to-see areas regularly.

Wash your feet daily with warm (not hot) water and mild soap.

Dry them gently, especially between the toes. Hot water can cause burns, while excessive moisture between toes promotes fungal growth. Use a soft towel to pat your feet dry, taking care not to rub vigorously, as this can damage the skin. If you have trouble reaching your feet, use a long-handled sponge or brush or ask a caregiver for assistance.

Moisturize your feet to prevent dryness and cracking.

Avoid applying lotion between the toes, as this can lead to fungal growth. Use a rich, hydrating cream or ointment on the tops and bottoms of your feet to keep the skin supple and prevent fissures. Cracks in the skin can allow bacteria to enter, increasing the risk of infection. Remember to apply moisturizer after bathing and whenever your skin feels dry.

Trim your toenails straight across and file the edges.

If you have difficulty, consider seeing a podiatrist for regular nail care. (This is no longer covered by insurance and we do not offer this on a cash basis) Improper nail trimming can lead to ingrown toenails and infections. Use clean nail clippers and file rough edges to prevent snagging on socks or bedding. If you have limited mobility, poor eyesight, or very thick nails, it’s best to have a podiatrist handle your nail care to reduce the risk of injury.

Always wear clean, dry socks and well-fitting shoes.

Avoid walking barefoot, even indoors. Wearing socks helps wick away moisture and provides a barrier between your feet and your shoes. Choose socks made from breathable materials like cotton or moisture-wicking fabrics. Properly fitting shoes reduce the risk of blisters, sores, and foot deformities. Barefoot walking increases the chance of injury from stepping on sharp objects or exposing your feet to extreme temperatures.

Choose shoes with good support, a wide toe box, and no pressure points.

Break in new shoes gradually. Proper footwear is crucial for preventing foot problems. Look for shoes with a supportive arch, cushioned soles, and a spacious toe area to accommodate any foot deformities. Avoid shoes with high heels, narrow or pointed toes, or rough seams that could rub against your skin. When buying new shoes, wear them for short periods initially to prevent blisters and ensure a comfortable fit.

Promote circulation by wiggling your toes and moving your ankles periodically throughout the day.

Sitting for long periods or having diabetes can reduce circulation in the feet. Engage in simple foot and ankle exercises like toe wiggles, ankle rotations, and calf stretches to help blood flow. If you spend a lot of time sitting, take breaks to stand up, walk around, or elevate your feet.

Good circulation is essential for wound healing and overall foot health.

Control your blood sugar levels as directed by your healthcare provider. High blood sugar can damage nerves and blood vessels in the feet, leading to neuropathy and poor circulation. Follow your diabetes management plan, including regular blood sugar monitoring, taking medications as prescribed, and maintaining a balanced diet. Keeping your blood sugar within the target range set by your healthcare team can help prevent or slow the progression of foot complications related to diabetes.

Don’t remove calluses or corns yourself.

Consult a podiatrist for safe removal. Attempting to remove calluses or corns at home can lead to cuts and infections, especially if you have reduced sensation in your feet due to neuropathy. Podiatrists have the proper tools and expertise to safely remove these thick, hardened areas of skin without causing damage. They can also provide guidance on preventing calluses and corns from recurring.

Have your feet checked by a healthcare professional at least once a year or more often if you have a history of foot problems.

Regular foot exams are essential for identifying issues early and preventing complications. During these check-ups, your healthcare provider will assess your feet for signs of neuropathy, circulation problems, skin changes, and any deformities. They can also trim your nails, remove calluses, and provide personalized advice on foot care based on your individual needs and risk factors.

To see a helpful graphic with some of these tips, check out the CDC’s resource.

How TSAOG Can Help

At TSAOG Orthopaedics, our foot and ankle specialists, like Dr. Kevin L. Kirk and Dr. Charles E. Bryant, help people with diabetes maintain healthy feet and prevent complications. If you have diabetes and want to ensure the best possible care for your feet, book an appointment today.

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References:

https://www.tsaog.com/find-physicians/?docSpec=Foot+%26+Ankle
https://www.tsaog.com/services/foot-and-ankle/
https://www.cdc.gov/diabetes/communication-resources/tips-for-healthy-feet.html
https://www.tsaog.com/
https://www.tsaog.com/physicians/kevin-l-kirk/
https://www.tsaog.com/physicians/charles-e-bryant/
https://tsaog.radixhealth.com/dash/self/