My doctor wants me to start physical therapy this week. I fell off a porch on 6/7 and fratured my patella. No surgery needed.

I am a little worried because almost everywhere I am reading it takes 6-8 weeks for a bone to heal. I saw the doctor friday (4 weeks and a day since my fall) he wants me out of the immobilizer and to start PT this upcoming week.  He took x-rays on Friday and to ME it still looks broken. But, he says the patella hasn't moved. So that's good. Still confused!

Having never gone to PT, I am hoping it is pretty mild at the beginning. Yes, I know it will be painful.  I think once past the six week mark I'll feel better. I just feel like I want to heal a little more. It has been hard having the immoblizer off, but I do put it on at night just incase so I dont move too much.

I think the hardest part was my parents in the room with me when the doctor said he wants to see me out of the immoblizer and to start walking and bending my knee. My parents thought I was just supposed to walk out of the doctors office and walk at home. I am still being told "the doctor said you can walk."  Hmmm.... 

I've read on here that with PT you can bend your knee a little bit more each time to a different rotation. It just takes time. It's hard on me because my family thinks since the doctor said I can walk that it's just me not wanting to. Ugh! Heck, I wasn't even able to swing my leg on crutches for a few weeks, I can now though. This is not fun.

Hi there,

Hope your PT goes well.  I have had 4 surgeries in the last 5 years and have always had therapists that pushed me to my limits but respected my limits.  I think that the advice from Rollerblade to have someone who has worked with your injury before is extremely important.  You have to wear that knee for the rest of your life, so you need to do everything possible to heal as perfectly as you can.  Since your parents were in the appointment, you are one of the younger ones here.  Learn from the experiences of others and remember to take this one thing at a time.  There are many here who rushed back to their sports or activities too soon and paid for it in pain.

Expect to have swelling after you PT and be sure you go home and ice right away.  The exercises you will get are easy to do but may be uncomfortable.  Notice I said uncomfortable, not excruciating.  If you find your pain level getting to bad, tell your therapist and take smaller steps forward.  When my therapist wanted to have me use 2 lb. weights on straight leg lifts after a couple of sessions, it caused me to swell and really hurt.  I dialed back to just 1/2 lb. for a few days, then 1, then finally 2.  If you are asked to do something that is too difficult, break it down-don't just refuse to do it.  And if you have to do your exercises twice a day do them exactly as ordered.  Your PT wants you to heal right on schedule with full range of motion and you won't if you don't do your part.

Good luck and good healing

Linda

Thank you both for all your help! I did take your advice and went to a PT that knows about patella fractures. Tomorrow is my fourth appointment.

I started PT four weeks after falling. Dr just told me to start going to PT and that I can bend my knee.  Sorry if I come off paranoid here but I am a bit confused.

 I was approved to go to PT by workers comp and they sent my paperwork into the PT.   So, I show up at my PT and they ask for the doctors report and the PT wants to see the lastest x-rays. I thought my paperwork was there and they say no, just the number of visits.The PT asked me if the doctor wants me to start putting weight on my leg. Not sure at all.  The person at the PT's office is finally able to get my first two reports from the doctor. Still, no instuctions from the doctor and not the most recent report. I went to the PT for the third visit on Tuesday of this week and he still doesn't have the doctors report.

I trust the PT, but I feel like we are doing this blindly. I worry when I have pain especially.  First visit, the PT had me lower my knee to the ground. I've done the exersizes and he's doing all sorts of massages and such to my leg. He wants me to dangle it straight down off a chair. :/. I HOPE this is what the doctor ordered.

There's stiffness of course and pain here and there, but I am more worried mentally about the lack of communication between the doctor and PT.  I go see both tomorrow, so wish me luck.

When I was at my doctor for the last time two weeks ago, he said I needed a brace for my knee and workers comp would need to approve it and it would be mailed or someone can pick it up.  I don't hear from them so while at the PT on Tuesday I call the dr office and ask that they mail the brace with the X-rays or I can have someone pick them up.  No response.

It takes 2 ppl to get me to PT on Tuesday and Thursday.  Did not get any response Wednesday when I called again and Thursday the doctor was out of the office. I called workers comp on Thursday and was told the brace was approved on Monday. They were angry I didn't have it all week.

After many phone calls on Thursday, I get a call at 4:45 that the brace is ready and I could pick it up the next day I call Friday morning to say my mom will pick it up. I'm told no, I have to be custom fitted and need to go in myself. Of course I couldn't go Friday and had to wait until this week.

I will feel better tomorrow if all is okay after the X-ray. I know I will feel a lot better in PT once he has the report and orders from my Dr. :/

I can do a lot of exersizes and wasnt in too much pain until the dangling of the leg. Ouch.  I am okay though. I do have a hard time bending my leg while laying down. I am supposed to push into the bed with my heel and bend my knee. That is hard.


I AM able to bend my knee completely down when sitting in a chair so that's great.  I know the stiffness hurts, but is it normal to have pain a little in the kneecap area? The knee is more sore after pt.  That mainly started the last few days from the massage and dangling.  Tomorrow is six weeks after my fall so I am not too worried. 


Thank you again for your help.

Irish-  my OS wrote me a PT perscription that I took to the PT.  plus, the OS sent over some notes.  The PT even called the OS for some clarification.  My perscription was for agressive ROM :/ and the OS told me to take my pain meds before I went. they didn't really help. It was torture.  But I liked my PT, she had a great personality and I tried to laugh as much as I could.  She pushed my leg to bend and yes it hurt.  I had a lot of scar tissue.  My X-rays showed my break was healed before I started PT.

The dangling of the leg seems normal and is a good way to gain ROM with a minimal amount of pushing.  I would put my other foot on top of my bad leg's foot and push down on my leg because my leg just stuck out there.  Are you saying that your leg will bend down and your foot will touch the floor when you are sitting in a chair?  That seems very good.  The heel slides on the bed are a good exercise. 

It's too bad you OS wasn't clearer on the Perscription....  A good PT wants to follow the OS.  Mine would not do strength training until it was approved by my OS and that was at the end.

Welcome Hockey!  I've seen a couple of people post similar agressive treatments as yours and I freaked out at the first one I saw who was starting PT very early with no hardware to hold together, but so far so good.  I think they had quick recoveries and posted here a couple of times and were gone.  It would be good if they would come back and post an update as to how they are doing.

Thanks for the updates!  Irish-  good luck with you appts.  It's frustrating to have to depend on others to get everywhere.  I went to PT 3x a week for almost 12 weeks and couldn't drive for 4 of those weeks.  I actually paid an aquaintance to take me 2x week and a friend took me the other day. 

Take Care and keep us posted!  Hopefully X-rays will show you are healed or very close.

Wow!! Thank you both for responding. I am feeling much better.  I know that I do trust my doctor and PT.

I was in so much pain after dangling because I didn't know I was supposed to relax my leg and so the muscles in my thigh hurt so bad on Thursday. But, I still went to PT and the doctor. The knee didn't hurt but my thigh was so painful.

I could tell a huge difference in the new x-ray. The bone is "filling in" well and the doctor said I am doing great.  He said I have "no restrictions" for PT and that I can return to work. Not sure about that on a walker. I may wait to get a bit stronger.

I feel a lot more relaxed and understand that it's normal to have pain, even in the knee cap area. I have to say I am lucky to not have to have surgery. I'll keep you all posted and comment to others on here going though the same thing.

Thank you!!!

Hey Irish
My PT office uses the TENS device. I asked about the h-wave and she told me is it was a very similar device that produced a different type of electrical wave that some believe produces better results. It is similar in that it acts to block pain to help increase range of motion. I have been offered the use of the TENS unit, but have not tried it, as I'd actually rather feel the pain and forcre myself to work through it. However, it sounds like you're level of pain is much higher than mine, so it may be very effective for you.

I'm not sure what your PT routine is at the therapist or at at home, but I make sure my knee and thigh/calf muscles are warmed up and stretched prior to working on ROM. I'll do a few reps of stretches and strength exercises, then slowly work in ROM. When I'm fully warmed up I lay on my back and using a rope looped around my foot I'll pull the heel back as far as I can (2 sets of 25 reps). The difference in doing this cold and doing it warmed up is about a 10 degree increase when warmed up, and considerably less pain. You can experiment doing it cold and warmed up and see the difference. Hope this helps a bit.