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Author Topic: 31/M patella fracture. How long until returning to running/riding/surf/snow etc?  (Read 717 times)

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Offline alessio_db

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Hi there people! I've just recently come across this site after spending hours net researching patella fractures and recoveries and the like, so hopefully have come to the right place for some advice - for info I'm a 31yr/M. I recently (about 2 weeks ago) fractured my patella (comminuted 3 part) at a local skatepark, falling down onto my knee against the hard concrete while trying to re-enter from the top of a small quarter pipe ramp. I'm not sure what I was thinking trying to go skating after about a 10yr hiatus from the sport, but it seemed like a good thing at the time - obviously the body didn't quite respond to what my mind thought it could.

I went straight to ED that morning and managed to get booked into an operation that afternoon (which meant I had to cancel my trip to Bali for a friends wedding which I was meant to fly out that night - the wife wasn't too impressed). I believe I had ORIF with k-wire and tension band to pull the pieces back together. Following the op the pain wasn't actually that bad, but maybe that was due to the nurses doing a great job and giving me pain meds nice and early into the piece. I was discharged the following morning, with notes for FWAT and given elbow crutches and placed in a full leg splint (richards splint). The visiting PT told me to just start doing isometric quad muscle tensions to keep it active.

So now I'm about 12 days post-op (went in on 4th May) and have been keeping up with the quad exercises and using the crutches when I'm out of the house, though I find that I can fully weight bear on the leg and can walk around without crutches at all (albeit at a very slow pace, as basically walking with a locked leg which I have to swing from my hips). Sleeping is a pain but I tried a pillow between my legs last night and that worked wonders. I have my post op review tomorrow where I'll get a hinged knee brace and then the surgeon can tell me how its progressing (hoping some healing is happening and I haven't stuffed it by being too mobile).

To the point, I'm just wondering what the recovery from this injury will be like? I'm actually getting married in about 6 weeks time, in Italy (I'm in Australia) so I'd love to be in some sort of better shape by then - hopefully be able to stand without a brace for the important bits (for photos!) and then bracing it when the music gets louder. I am a keen runner and road biker, quite often going for 6-8km runs and 30-40km rides. I've also done a few triathlons in the past (HIMs - latest was about a 4:30) and did run a marathon once (did a 3:03) but would like to one day try get under the 3hr mark. I also do surf when I can find time, and was planning on a snowboarding trip at the end of this year/early next. I'm just wondering whether any of these past hobbies are still possible and when I'd likely be able to return to any previous ability? Has anyone had experiences with similar injuries and return to these type of sports?

FYI I've previously had an ACL reconstruction in the same knee about 10 years ago (ruptured it playing indoor soccer - operation was a patella tendon autograph), but my recovery from that was actually very good and I was running 6wks after the op, and at 8wks was running up to 8kms. I realise that this bone injury is different than a ligament injury, but I wonder if I can have a similar sort of success as I had with the ACL. I've got naturally pretty big/defined quads, so hoping these could help with the recovery.

Thanks in advance for your responses, it seems like there is a mountain of info on this site so I'm sorry if this is covered elsewhere, it just feels nice to put your own story out there and get heard!

Cheers
Alessio
« Last Edit: May 18, 2018, 04:37:28 am by alessio_db »

Offline reflex_nl

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bad luck... just a simple incident. A broken patella needs time, but there is a good outcome in many occasions, but it will take time, at least a year.

Your young an hopefully the cartilage is still ok. The first milestone is at about 12 weeks... be very careful not to overdo stuff.  Goodluck and try to read some stories on the recovery on this website; there are many broken patella's.
RK Patella Luxation in 2000
RK Scope grade 2 damage to patella
RK PT for 4 mths, recovered 90% after 4 years
LK Patella Luxation in Oct'16
LK Scope to remove loose bodies (grade 4) to patella Nov'16
LK Lateral Release + MPFL Reefing + MCIC in the UK Dec'17

Offline alessio_db

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Yeah a Ďgreatí return to a previous past time that lasted about 10mins! Makes knee pads and safety gear look ever so much more enticing.

I had my 2wk post op review last week, which they said from the X-rays looked good so far (well the wires and pins were doing their job) and they changed me over to a hinged knee brace from the splint - much more comfortable. Am at 0 degrees for the next 2 wks then 30 degrees increase every 2 weeks after that.

Canít believe how much leg mass Iíve lost already in 3 weeks, I think Iím already down 3kg!

From what Iíve read it sounds like a slow recovery but does sound promising about returning to previous activities, just will require diligent PT and a strong will.

Offline MasterForte

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Keep your head up, brotha. You got this.

It's crazy how fast muscle begins to deteriorate after an injury, but you'll get it back to where it was in no time. Do push that knee, but don't overdo it. Listen to your body when it tells you too much is too much otherwise you will only prolong your recovery. You are young and will be back to where you were in time. I'm happy to hear things are progressing well so far, and congrats on the upcoming wedding!

Offline Tortor373

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Itís been six months for me and quite funny I had to get married after my accident too. But I can walk I can still ride moto very carefully riding a sport bike is out of the question and I canít run. And the pillow between the legs. Yea you will do that for the rest of your life. The best way to describe he pain is like getting a shot in the knee. Repeatedly with every step. Itís not. Terrible but itís annoying and you try different steps to get it to stop. Thatís on a good day. A bad day I canít even walk without some form of support. From what Iíve read every situation is different though. You might not have any pain at all. Either way I hope you have a better recover then I am. I will never be able to skate bike run again so Iím actually considering amputation. I actually just made a post to see if anyone has any ideas as well.

Offline Geronimo

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see if your PT can prescribe you  some exercises, not wasting your quads is your goal for now imho, trust me, it's hell of a job to build quads back when your patella can't stand pressure. google PTFS exercises, i suppose they should work for you.

Offline alessio_db

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Thanks all for the responses so far!

Have been back at work the last two weeks, restricted to the office and not going on site (I work in construction as an engineer). A bit limiting but itís good to get out of the house! I also had my bucks last weekend, which I thankfully survived and the knee held up pretty well as well (did my brace up nice and tight), albeit swelling had increased by the end of the day/night.

Iíve just set the brace to 30deg ROM a couple of days ago according to my OS recovery schedule, and while initially getting it to bend to that 30 deg was feeling quite tight itís actually feeling much better today. Iím also trying to get my walking gait to a more normal pattern with the increased ROM - Iím walking very slow around the place but with no crutches - I still bring them out on the street for longer walks just for extra safety support as Iíd hate to accidentally step wrong and put too much pressure on the knee.

Seems like the atrophy has levelled off and I havenít really dropped any more weight. The quad exercises feel better now and while Iím not yet confident to do straight leg lifts Iím attempting partial leg straighting lift exercises - feels like Iíll rip my patella tendon off when I try tho!

Just thinking towards the future - weíre going to mexico for our honeymoon, where originally I had intentions of going diving and the like (swimming, snorkelling etc) - that will prob be around 4-5 weeks from now (8-9 weeks post op) so wondering whether these activities are out the window or I could still get away with some gentle swimming? Would the kicking activities be out until say the 12 week mark? And say walking on the sand at the beach be also pretty difficult?

Offline Geronimo

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if possible i'd try this in a pool and see if your knee will like it or not, if not - you  still have some time to adjust your plans. mexico has plenty of things to do even if you  don't involve diving.

Offline alessio_db

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Thought Iíd give an update on progress. The last 2 weeks Iíve been at 30deg ROM on the brace, and have been noticing movement getting better every day (although it sucks wearing the brace over pants for work!).

Am now 6 wks out from surgery, and had my 6wk review with the OS today at the outpatient clinic. X-rays showed good bone healing/knitting, and then when I saw the OS he was very pleased - he checked my ROM out of the brace and I was close to 90deg, so he said weíll put the brace onto 90 (was on 30deg previously) and with the goal to wean out of the brace over the next 1-2 wks. Pretty progressive but he said everything was looking good and the goal was to get moving and full ROM back. Also said I could start Physio, and that weíd do another checkup in about 8 weeks to see how it was going (and check on hardware as mine is a bit prominent).

I also checked in with my usual Physio tonight who has really said the same things as the OS - main goals now are to get as much ROM back as possible (passive not quite active yet), and to focus more on that rather than muscle regrowth for the moment as no use having the muscles with no movement.

So yeah all in all it was the news I was hoping for, and had given me a good outlook for the future. I know itís going to be tough getting back to normal, but itís always good to have some positive reinforcement from the people that are around this stuff every day.

Both the OS and the Physio said thereís no reason why I canít go on a ski/snowboard end of this year/early next. Hereís for hoping anyway!

Offline alessio_db

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Quick update as I wait to fly out for the wedding - itís been great actually walking around a bit more normally without the brace! Out in public I put it back on but Iíve been trying to follow the OSís advice and Ďweaní out of it.

ROM wise at the PT last Thursday I was barely at 90, but the day after was hitting 95, and I think every day since then Iíve increase about 10deg. Today I reckon I got pretty close to 135! Though that was after a few exercises and some helping self massage on the muscles. I feel like I loose a bit of the ROM during the day but if I then sit down and work on it, it comes back.

Straight leg raises are ok, but sometimes painful, sometimes not. Trying to do it all slowly as can feel my leg is quite weak. The PT also told me to slightly rotate my leg when doing a straight leg and focus on the VMO as thatís quite import to activate as well. He even seems to remember when I had my ACL done 10 years back and reckons my leg almost went concave with the muscle loss. Guess that means that it is possible for it to all come back again  ;)

Offline alessio_db

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8wk (plus a couple days) update - I think my ROM is nearly back to normal. This morning I was probably about 5-10deg off the other leg (say about 160/165deg all up). Basically have spent the last 2 weeks in a very hilly Italian town, walking up and down the hills a lot (my fitness watch says one day I clocked up +50 flights of stairs!).

Things are going well, though the knee still throbs a bit at night during sleeping. One of the k wires (I think itís one of them) has both ends pretty prominent, so Iím thinking thatís where the pain is originating from. I also have a bit of clicking going on in the knee, but again I feel like it is the skin rubbing against one of the k wire ends. Bending the knee is fine, itís just a bit painful trying to get it really straight and hold a straight leg raise any longer than 5-10 seconds.

Been trying to do stairs where I can - going up is ok, though still like to grab a handrail for support. Going down is a whole other story, but I can go down if I am definitely holding onto something.

As weíre travelling at the moment we are doing a fair amount of walking - did 18k steps yesterday, and it all felt ok. Not 100% but not bad in any sense. Had a few wobble moments but I think that is because the muscles are not firing in the right sequence and are atrophied - hopefully all comes back soon. The knee does feel weird though, like you can feel with the tension band that itís just not natural - maybe itís because itís putting a different loading into your knee (ie compression vs usual tension).

Anyway not sure who is reading this, but just posting to keep track of progress and if anyone else wants to share their experiences 👍
« Last Edit: July 02, 2018, 08:17:28 pm by alessio_db »















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