Advertisement - Hide this advert





Author Topic: Patella Fracture - For The Athlete  (Read 460 times)

0 Members and 1 Guest are viewing this topic.

Offline caseam

  • MICROgeek (<20 posts)
  • *
  • Posts: 10
  • Liked: 0
Patella Fracture - For The Athlete
« on: May 16, 2018, 07:15:27 PM »
I have decided to start a new thread on this due to the fact that everything I was reading either A) Involved the 50+ year old population, B) Had something negative associated with it, and C) Was out dated.

I wanted to take this opportunity to share my on-going journey and will continue to update as time goes on. I hope that this thread will live on for the coming years and provide helpful insight for the injured high performing athletes that have been plagued with this injury (FYI Kyrie Irving broke his patella in the 2015 NBA season with the Cavaliers). This injury is not for the faint hearted nor the weak minded, but since you are already an athlete I’m going to assume you are not among the vast population that is. If you are not a patient person, you will very quickly become one due the nature of this injury. Tough times don’t last, tough people do.

Background:

I just turned 25. I played 4 years of college lacrosse and never once had an injury I couldn’t play through. I grew up playing soccer, lacrosse, snowboarding, riding dirtbikes, and consistently went to the gym 6-7 days a week for about 4 years now. And yes I was consistent with leg days – could squat 315 for reps. I graduated in 2016 & started working as a field engineer where I would be walking on average 4-5 miles per day.

The injury occurred on 02/18/2018 at Mountain Creek ski area in New jersey. I fell into a steel post in the terrain park while snowboarding where I hit my patella perfectly on the rail. I immediately went down and knew I was done. I then had a 3 hour car ride back to Binghamton, NY where I went to the ER, luckily I was with a friend (Shout out to Jordan Smith) and he was able to drive us back. The ski patrol assessed me and though I had dislocated my knee, little did I know…

About 6 hours after I fell they examined my x-rays and broke the news to me: Broken left patella in 2 large pieces (horizontally) and a smaller third piece (upper corner – inner thigh side). They sent me home with 3 Percocet’s and arranged for surgery the next morning where Dr. Tina Maxian would head the operation. She had an undergraduate & MS degree in Mechanical Engineering from RPI along with her PHD from medical school – obviously very smart & so I trusted she would do a phenomenal job. I woke up from surgery where they then put me a hinged knee brace where it would remain locked & immobile for the next 6 weeks. They put two vertical screws, a figure 8 tension wire, and wrapped my knee cap in suture material to hold the smaller piece into position.

The next 2 weeks were miserable. There’s no other way I will put it. Day 2 after the nerve block wore off was an absolute living nightmare. I was sleeping on average 4 hours a night. The hardest part was teaching my leg to NOT use it’s muscles – train it to be a dead leg. So a dead leg it became, and sure enough the atrophy started. I showered every 3 days or so and ate almost nothing as I was not active and had zero appetite. I could not crutch forward what so ever as my quad muscle would flex and send me into tears almost. I learned to crutch backwards where my foot would slide across the floor. I saw my OS at the 2 week mark and it revealed the bone was beginning to heal – my knee was still immobilized. At 3 weeks I was able to manage to get up and move around somewhat at will, my knee was still extremely sore and my foot still had minimal contact on the ground. The next few weeks went by very slow, the withdrawal from percocets was hard for a couple days: I struggled to sleep, I wanted to get up and walk around, and was very irritable. The next few weeks slowly went by – TV got extremely boring. I finally put my mind to use and returned to work at the 4 week mark where I was now behind a desk. I started driving to and from work at 6 weeks. Any drive longer than 20 minutes became very uncomfortable for me.

Week 6: Staying Motivated

I saw my OS at the 6 week mark, there was no muscle left what so ever. She x-rayed my knee and said everything looked good. There was still a large amount of swelling, but she told me I could come out of the brace at the appointment and could begin to go full weight bearing. I was shocked. She then proceeded to tell me to swing my leg over the side of the exam table to see how far I could bend it… My leg was stiff as a board – Literally 0 degrees of mobility. My OS was fairly surprised and told me I would surprisingly need therapy.

The journey began, I started PT the next day after touring nearly every PT place in my area. So I started PT 2 times per week beginning with literally 0 degrees of mobility.

I ordered a goniometer off of eBay to track my knee flexion (along with 2 medical grade ice gel packs), I plotted my progress on a graph and kept a daily log/journal of how things were going. I will attach this graph to the thread of where I am at currently for your viewing pleasure and will continue to update (Week 0 signifies the start of PT, but 6 week post-operation).

I ditched the brace entirely at 7 weeks. I was very protective (still am) and would become extremely nervous in a social setting if I didn’t have it on. My confidence grew.

Week 8-10: Ditching the crutches

There have been some very tough days thus far. Staying motivated and optimistic is a daily challenge. Things like, “will I ever run a 4.5 sec. 40 yard dash again” crossed my mind constantly. Keep a strong mind and remember this is merely a battle within. I started swimming at about 8 weeks post-op and saw tremendous gains in strength & mobility within the first 2 days of swimming. I went to one crutch at 9 weeks and then ditched them entirely at about 10 weeks. It is very important to try and not walk with a limp. You’re body will begin to adapt to you’re limping and cause you further issues. Be extremely methodical in your steps. I spend 15 minutes in the hot-tub/whirlpool before and after each swimming session. Walking lunges, back stroke, freestyle stroke, side stroke, & standing on my injured leg are some of the basic things I started doing in the pool. I spend roughly 1.5 hours in the pool per day. After swimming (followed by the hot-tub) I hop on the stationary recumbent bike for 10-15 minutes. Here I go halfway back and halfway forward until my knee doesn’t bend anymore. I use my good knee to “drive/push” the other knee to get it to bend more – this is pretty painful as well.

Week 12: Learning

I learned a lot about myself the past 3 months. You will learn where your boundaries lie and then you will learn how far you can push them. You will learn what pain feels like, but you will have a great appreciation for how good you also have it. You will meet a handful of strangers who have shared their stories with you – you will be able to relate them. This injury will humble you to the core, I can promise you that.
Currently I am at 65-70 degrees pushing into my knee; my leg sits at about 55-60 degrees hanging off of the bed/chair. I average about 10 degrees more per week. I will continue to push myself at PT and with the swimming in the coming weeks/months. The pool has served a huge physical & mental escape for me. It has helped me start to feel like a young athlete should, putting me in a better state of mind. I also started lifting upper body again using machines only.

Offline Sampson19511

  • MINIgeek (20-50 posts)
  • **
  • Posts: 30
  • Liked: 2
Re: Patella Fracture - For The Athlete
« Reply #1 on: May 30, 2018, 12:27:51 AM »
I read your email and age really has nothing to do with it.  I am 66 and have worked out for over 42 years in the gym and at home.   I did also learn a lot about myself while in a brace on crutches.  I am fairly small but strong and athletic.  By the way I wasn't trying to be negative, just relaying what I have learned this past year and had been told by other PT recently.  I am 14 months post-op same surgery you had without the smaller broken piece.  I always had excellent range of motion a few weeks after brace removal.  I can touch my heels to my butt when standing or lying on side.  My problem is after 14 months of working out my muscles have not responded at all, my surgical leg is 1 to 1.5 inches smaller in circumference than my left leg, which leaves me too weak to snow ski very long, mow an acre of land with a regular mower, inline skate, dance, run with my dog or hike up mountains for 8 to 10 miles.  I have also been in medicine my whole like so I am pretty versed on medical issues. (I am told the patella is the worst bone to break because of damage to meniscus and nerves and onset of arthritis).  I am seeing a new surgeon next week to find out why this is happening.  May have hardware removed.  I was told this could help pain but not help muscle to grow.  My pants don't even fit on that side!  It is not that I am negative but I was told my leg would never be normal again and would never regain the bulk which means I can't be as active as I was.  I was told nerves were damaged during my traumatic injury so muscles are not listening or responding.  Like you, I could not sit in a car for more than 20 minutes without getting out to stretch.  I also was nervous in social settings or shopping, fearing someone would run into me.  I still can't move sideways very fast!  I did snow ski a bit this past winter.  Also met an 85 year old couple who still skiing.  I wish for you a strong recovery.  Let me know how your muscles are responding, not just the quad, but all the other ones.  I have lost muscle from the my hip and butt, down to my ankle, working out like crazy.  so, yes I may sound negative, but I am still working on it and have not given up.  Perhaps the second year of recovery will afford me some relief. 

Offline caseam

  • MICROgeek (<20 posts)
  • *
  • Posts: 10
  • Liked: 0
Re: Patella Fracture - For The Athlete
« Reply #2 on: May 30, 2018, 06:57:54 PM »
Sampson19511,

That sounds like a long road - especially the toll it takes on your mind! Keep me posted on what comes of the near future. I can’t imagine not being able to build muscle back regardless of how much activity. I’m rooting for you

Offline caseam

  • MICROgeek (<20 posts)
  • *
  • Posts: 10
  • Liked: 0
Re: Patella Fracture - For The Athlete
« Reply #3 on: June 15, 2018, 06:54:27 PM »
For everyone's information I sought a second opinion from Dr. John Cannizzaro in Syracuse, NY. He is the primary surgeon for Syracuse University Athletics & is an assistant professor at Upstate Medical. He told me I am suffering from anthrofibrosis & no matter how hard I work it will nearly impossible to get my ROM back in due time. In conclusion, he will be performing MUA & arthroscopic scar tissue removal (4 points of insertion I was told).

FYI the surgeon who performed the initial surgery would not even entertain the idea of MUA & said there was no need for it (This was after scheduling 2 separate visits where I was told "She was too busy for me"). After 15 weeks of not even being at 90 degrees ROM, something had to change...

Offline Sampson19511

  • MINIgeek (20-50 posts)
  • **
  • Posts: 30
  • Liked: 2
Re: Patella Fracture - For The Athlete
« Reply #4 on: June 15, 2018, 07:23:26 PM »
Hi again everyone with patella fracture/surgery!  I also sought a second opinion for another OS.  He said complete opposite of what PT and first OS said.  I am kind of fed up. 
1.   I was told I was working out too hard by PT recently. 
2.  Second opinion from new OS:  He said I was not working out hard enough!
3.  OS who did the surgery 14 months ago does not seem to care about me at all, if I can walk and have full range of motion, than so be it!  This is not good for me.  I want to be strong again and active.
4.  PTs just take your money, not sure they know what they are doing with such an injury of this serious nature. 
5.  PT also told me I had "nerve damage" and that was why my muscles were not responding.  New surgeon said NO nerve damage.
6.  I was told by new I would not get muscle bulk back but could possibly still get strength back if I worked out harder!  Told me to join a gym again!!
7. Radiologist said I have arthritis from accident.  New surgeon said I do not have it.
8.  Told to use my STIM unit also which does not help.

What is a person to believe anymore.  I have worked out over 43 years.  I snow ski, do aerobics, lift weights, whole body workouts 3 times a week at home and at gyms.  I do every exercise in the book and rotate them weekly.  I also mow a fairly hilly one acre with a regular mower!  I inline skate and hike up mountains.  SO HOW CAN I WORKOUT HARDER!  So now I am just going to listen to my body.  I will do my workouts and add extra knee muscle workouts that I have printed from OS and info online.  I have heard it can take 2 years go get full recovery, who knows!   As far as range of motion for those of you that can't get it to be 100%l, they say some people can get to 90 and that is just fine for most.  Because I have worked out my entire life I had 100% ROF almost since brace was discontinued.  I wish everyone a full recovery.  I am sad and miss being active but have not given up.  I did break down and get a riding mower recently (hate it)! S