KNEEtalk

The SPECIALIST'S OFFICE => Bone breaks around the knee => Topic started by: tophercfh on May 31, 2014, 11:50:10 AM

Title: Cycling Patella Fracture.
Post by: tophercfh on May 31, 2014, 11:50:10 AM
Hey guys! On 17 Apr, I was involved in an RTC, leading to a vertical, nondisplaced patella fracture. Unlike most I see on here, I wasn't required to undergo surgery, I have just been in fibreglass casts since it happened. I am walking and putting a little weight on the leg now, with the assistance of crutches, but can walk small distances if necessary without. I'm getting my cast off for the final time on 3 Jun, and am wondering what's next. Mainly, my questions are a) How long is recovery typically for someone who hasn't had surgery compared to someone who has, and b) how long should I leave it before I get back on my bike? I am a keen cyclist, and was cycling a good 30 mile round trip to work every day. Thanks for reading!
Title: Re: Cycling Patella Fracture.
Post by: charlottekatt on June 02, 2014, 05:25:25 PM
I'm strictly a short distance commuter cyclist (3 miles round trip).  But it was my only form of transportation (well, aside from 2 feet) prior to the pavement attacking my knee (NOT bicycle related).  Bicycling was one of my first questions to my Ortho-doc.  And, he cheerfully assured me that I'd be seeing a bike in physical therapy, and that he strongly recommended cycling for his knee patients.   It was a good month and a half, however,  before he let me do any bending of my knee. 

I went ahead and borrowed a bicycle training stand and set my bike up on it, waiting for my PT to say I had enough ROM to attempt using it.  He start putting me on a recumbent (sp)  bike for warm-ups  before I had enough ROM to pedal a standard bike.   As soon as I reached the 110  mark, I reached a bit of a sticking point (PT thinks I had some adhesions that needed to be broken loose) Anyhoo...you can look below to see my progression kind of sped up once I was able to pedal my own bike on the stand.

I tried my first ride to work yesterday.    Made it most of the way (shifting into easier and easier gears for the mildly hilly parts of the ride).  I did end up having to walk up the "killer" hill ...and I can't stand and pedal yet.  Oh, and that one-legged "wait at a stoplight" stance gets real wobbly after the 1 minute mark.  I am making progress even though I feel about as strong (Okay, pathetically weak) as the first day that I tried cycling to work.  Have A LOT of leg strength to build. But will get there.

Make sure that your doc and your Physical Therapist know that your goal is to cycle ....they'll tailor some of your exercises towards that....
-------------------------
2/23/14 - Fractured Patella - Transverse/Displaced - Immobilized
2/25/14 - Doc appt, surgery scheduled
3/4/14 - ORIF  - 2 pins, Tension band - cylinder cast NWB
3/11/14 - Follow-up - NWB
3/21/14 - Cast off.  ROM Brace locked in full extension - NWB
4/4/14 - Brace, Full extension - NWB 70% healed
4/11/14 - Physical Therapy start - 38 ROM
4/14/14 - 48 ROM
4/17/14 - 60 ROM
4/21/14 - 78 ROM
4/24/14 - 90 ROM
4/25/14- Doc appt, w/wean from brace instructions/wean from crutches instructions
4/28/14 - 105 ROM
5/1/14 - 110 ROM
5/5/14 - 112 ROM
5/6/14 - Started bike trainer (10/15 min/day)
5/08/14 - 120 ROM
5/12/14 - 125 ROM
5/14/14 - 130 ROM
5/19/14 - 137 ROM - started walking home from work (1.5 miles)
5/25/14 - 4 mile bike ride (flat)
5/27/14 - 142 ROM
Title: Re: Cycling Patella Fracture.
Post by: daihard on June 27, 2014, 01:23:34 AM
Hi.

I just had a fractured patella on the weekend. Saw my orthopedic surgeon this afternoon to discuss the details of the injury. The surgery has been scheduled for next Wednesday (July 2).

I too am an avid cyclist who puts in about 300 miles a month. Naturally, my greatest concern is how soon I will be able to get back in the saddle. My OS told me it would be a good 3 months. @charlottekatt's post seems to agree with that. I at least have a ballpark figure.

Wish me luck. :)
Title: Re: Cycling Patella Fracture.
Post by: Cassaroles on June 27, 2014, 02:52:24 AM
GOOD LUCK!!!  This board is a great resource, with some really supportive empathetic folk on here.  And welcome to the club.   :D
Title: Re: Cycling Patella Fracture.
Post by: daihard on June 27, 2014, 03:08:33 AM
GOOD LUCK!!!  This board is a great resource, with some really supportive empathetic folk on here.  And welcome to the club.   :D

Thank you! Already want to start PT, and I haven't even had the surgery done. :D
Title: Re: Cycling Patella Fracture.
Post by: Cassaroles on June 27, 2014, 03:15:34 AM
hahah!  I was the same way!  Sounds like you're a determined mofo - good quality to have for a successful recovery.  Though employing patience will be essential.  Keep us posted!!
Title: Re: Cycling Patella Fracture.
Post by: charlottekatt on June 30, 2014, 06:08:14 PM
Just a quick "one month further on" update --  cycling is wayyyy easier -- can feel my left leg taking on more and more of the work every day.  Getting out of the saddle to peddle up an incline is not a possibility yet, but I think I'm close.  PT guy says that's almost 100% quads and will come naturally.  Anyhoo.... I'm not having to get off the bike to tackle the "killer hill" any more .... (tho I'll be d****d if I'm going to stop at the stop sign halfway up it unless there's a police car in back of me.) And, leg isn't wobbling like jelly at long (non bicycle friendly) traffic lights.   
Title: Re: Cycling Patella Fracture.
Post by: daihard on June 30, 2014, 06:12:53 PM
Just a quick "one month further on" update --  cycling is wayyyy easier -- can feel my left leg taking on more and more of the work every day.  Getting out of the saddle to peddle up an incline is not a possibility yet, but I think I'm close.  PT guy says that's almost 100% quads and will come naturally.  Anyhoo.... I'm not having to get off the bike to tackle the "killer hill" any more .... (tho I'll be d****d if I'm going to stop at the stop sign halfway up it unless there's a police car in back of me.) And, leg isn't wobbling like jelly at long (non bicycle friendly) traffic lights.
That sounds great! How long has it been since the surgery? I'm having my surgery on Wednesday and want to know roughly how long it would take me to get back in the saddle. I know it depends a lot on individuals, but if you wouldn't mind letting me know, that'd be great.
Title: Re: Cycling Patella Fracture.
Post by: charlottekatt on June 30, 2014, 07:26:45 PM
DH -  whoops sorry, didn't put the blurb at the bottom of the last post -- surgery was 3/4/14.  Soo... yes, it takes a while..but I was immobilized for a bit longer than average, I believe. 

----------------
2/23/14 - Fractured Patella - Transverse/Displaced - Immobilized
2/25/14 - Doc appt, surgery scheduled
3/4/14 - ORIF  - 2 pins, Tension band - cylinder cast NWB
3/11/14 - Follow-up - NWB
3/21/14 - Cast off.  ROM Brace locked in full extension - NWB
4/4/14 - Brace, Full extension - NWB 70% healed
4/11/14 - Physical Therapy start - 38 ROM
4/14/14 - 48 ROM
4/17/14 - 60 ROM
4/21/14 - 78 ROM
4/24/14 - 90 ROM
4/25/14- Doc appt, w/wean from brace instructions/wean from crutches instructions
4/28/14 - 105 ROM
5/1/14 - 110 ROM
5/5/14 - 112 ROM
5/6/14 - Started bike trainer (10/15 min/day)
5/08/14 - 120 ROM
5/12/14 - 125 ROM
5/14/14 - 130 ROM
5/19/14 - 137 ROM - started walking home from work (1.5 miles)
5/25/14 - 4 mile bike ride (flat)
5/27/14 - 142 ROM
Title: Re: Cycling Patella Fracture.
Post by: daihard on July 01, 2014, 12:59:51 AM
DH -  whoops sorry, didn't put the blurb at the bottom of the last post -- surgery was 3/4/14.  Soo... yes, it takes a while..but I was immobilized for a bit longer than average, I believe. 

----------------
2/23/14 - Fractured Patella - Transverse/Displaced - Immobilized
2/25/14 - Doc appt, surgery scheduled
3/4/14 - ORIF  - 2 pins, Tension band - cylinder cast NWB
3/11/14 - Follow-up - NWB
3/21/14 - Cast off.  ROM Brace locked in full extension - NWB
4/4/14 - Brace, Full extension - NWB 70% healed
4/11/14 - Physical Therapy start - 38 ROM
4/14/14 - 48 ROM
4/17/14 - 60 ROM
4/21/14 - 78 ROM
4/24/14 - 90 ROM
4/25/14- Doc appt, w/wean from brace instructions/wean from crutches instructions
4/28/14 - 105 ROM
5/1/14 - 110 ROM
5/5/14 - 112 ROM
5/6/14 - Started bike trainer (10/15 min/day)
5/08/14 - 120 ROM
5/12/14 - 125 ROM
5/14/14 - 130 ROM
5/19/14 - 137 ROM - started walking home from work (1.5 miles)
5/25/14 - 4 mile bike ride (flat)
5/27/14 - 142 ROM

Thanks again! I assume NWB means no weigh bearing on your injured leg. Does it mean you weren't even allowed to stand on both feet while your knees were completely straight? I can currently do that and even walk slowly with no crutch as long as I have my brace on and don't bend my bad knee without feeling any pain. The ER doctor never told me I must not do that either, but your log makes me wonder if I'm doing something I'm not supposed to be doing?

Dai
Title: Re: Cycling Patella Fracture.
Post by: charlottekatt on July 01, 2014, 01:38:33 AM
Nonweight bearing, yes...after surgery all the way to my first PT appt.   In my case it was defined as "toe touch for balance only."    I have osteopenia bordering on osteoporosis...and the doc wanted to make sure there was no chance of the the hardware shifting in what he said was "mushy" bone. 

 


Title: Re: Cycling Patella Fracture.
Post by: daihard on July 01, 2014, 05:35:48 AM
Nonweight bearing, yes...after surgery all the way to my first PT appt.   In my case it was defined as "toe touch for balance only."    I have osteopenia bordering on osteoporosis...and the doc wanted to make sure there was no chance of the the hardware shifting in what he said was "mushy" bone.

Thanks again! My OS (orthopedic surgeon) did tell me that the pins and wires they'd use on me might move during the recovery period, which may or may not be an issue depending upon how. I got a fractured wrist back in February and had a surgery followed by 2 months of no bike riding, but the wrist has healed well. I hope my knee does as well.
Title: Re: Cycling Patella Fracture.
Post by: fsugirl on July 02, 2014, 03:08:58 PM
You know, I hadn't really thought about it, but...  I, too, was able to (and did) walk straight-legged pre-surgery - even when I initially went to the hospital.  As you mentioned, DH - as long as it didn't bend, I was fine; however, the slightest bend caused the most excruciating pain!

My recovery was much longer (again, it's different for everyone), but I was in an immobilizer for 6 weeks as well.  I think my long recovery is less common, if that helps.
Title: Re: Cycling Patella Fracture.
Post by: fsugirl on July 02, 2014, 04:01:29 PM
Oh and.... Good luck with your surgery today!!  Here's to quick healing and recovery!!!
Title: Re: Cycling Patella Fracture.
Post by: daihard on July 03, 2014, 03:16:44 AM
Oh and.... Good luck with your surgery today!!  Here's to quick healing and recovery!!!

Thank you! Had a successful procedure this morning. They bound the patella together with wires. I don't recall the OS telling me she was going to use pins, but I'd imagine she did. Anyway, came out around 9 AM (yes, it was an early morning one) and spent a couple of hours in the recovery room. Somehow the pain was exuberant - I never experienced anything like that. The nurse said it was on the bone. Took the pain med, managed to get dressed (with help of wife and nurse) and came home around noon. Took more pain med and dozed off for a few hours.

Fortunately, the pain wasn't nearly as bad when I woke up in the early evening. I have soreness now coming from the incision, but it is manageable. Whew. :)
Title: Re: Cycling Patella Fracture.
Post by: Cassaroles on July 04, 2014, 01:43:18 AM
Congrats on a successful surgery.  One word of advice...get in front of the pain with your pain meds and stay there.  Not sure they used a nerve block or not, but they do with a lot of people and when that wears off watch out!!!  It was the most pain I've ever felt in my entire life.  After about 4 days I was able to get off pain meds, but in the first 3 days it can get pretty bad. 

GOOD LUCK and keep us posted!!
Title: Re: Cycling Patella Fracture.
Post by: daihard on July 04, 2014, 01:55:11 AM
Congrats on a successful surgery.  One word of advice...get in front of the pain with your pain meds and stay there.  Not sure they used a nerve block or not, but they do with a lot of people and when that wears off watch out!!!  It was the most pain I've ever felt in my entire life.  After about 4 days I was able to get off pain meds, but in the first 3 days it can get pretty bad. 

GOOD LUCK and keep us posted!!

Thank you!

About the pain, I've learnt it the hard way. Yes, they used local anaesthesia on my knee. I was relatively comfortable in the evening after the surgery, so I didn't bother to take additional dose of Hydrocodone before I went to bed. I definitely should have! :)

Did you take two doses at a time when the pain was merciless? I've only been taking one at a time so far, but it's only because that's what the prescription says.
Title: Re: Cycling Patella Fracture.
Post by: Madyakker on July 04, 2014, 11:03:05 PM
Oh yes I remember that pain! I was kept in for 4 days after the op but the pain was truly awful in those first 2 days. Unfortunately I tend to pass out when I get a lot of pain and my blood pressure drops right down. The poor nurses had to wheel out an ancient blood pressure machine since the digital machines couldn't measure my blood pressure as it was so low!
As a word of warning though, do be careful with self medicating when you get home. Looking back I should have got my husband to do it but I thought I was fine.  In the hospital I had been on maximum doses of tramadol and just continued with them when I got home. However I didn't realise how confused I was in the first week home and ended up taking an overdose in error (Thought 4 hours had passed and only 1 hour had passed. My husband was out so my poor kids had the joy of phoning the emergency doctors system on Christmas eve and checking me for symptoms since I couldn't even get out of bed to get to the phone. I felt so stupid and useless)
Title: Re: Cycling Patella Fracture.
Post by: daihard on July 05, 2014, 06:18:35 AM
As a word of warning though, do be careful with self medicating when you get home. Looking back I should have got my husband to do it but I thought I was fine.  In the hospital I had been on maximum doses of tramadol and just continued with them when I got home. However I didn't realise how confused I was in the first week home and ended up taking an overdose in error (Thought 4 hours had passed and only 1 hour had passed. My husband was out so my poor kids had the joy of phoning the emergency doctors system on Christmas eve and checking me for symptoms since I couldn't even get out of bed to get to the phone. I felt so stupid and useless)

I've been trying not to take the pain med too much. Constipation is my No 1 enemy. I'm on Day 3 since the surgery and I've only had to take one Hydrocodone the whole day. Looks like I will be able to dispense with it from tomorrow on.
Title: Re: Cycling Patella Fracture.
Post by: Madyakker on July 05, 2014, 06:08:48 PM
Its good that you are on lower doses now. Are you taking anything for the constipation? I was given a lot with the tramadol and did end up feeling quite sick for the first 2 weeks when nothing was moving until they kicked in. I think lying down a lot doesn't help. How much are you up out of bed now?
Title: Re: Cycling Patella Fracture.
Post by: daihard on July 05, 2014, 06:27:33 PM
Its good that you are on lower doses now. Are you taking anything for the constipation? I was given a lot with the tramadol and did end up feeling quite sick for the first 2 weeks when nothing was moving until they kicked in. I think lying down a lot doesn't help. How much are you up out of bed now?

I haven't gone out since the surgery, but I've been walking inside the house since Day 2. When I lie down, I typically sit in an Ekornes reclining chair throwing my legs on the ottoman. I make a habit of standing up and walking a bit every half hour or so. I take stool softener to fight constipation, but it doesn't seem to help much. My stool is pretty stiff, causing me to try very hard to do my business each morning. (Apologies if you didn't want to read such details.) Now my worry is that, as I posted in another thread, my excessive bathroom effort, which puts some force on the injured leg, might cause the repaired patella to break away again. I hope the wires are strong enough...
Title: Re: Cycling Patella Fracture.
Post by: Madyakker on July 05, 2014, 10:45:59 PM
It sounds as if you are pretty active compared to how I was so that will be helping. I think it is just a question of waiting until your body clears enough of the drugs to function well again. When I had the same problem I was lucky and my parents came to visit and fed me a constant diet of very small meals (lots of vegetable soup and fruit) eaten often. The regularity seemed to help kick start my system again and meant that I started to regain my appetite which I had completely lost during my 2 weeks in hospital. Hope this helps.
Title: Re: Cycling Patella Fracture.
Post by: daihard on July 07, 2014, 12:43:31 AM
It sounds as if you are pretty active compared to how I was so that will be helping. I think it is just a question of waiting until your body clears enough of the drugs to function well again. When I had the same problem I was lucky and my parents came to visit and fed me a constant diet of very small meals (lots of vegetable soup and fruit) eaten often. The regularity seemed to help kick start my system again and meant that I started to regain my appetite which I had completely lost during my 2 weeks in hospital. Hope this helps.

You are right. My system started to work last night - literally all of a sudden. It's still not as good as usual, but I feel much better now. The incision is still a bit sore from time to time, but other than that I feel no pain. I've been off Hydrocodone for about 30 hours.
Title: Re: Cycling Patella Fracture.
Post by: Cassaroles on July 10, 2014, 01:20:51 PM
By now, you're way past all this and are bored out of your mind ---  ;)

I should have also warned you of the constipation situation.  I had such a terrible reaction to the hydrocodone as well and was anxious, constipated and threw up like crazy on the 4th day.  Hope you got through all of that ok... 

No worries about the hardware moving around.  I worried I'd shift the bone out of place as well, one time the elevator gate hit my leg and I swore it all broke again...but apparently that hardware will keep it in pretty good.  Everything turned out fine.

Just get some good TV going and wait until PT.  Keep us posted!
Title: Re: Cycling Patella Fracture.
Post by: daihard on July 11, 2014, 10:39:28 PM
By now, you're way past all this and are bored out of your mind ---  ;)

I should have also warned you of the constipation situation.  I had such a terrible reaction to the hydrocodone as well and was anxious, constipated and threw up like crazy on the 4th day.  Hope you got through all of that ok... 

No worries about the hardware moving around.  I worried I'd shift the bone out of place as well, one time the elevator gate hit my leg and I swore it all broke again...but apparently that hardware will keep it in pretty good.  Everything turned out fine.

Just get some good TV going and wait until PT.  Keep us posted!

Just came back from the follow-up appointment with the OS. She says the X-ray looks pretty good, with the back surface of the patella looking smoothly flat. I am going back next week to remove the stitch. She was going to do it today as well, but my incision hadn't healed enough. No X-ray next week... she says I will start gentle PT at the end of the 4th week after the surgery. That's 3 more weeks. TV will be my friend. Tour de France and the World Cup! :)
Title: Re: Cycling Patella Fracture.
Post by: daihard on July 15, 2014, 06:53:26 PM
Nonweight bearing, yes...after surgery all the way to my first PT appt.   In my case it was defined as "toe touch for balance only."    I have osteopenia bordering on osteoporosis...and the doc wanted to make sure there was no chance of the the hardware shifting in what he said was "mushy" bone.

I just saw your updated signature that said you'd graduated from PT on the 7th. Congrats!
Title: Re: Cycling Patella Fracture.
Post by: charlottekatt on July 16, 2014, 12:49:04 AM
Ahh Thank-you!  Now, the wait to see the last insurance statement from doc, hospital, and PT.   

note:  graduated, but left holding a sheet of 14 exercises to keep up with and the advice... "when they get too easy, increase the reps or increase the weight"   :o
-------------------------
------------------------
2/23/14 - Fractured Patella - Transverse/Displaced - Immobilized
2/25/14 - Doc appt, surgery scheduled
3/4/14 - ORIF  - 2 pins, Tension band - cylinder cast NWB
3/11/14 - Follow-up - NWB
3/21/14 - Cast off.  ROM Brace locked in full extension - NWB
4/4/14 - Brace, Full extension - NWB 70% healed
4/11/14 - Physical Therapy start - 38 ROM
4/14/14 - 48 ROM
4/17/14 - 60 ROM
4/21/14 - 78 ROM
4/24/14 - 90 ROM
4/25/14- Doc appt, w/wean from brace instructions/wean from crutches instructions
4/28/14 - 105 ROM
5/1/14 - 110 ROM
5/5/14 - 112 ROM
5/6/14 - Started bike trainer (10/15 min/day)
5/08/14 - 120 ROM
5/12/14 - 125 ROM
5/14/14 - 130 ROM
5/19/14 - 137 ROM - started walking home from work (1.5 miles)
5/25/14 - 4 mile bike ride (flat)
5/27/14 - 142 ROM
7/7/14 - 150 ROM - Graduated from PT
Title: Re: Cycling Patella Fracture.
Post by: daihard on July 16, 2014, 02:01:27 AM
Ahh Thank-you!  Now, the wait to see the last insurance statement from doc, hospital, and PT.   

note:  graduated, but left holding a sheet of 14 exercises to keep up with and the advice... "when they get too easy, increase the reps or increase the weight"   :o

I'm looking forward to the day when I can start PT. :)

For my future reference, how often did you go to the therapist's office? I'm torn between two PT offices - one near home and one quite a bit further. The latter requires driving, which I don't think I'll be able to do for another while, but I'd prefer going there because they are directly affiliated with the surgeon's office.

Thanks!
Dai
Title: Re: Cycling Patella Fracture.
Post by: charlottekatt on July 16, 2014, 12:46:59 PM
My prescription for PT was for  2 - 3 visits a week (at the PT's discretion).  I think I only did the 3 visits a week once and that was because the PT was needing to take some time off the following week.  Can't give any advice on the driving - I'm firmly stuck in the 1800's transportation-wise! Handicap transport is a blessing tho (usually available free if where you live has a public transportation system).
Title: Re: Cycling Patella Fracture.
Post by: mjeffrey on July 16, 2014, 08:31:09 PM
Hi Daihard
I had my PT at home for the first 6 weeks, you should definitely ask if will they do that. It was only a few euros more expensive and the PTs didn't mind, most of their patients can only come in the evening, with me they could come anytime that suited them, I was there all day :).
p.s. ask what exercises you should do on the non-PT days. Mine had me doing exercises 3 times a day.

Hope you are at least getting to see the tour :)
Title: Re: Cycling Patella Fracture.
Post by: daihard on July 17, 2014, 12:52:55 AM
My prescription for PT was for  2 - 3 visits a week (at the PT's discretion).  I think I only did the 3 visits a week once and that was because the PT was needing to take some time off the following week.  Can't give any advice on the driving - I'm firmly stuck in the 1800's transportation-wise! Handicap transport is a blessing tho (usually available free if where you live has a public transportation system).

Thanks. I'm not one to drive willingly, but the location of the PT associated with the clinic is so inconvenient, taking the bus there wouldn't be viable. I should look into ride-share services such as Uber, who operates in this area. I wouldn't mind paying them 1-2 times a week. :)
Title: Re: Cycling Patella Fracture.
Post by: fsugirl on July 17, 2014, 06:14:52 PM
I was fortunate that I had a PT office with which I was content that was in walking distance because I went 3 times a week, for about the duration of my long treatment.  I was also fortunate enough to work from home the majority of the time, so I just walked over on the 3 days & then did the assigned exercises at home or at our community gym on the other days.

We have public transportation available (and use it often/daily, normally), but I was so uncomfortable initially, I was NOT interested... so having PT close was very nice.  My experience, as I got a little better, and DID use public transportation is that people (in general) are rude and oblivious - I spent most of my time concerned someone was going to kick my leg and rush/push me and make me fall. :/

And, yes, Charlottekatt - I noticed the graduation too!  Woo hoo!! Congrats! :)
Title: Re: Cycling Patella Fracture.
Post by: daihard on July 18, 2014, 01:45:56 AM
I've exchanged mail with the PT closer to home. They seem to be pretty good. I'm probably going to work with them instead of the one associated with the clinic. They are a couple of blocks from the bus stop.

I've been a public transit user for over 6 years, so taking the bus is second nature to me. I too was concerned that some passengers might kick me leg while I was seated, and I'm afraid it can happen. The one time I took the bus since I got injured, an old woman tripped over my leg while walking past me. It didn't hurt me and I knew it wasn't intentional, but she must have felt so bad, she kept apologizing to me until she got off the bus!

Fortunately, I can work from home as well. My current plan is that once I start PT, I will take the bus to the PT office, and once done, go to work in the office (by bus again). Other days I will be working from home.

The frustrating part is that I will need to wait for 2 more weeks before I can begin PT. Time doesn't fly when I want it to. lol


Title: Re: Cycling Patella Fracture.
Post by: fsugirl on July 18, 2014, 04:03:56 PM
One of THE hardest parts of this experience.... waiting until you can start PT!  Once I finally got the 'go ahead' from my OS, I had some issues getting it going & scheduling my first appointment - the people I talked on the phone with at this time had to deal with a very angry/upset person on the other end of the line!

Sounds like a good plan, Dai.
Title: Re: Cycling Patella Fracture.
Post by: MDAL on July 18, 2014, 05:59:53 PM
I've exchanged mail with the PT closer to home. They seem to be pretty good. I'm probably going to work with them instead of the one associated with the clinic. They are a couple of blocks from the bus stop.

I've been a public transit user for over 6 years, so taking the bus is second nature to me. I too was concerned that some passengers might kick me leg while I was seated, and I'm afraid it can happen. The one time I took the bus since I got injured, an old woman tripped over my leg while walking past me. It didn't hurt me and I knew it wasn't intentional, but she must have felt so bad, she kept apologizing to me until she got off the bus!

Fortunately, I can work from home as well. My current plan is that once I start PT, I will take the bus to the PT office, and once done, go to work in the office (by bus again). Other days I will be working from home.

The frustrating part is that I will need to wait for 2 more weeks before I can begin PT. Time doesn't fly when I want it to. lol

What I used to do in Public Transportation, was to take crutches and a visible brace, and make sure it was really visible... typically someone will give you a seat and most will be more careful.

But Public Transport is always dangerous when you are non-weight bearing... I had doors shut on me while going out, driver starting to move before I was sited, and so on...

One time in a tram, a lady had just given me her sit, I sat down, the driver starts moving at high speed, and then breaks all of a sudden... several people who were standing were falling (more like almost falling), and if I wasn't sited I would have most likely got hurt, since I had the leg fully immobilized and totally non-weight bearing.

You can never be too careful...
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 01, 2014, 02:24:22 AM
Just came back from my first PT session. Those of you who told me it could be a painful experience, you guys were right. The knee bending exercise was torture! I'm going back twice a week for the next 6-8 weeks. The therapist (Kelly) gave me some work to do at home as well. She says my ROM isn't bad for the first time (went from 40 to 64). I'm ready to take more pain - in the hope that the ROM will improve over time. :)
Title: Re: Cycling Patella Fracture.
Post by: charlottekatt on August 01, 2014, 07:30:14 PM
remember...PT is fun, PT is fun, PT is fun (most especially when PT has you kneeling doggy style on one knee at the very end of the table, butt in the air,  doing reverse leg lifts) :P :o
Title: Re: Cycling Patella Fracture.
Post by: MDAL on August 02, 2014, 04:37:23 PM
Just came back from my first PT session. Those of you who told me it could be a painful experience, you guys were right. The knee bending exercise was torture! I'm going back twice a week for the next 6-8 weeks. The therapist (Kelly) gave me some work to do at home as well. She says my ROM isn't bad for the first time (went from 40 to 64). I'm ready to take more pain - in the hope that the ROM will improve over time. :)

The good news is that pain usually happens only the first times you try to bend it. I was immobilized from like 2 months before I started PT. The first time was hell, then after 3 or 4 times it was just locked, but no pain.

Hope you get a similar experience...
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 03, 2014, 12:44:36 AM
The good news is that pain usually happens only the first times you try to bend it. I was immobilized from like 2 months before I started PT. The first time was hell, then after 3 or 4 times it was just locked, but no pain.

Hope you get a similar experience...
I'm kind of getting there. It's Day 3 today, and I don't feel as much pain as I did on my first day. I'm still pretty stiff, though. When it comes to knee bending, should I push harder so it starts to hurt in order to regain ROM faster? My current ROM is around 70 before it starts to hurt.
Title: Re: Cycling Patella Fracture.
Post by: MDAL on August 03, 2014, 02:48:50 AM
No, don't push it hard, you want to stretch the shorten ligaments and tendons, not break them or cause damage that will be hard to recover from.

You also don't want to over push the level which causes extreme inflammation, it will always cause some, but if you over do it, it will delay you rather than making you move faster.

What worked better for me, was to take it to the limit point (without critical pain), and hold it there for a longer period of time, then stretch back, and slowly repeat. I noticed that CPM type of movements, always back and forth without holding, did not gave me much progress. When I switched into holding it bent for periods between 1 minute to 5 minutes, that was when I made serious progress.

Another thing that helps with success and pain control is heat. I even went to bikram yoga (yoga in very high temperatures like a sauna, you are sweating all over there) and this made me achieve huge progress in a very short time. You can also do this inside a hot bath tub (I assume you don't have stitches by now and you can dive into hot water).

Heat really helps, never try to do these exercises if your knee is cold (under cold weather use a blanket around it), easier to cause injury. Also massage before hand to promote blood flow as well.

So in resume:

 - Include the exercise of holding bent for long periods of time, and not just moving back and forth (do both though).

 - Use heat as possible. At this point you can easily injury your ligaments and get delays in your progress. Heat will protect them and promote the needed blood flow for them to grow back and heal the minor fissures that may happen. Aside that, I noticed it speeds up the progress tremendously, try really hot bath, sauna, etc.

 - Don't over do it, in a way that the inflammation will get out of control and lock the knee. This is moving back not forth.

Good luck!
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 03, 2014, 08:26:26 PM
Thanks a LOT! Your advice is much, much appreciated.

I now do the "long hold" routine as part of my home exercise program - slowing bending my knee to the place where I can't push any harder, holding it for 2 minutes, and slowly straightening the knee back. I do it 5 times. I haven't decided how often I should do it - I will ask my therapist tomorrow. My homework she gave me already includes 3 sessions of heel slides per day, each session consisting of 30 repetitions. Like you say, I don't want to overdo it.

I don't have stitches anymore. I can also probably sit in the bathtub, though I'm not sure how I can stand up from that position. I should practice it on the floor a few times first. :)
Title: Re: Cycling Patella Fracture.
Post by: MDAL on August 03, 2014, 10:27:46 PM
Well, of course by exercising in ROM a hot bath tub, I meant this in case you can do it safely. If you can't do it in a safe manner than of course post pone it for when you can.

Another thing that may help you now is a TENS machine, to re-activate the muscles. Below are some links to youtube videos that show you how it works:

Setting for muscle strength (long contraction)
http://www.youtube.com/watch?v=e_8kiDhO3CQ

Setting for activation speed (short fast contractions)
http://www.youtube.com/watch?v=QiUCpMMzNoc


This could be very important for you, because your muscle situation should be going down the hill, and this really helps getting them back to shape and avoid further loss.
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 03, 2014, 10:33:58 PM
I know, I don't want to risk slipping and making things worse when my goal is to make things better. :)

As for TENS, I believe one of the home exercise routines my therapist gave me (called "quad sets") is supposed to do that - to re-activate my quad muscles. I have a towel rolled under the back of my injured knee, push the knee to the towel and hold it for 5 seconds, and repeat it 20 times per session. She told me to do this as much as I can throughout the day. Do you think TENS machines will work better?
Title: Re: Cycling Patella Fracture.
Post by: MDAL on August 03, 2014, 10:39:51 PM
That is a typical exercise the one you mentioned and really important. That's how I started too.

About your question, this is not so much about what is better, but about adding multiple things. Obviously you are limited in the type of exercises you can do. A TENS machine is not meant to be a replacement for conventional physio exercises, but an addition, that in my personal experience really helps. Muscles that you can't yet use that much, you can just place the pad over it and the machine makes them start working...

I paid a bit over 100 dollars for one, and it was one expense I don't regret at all. My only mistake was to start using it far too late, if I only knew in the beginning, I would have been up far sooner.
Title: Re: Cycling Patella Fracture.
Post by: mjeffrey on August 05, 2014, 07:14:37 PM
Hi
Just wanted to add to what MDAL said about the TENS machine. I read a study while I was lying in my hospital bed that compared the outcomes of a group using a muscle stimulator during rehab with a control group that weren't (I looked but didn't find it again). After one year the TENS group were doing significantly (statistically speaking) better. I bought this one but it is way more than I needed and a cheaper model would have been just as good.
http://www.currentbody.com/compex-performance-mi-ready.html (http://www.currentbody.com/compex-performance-mi-ready.html)

p.s. the CPM machine I hired went to the maximum and then paused for X seconds, where X was adjustable between 5-30 seconds. Extension and Flexion were digitally adjustable from -10 to 120 degrees. So it did the stretch and hold as recommended by MDAL. I guess it depends on the machine you get.
http://www.medi-shop.gr/en/Physiotherapy/CPM/Artromot-K1-standard (http://www.medi-shop.gr/en/Physiotherapy/CPM/Artromot-K1-standard)

I think hiring the CPM machine was the best thing I did after the MUA and I wish I'd done it earlier.
Title: Re: Cycling Patella Fracture.
Post by: MDAL on August 05, 2014, 11:32:24 PM
That TENS looks a like serious piece of machinery... Mine was way cheaper, works with only 2 pads, it doesn't looks so Pro as that, but it still did the job, in spite of some limitations.

Also rented a CPM machine before, different brand but same specs, had it for almost 2 months, since my problems were serious in terms of ROM, after 2 months of immobilization and extra surgeries.
Title: Re: Cycling Patella Fracture.
Post by: mjeffrey on August 06, 2014, 06:08:48 AM
Hi MDAL

At the risk of hijacking this thread I want to take advantage of you reading it to ask a question :). I've been reading your recent posts and you seem to have expertise in the area so I was hoping for a little advice. I can repost the question in another forum if you want as well.
My story is basically in my signature below, successful MUA after diagnosis of adhesions 3 months ago, patella fracture with ORIF 6 months ago.
I now have full ROM compared with the uninjured side although the quads are slightly tighter (improving gradually). It does not move as freely as the other and there has been a clunk on extension since day 1 after the surgery. The annoying but not painful clunk occurs during walking and particularly after stretching; the OS says it is the wires. My patella tendon feels harder than the other and I am worried about patella baja.
I am having the wires out on Friday and asked the OS if he was going t remove any scar tissue he found. He said the adhesions have gone and there won't be any scar tissue to remove.
Do you have any recommendations for improving the flexibility of the patella tendon? Currently I do a bit of massage/patella mobilisation but it is not very directed or systematic.
Any other suggestions, or things I should point out to the OS on Friday?

thanks
Mark
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 06, 2014, 04:54:12 PM
Good luck with the hardware removal surgery, Mark!

I don't think you're hijacking the thread. I would personally appreciate any information and advice regarding post-op recovery from a fractured patella. That would help cyclists greatly. :)
Title: Re: Cycling Patella Fracture.
Post by: MDAL on August 08, 2014, 07:09:49 AM
Hi MDAL

At the risk of hijacking this thread I want to take advantage of you reading it to ask a question :). I've been reading your recent posts and you seem to have expertise in the area so I was hoping for a little advice. I can repost the question in another forum if you want as well.
My story is basically in my signature below, successful MUA after diagnosis of adhesions 3 months ago, patella fracture with ORIF 6 months ago.
I now have full ROM compared with the uninjured side although the quads are slightly tighter (improving gradually). It does not move as freely as the other and there has been a clunk on extension since day 1 after the surgery. The annoying but not painful clunk occurs during walking and particularly after stretching; the OS says it is the wires. My patella tendon feels harder than the other and I am worried about patella baja.
I am having the wires out on Friday and asked the OS if he was going t remove any scar tissue he found. He said the adhesions have gone and there won't be any scar tissue to remove.
Do you have any recommendations for improving the flexibility of the patella tendon? Currently I do a bit of massage/patella mobilisation but it is not very directed or systematic.
Any other suggestions, or things I should point out to the OS on Friday?

thanks
Mark

mjeffrey:

My personal experience is that things will never be the same again, this is something we need to live with and keep fighting. With all this (we) have scar tissue, both in the infra patella fat pad and above. All our ligaments and tendons and fist got shorten and then stretched back (will never be the same as the original).

If you do have patella baja, you should be able to measure it comparing to the other. However your patella ligament should be shorter now and surrounded by scar below it (fat pad scarring), which happens after long periods of inflammation. This is not necessarily patella baja, it's scar tissue together with shorten ligaments on both sides. This is why is not so mobile as before. If it is actually lower it should be visible.

I wish I had good news for you or a solution. I don't, I have made a long way through several surgeries (3 and probably counting), plus stem cells treatments, 12 shots of PRP, 5 of hyaluronic acid, physiotherapy to death, bought and rented devices I can't even count. I have made a lot of improvement, pulled myself out of disability, but I have the same thing you do, a knee that is not and will never be perfect, and will require maintenance for life.

You mentioned ROM is good for flexion (very few that have went through what you did can claim the same), extension is hard to get back, but can be done, you need to exercise in 2 ways, one for stretching the ligaments in the back of your leg which are shorter, the second is to get the quads strong enough to pull the knee straight. If you still have inflammatory reaction in the knee, means the extension deficit is likely to continue.

Good luck with the hardware removal, I hope this will contribute to further progress.
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 08, 2014, 07:23:54 AM

mjeffrey:

You mentioned ROM is good for flexion (very few that have went through what you did can claim the same)...

I hope it's not true for people with a fractured patella in general. Both my OS and my therapist have told me most  of those people will get a full ROM back - though it may take longer for some than others. While the therapist says 125-130 degrees should be good enough for me to do everything I want to do, I'm still aiming to regain all my ROM (which should be about 140-150 degrees).
Title: Re: Cycling Patella Fracture.
Post by: mjeffrey on August 08, 2014, 08:52:11 AM
Hi daihard

I don't know if there is any research on regaining ROM but in reality every case is different and even if the outcomes don't seem that good , remember that you're part of a select group (kneegurus) who intelligently work hard toward getting better. Most people are pretty passive or don't work at getting better.
My roommate during my initial operation would tend to skew any statistics. He drank alcohol ,smoked and ate the day of his operation. He weighed 48 kg and was my age but looked twice as old. Just before the operation they put him on oxygen since his stats were low, he went out to smoke during this!

it's your outcome that counts not the average.
My extension and flexion are both good (same as the good knee) but I am realistic that I will always have problems with the knee. I just want to do what I can to minimize them.
Title: Re: Cycling Patella Fracture.
Post by: mjeffrey on August 08, 2014, 09:14:29 AM
Hi MDAL
Thanks for the reply. I'm writing from my bed waiting for the operation now. Will update when it is over, I need to spend the night so will have plenty of time  :)
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 10, 2014, 04:40:35 PM
Hi daihard

it's your outcome that counts not the average.
My extension and flexion are both good (same as the good knee) but I am realistic that I will always have problems with the knee. I just want to do what I can to minimize them.
That's true. I do hope that I won't have too much issue with my knee once I've healed, but I should be realistic about it. I am making progress, after all.
Title: Re: Cycling Patella Fracture.
Post by: mjeffrey on August 11, 2014, 06:46:39 AM
In the beginning my OS told me I should be at 90 after 6 weeks (but I also started PT straight away). You have better ROM than I did at that stage and given you've only just started it seems like good progress to me (60-90 in a little over a week looks pretty good to me).
I was sure the hardware would limit my ROM but it didn't seem to at all.
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 11, 2014, 03:17:28 PM
In the beginning my OS told me I should be at 90 after 6 weeks (but I also started PT straight away). You have better ROM than I did at that stage and given you've only just started it seems like good progress to me (60-90 in a little over a week looks pretty good to me).
I was sure the hardware would limit my ROM but it didn't seem to at all.

Thanks Mark. That's encouraging. I started wondering whether I would stall as I wasn't making as much progress this past few days compared to last week. I got 90 on Thursday. As of Sunday, I was only getting 95 or so at home. Can I assume that the rate of progress in terms of the angle will slow as I get more ROM back?
Title: Re: Cycling Patella Fracture.
Post by: MDAL on August 11, 2014, 04:08:06 PM
Yes Daihard, it tends to slow down, because now you are not just releasing the tightness, now you are actively growing the shorten ligaments and tendons... (they do shorten fast under immobilization).

Yet, gains in the order of 10 degrees (at least) a week are perfectly attainable with enough effort, and that means a lot of it. Sometimes it seems to stall, other times it seems to release. It depends a lot on the inflammatory moods...

The last degrees are always the hardest. I used to call it the "Great journey to the butt"! An epic adventure! You can write a memoir book about it later!
Title: Re: Cycling Patella Fracture.
Post by: mtb1 on August 12, 2014, 03:39:40 PM
"Great journey to the butt"! An epic adventure! - MDAL

Sir, you just made my day.
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 15, 2014, 07:18:39 AM
It's been 2 weeks since I started PT. I was able to get 115 ROM this afternoon. I still can't do much else, but the therapist told me this is pretty good flexion for someone who is 6 weeks post-op. I will keep on trying. :)
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 24, 2014, 12:34:24 AM
Another update. It has now been 7 weeks since the surgery.

I was cleared to start working actively on regaining muscle as of last Thursday. Knowing my passion for cycling, my therapist put me on an indoor bike trainer. I initially wasn't able to bring the right pedal up to the top dead centre. The therapist told me to just lock the pedals back and forth as much as I could, and in a few minutes I was able to spin it. It was painful, but it sure gave me hope.

She also used a TENS machine on me for the first time, in addition to some exercises to wake up my quad muscle.
Title: Re: Cycling Patella Fracture.
Post by: charlottekatt on August 24, 2014, 03:07:22 AM
*balancing on one leg and applauding*   ;D 
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 26, 2014, 05:37:52 AM
mjeffrey:

My PT clinic somehow let me borrow one of their TENS wraps to test it out at home. It looks like a leg brace that only covers the upper part of the leg. On the back of it are electric pads that send pulses to the quad muscle. It stays on for 10 seconds and off for another 10. I can adjust the strength of the pulse - on the inside and outside independently. My therapist told me to use it a couple of times a day to help activate my quad muscle.

She has even mentioned I can keep it for the weekend if I like it. Hopefully it means I won't have to buy one myself. :)

Dai
Title: Re: Cycling Patella Fracture.
Post by: mjeffrey on August 27, 2014, 07:48:38 PM
Nice that they let you borrow it. I was able to borrow one for the weekend when I was considering buying one as well. I thought the wrap around ones would be the most convenient but ended up getting a normal one for more flexibility (but more hassle).
I guess yours is something like this? http://www.neurotechgroup.com/us/products/kneehab-xp (http://www.neurotechgroup.com/us/products/kneehab-xp).
At PT did they use it for strengthening (NMES) at fairly high currents (highest tolerable mine says) or (TENS) for pain relief (pretty gentle)? There is some research to indicate that TENS may help activation deficits as well as NMES so I was just wondering what they used.

I've also read that when trying to overcome muscle activation deficits that you should contract voluntarily during the contraction phase, so maybe try that too.

The unit I have has 4 channels and normally I just do the injured leg but recently I did both at the same time.
At one point the readings for each channel (at maximum tolerable) were 90, 370, 90 and 90. 370 was the bad leg on the inside (VMO). So I was needing 4 times more current to get a full contraction. Will try again soon now my knee is out of bandages...

I uploaded a photo, but you don't really see the contraction, the photo flattens it, looks a bit scary in reality :)

p.s. easy to see I'm not a roadie  ;)
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 28, 2014, 06:46:45 AM
I guess yours is something like this? http://www.neurotechgroup.com/us/products/kneehab-xp (http://www.neurotechgroup.com/us/products/kneehab-xp).
At PT did they use it for strengthening (NMES) at fairly high currents (highest tolerable mine says) or (TENS) for pain relief (pretty gentle)? There is some research to indicate that TENS may help activation deficits as well as NMES so I was just wondering what they used.

Hi Mark!

That's exactly what I have. My PT also told me to set the currents as high as tolerable, so it must be NMES. I've been using it twice a day, for 10 minutes each time. Hopefully they will let me keep it over the weekend.

Yes, your machine seems a lot more flexible than mine. Mine comes in two different sizes - I wanted size small but the PT only had medium-large. To accommodate it, I have to hike my shorts up to a potentially embarrassing point. I'd have no such issue with yours...
Title: Re: Cycling Patella Fracture.
Post by: schecro on August 28, 2014, 10:13:12 PM
Does anyone have experience with going back to cycling post injury?  I saw only one related post.  I am attempting to bike again and find that cages help, but I still feel a fair amt. of pain on the muscle (tendon or ligament?) that runs above the inside, top part of my knee as I bike.  Any suggestion as to an exercise/equipment that might help this?
Title: Re: Cycling Patella Fracture.
Post by: daihard on August 29, 2014, 02:41:24 AM
Does anyone have experience with going back to cycling post injury?  I saw only one related post.  I am attempting to bike again and find that cages help, but I still feel a fair amt. of pain on the muscle (tendon or ligament?) that runs above the inside, top part of my knee as I bike.  Any suggestion as to an exercise/equipment that might help this?
How long has it been since the date of your injury? I personally know someone who was able to ride (with clipless pedals) 5 months after he had a surgery on a fractured patella. He probably started cycling with flat pedals sooner than that.

Dai
Title: Re: Cycling Patella Fracture.
Post by: mtb1 on August 29, 2014, 02:15:29 PM
schecro:

I got back on the bike 11 weeks after my injury. My hardware started giving me problems 4 weeks later and continued for 2 months before subsiding a few weeks before my removal surgery. I was on the bike again 2 weeks after my removal & so far, so good.

Location of pain & severity really varies among the group of us here. Mine was just below the kneecap where the end of a K-wire formed a lump close to the skin and irritated the patellar tendon. It pretty much stopped me from riding when it would flare up. I had to pedal with one leg & let the bad one dangle to get home a few times.

I prefer flat pedals. They will give you more flexibility on foot placement and some peace-of-mind that you can get your foot down quickly.

Hope this helps.

Aaron.

Title: Re: Cycling Patella Fracture.
Post by: daihard on September 07, 2014, 07:38:50 AM
I'm getting closer and closer to riding on the street again.

I've been spinning an indoor bike trainer for 2 weeks. I am able to pedal smoothly at 50-60 RPM for 10-15 minutes. My injured knee still feels stiff at the top dead centre, but it doesn't hurt much anymore.

I finally set my own bike up on a trainer at home today. I took a quick spin for a few minutes just to make sure the bike was mounted correctly. The level of stiffness on my knee was about the same as on the bike trainer, which is definitely a good sign. I will continue to spin it in the hope that the knee movement will be smoother and smoother over time. :)
Title: Re: Cycling Patella Fracture.
Post by: charlottekatt on September 08, 2014, 03:30:52 PM
Cycling update -   so, at the six month(ish) mark  -  flats and slight inclines, I can fly like the wind (aka look a lot like the wicked witch pedaling past Dorothy's window).   I can get up off the saddle to pedal, but the coordination is still ever so slightly out of synch and I'm not quite pushing down at the right point (brain to leg signal lag, I think..or maybe NOT thinking is what's needed!).  It's getting better tho.   

Pushing off at stoplights on uphill inclines, that's still a  bit scary.  Definitely do not want to be in the middle of a lane with an impatient driver in back of me, so I've either changed my route or on left hand turns, I'm hugging the curb to the right and curving way right to enter an intersection. And, I'm still blowing through a couple of nasty uphill stop signs.
----------------
2/23/14 - Fractured Patella - Transverse/Displaced - Immobilized
2/25/14 - Doc appt, surgery scheduled
3/4/14 - ORIF  - 2 pins, Tension band - cylinder cast NWB
3/11/14 - Follow-up - NWB
3/21/14 - Cast off.  ROM Brace locked in full extension - NWB
4/4/14 - Brace, Full extension - NWB 70% healed
4/11/14 - Physical Therapy start - 38 ROM
4/14/14 - 48 ROM
4/17/14 - 60 ROM
4/21/14 - 78 ROM
4/24/14 - 90 ROM
4/25/14- Doc appt, w/wean from brace instructions/wean from crutches instructions
4/28/14 - 105 ROM
5/1/14 - 110 ROM
5/5/14 - 112 ROM
5/6/14 - Started bike trainer (10/15 min/day)
5/08/14 - 120 ROM
5/12/14 - 125 ROM
5/14/14 - 130 ROM
5/19/14 - 137 ROM - started walking home from work (1.5 miles)
5/25/14 - 4 mile bike ride (flat)
5/27/14 - 142 ROM
7/7/14 - 150 ROM - Graduated from PT
Title: Re: Cycling Patella Fracture.
Post by: daihard on September 09, 2014, 07:06:22 AM
@charlottekatt

Glad to hear you're continuing to make progress, especially as a fellow cyclist. :)

Looks like the rate of my progress is pretty much identical to that of yours, at least in terms of ROM. Your history says you had a 4-mile bike ride about 12 weeks post-op. How did your knee treat you there? Was the rotation as smooth as with your good knee, or was it still stiff (if not painful)? I will be 10 weeks post-op as of Wednesday, and I still feel some stiffness on my bad knee as I pedal my bike on a trainer.  I'm just wondering whether it should go away in a couple of weeks or I just have to pedal with it for a while. I'm fine if it's the latter - I just want to know what to expect.

Thanks!
Dai
Title: Re: Cycling Patella Fracture.
Post by: charlottekatt on September 10, 2014, 01:48:26 AM
Welll..let's see, left leg (and knee) were pretty well "along for the ride"...going around nicely, but not putting much work in.  Note, it was 4 miles of VERY flat road.   That whole little trip was about confidence and just getting going and knowing I could do it.   For me, the stiffness wasn't a factor while riding.  Pain wasn't either.   Afterwards, I probably should have iced..but by the time the "woohoo, I did it" micro adrenalin burst wore off, it was a bit too late for the ice. 

As for pain,  throughout this journey I really haven't had true pain except for the 24 hours after surgery,  and for a few days after my first set of leg presses with weight. And even then it was way less than what I've experienced from a sprained ankle.    I do have times when my knee feels stiff..but if I check ROM, it's fine.  And, in the mornings, there is some discomfort when stair climbing, but that resolves itself during the day.   If I think about it, the morning discomfort seems to correlate with sleeping with my leg straight versus sleeping with my leg bent. 

Title: Re: Cycling Patella Fracture.
Post by: daihard on September 10, 2014, 05:06:54 PM
Thanks @charlottekatt!

I haven't had trouble with pain so far either, except for the first couple of days after the surgery. I'm not even sure if "stiffness" the right word to describe the state of my knee when pedalling. It feels as if something covers the knee. I can pedal smoothly without pain, but this feeling is always there. It may just be the remaining swelling. Oh well. :)

I'm with you on the morning discomfort on the knee. I was very stiff in the morning when I slept with the brace on as it kept my leg completely straight for several hours. Heal slides in the morning was extremely tough. Now I'm off the brace, I almost always keep my knee bent while sleeping. That seems to help a lot.
Title: Re: Cycling Patella Fracture.
Post by: charlottekatt on September 12, 2014, 04:03:10 AM
Kind of like your knee wearing a skull cap that's a size or two too small?  Not painful, just different/off in a "if the  other knee felt like this, it would be okay because they'd both feel the same" kind of way?  It sometimes feels like maybe someone has stuck their fist inside my knee.  Anyhoo... the swelling is totally gone, and there's no heat from inflammation, so the only thing I can attribute it to is hardware.  And since my doc pretty well told me there wasn't going to be any discussion of me having it removed unless something shifted, sheared or came apart, I'm content with it working.  And odd peculiar stuff that doesn't hurt, I can live with.   Well, at least until I go in for a follow-up in December and ask him the question one more time : )