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Author Topic: Cycling Patella Fracture.  (Read 18686 times)

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Offline daihard

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Re: Cycling Patella Fracture.
« Reply #30 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. :)
2014:
06-21  Fractured right patella
07-02  ORIF - figure 8
07-29  4-week post-op follow-up
07-31  Started PT - 60 ROM
08-07  90 ROM
08-14  115 ROM
08-21  Started bike trainer - 122 ROM
08-28  132 ROM
09-04  135 ROM
09-08  139 ROM

Offline fsugirl

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Re: Cycling Patella Fracture.
« Reply #31 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! :)
3/17/12 patella fracture
3/22 ORIF - 3 screws, wire, immobilizer
4/2 - sutures removed, crutches, nwb
4/30 new brace-locked, referral for pt ~20/25ROM, pwb
5/9 started pt 30ROM
5/18 45ROM
5/25 50ROM-brace to 30
6/1 60ROM-brace to 50
7-MUA
More PT
Dynasplint fullROM
10/30-PT release
4/30/14-HW remova

Offline daihard

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Re: Cycling Patella Fracture.
« Reply #32 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


2014:
06-21  Fractured right patella
07-02  ORIF - figure 8
07-29  4-week post-op follow-up
07-31  Started PT - 60 ROM
08-07  90 ROM
08-14  115 ROM
08-21  Started bike trainer - 122 ROM
08-28  132 ROM
09-04  135 ROM
09-08  139 ROM

Offline fsugirl

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Re: Cycling Patella Fracture.
« Reply #33 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.
3/17/12 patella fracture
3/22 ORIF - 3 screws, wire, immobilizer
4/2 - sutures removed, crutches, nwb
4/30 new brace-locked, referral for pt ~20/25ROM, pwb
5/9 started pt 30ROM
5/18 45ROM
5/25 50ROM-brace to 30
6/1 60ROM-brace to 50
7-MUA
More PT
Dynasplint fullROM
10/30-PT release
4/30/14-HW remova

Offline MDAL

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Re: Cycling Patella Fracture.
« Reply #34 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...

Offline daihard

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Re: Cycling Patella Fracture.
« Reply #35 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. :)
2014:
06-21  Fractured right patella
07-02  ORIF - figure 8
07-29  4-week post-op follow-up
07-31  Started PT - 60 ROM
08-07  90 ROM
08-14  115 ROM
08-21  Started bike trainer - 122 ROM
08-28  132 ROM
09-04  135 ROM
09-08  139 ROM

Offline charlottekatt

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Re: Cycling Patella Fracture.
« Reply #36 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

Offline MDAL

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Re: Cycling Patella Fracture.
« Reply #37 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...

Offline daihard

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Re: Cycling Patella Fracture.
« Reply #38 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.
2014:
06-21  Fractured right patella
07-02  ORIF - figure 8
07-29  4-week post-op follow-up
07-31  Started PT - 60 ROM
08-07  90 ROM
08-14  115 ROM
08-21  Started bike trainer - 122 ROM
08-28  132 ROM
09-04  135 ROM
09-08  139 ROM

Offline MDAL

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Re: Cycling Patella Fracture.
« Reply #39 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!
« Last Edit: August 03, 2014, 02:53:38 AM by MDAL »

Offline daihard

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Re: Cycling Patella Fracture.
« Reply #40 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. :)
2014:
06-21  Fractured right patella
07-02  ORIF - figure 8
07-29  4-week post-op follow-up
07-31  Started PT - 60 ROM
08-07  90 ROM
08-14  115 ROM
08-21  Started bike trainer - 122 ROM
08-28  132 ROM
09-04  135 ROM
09-08  139 ROM

Offline MDAL

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Re: Cycling Patella Fracture.
« Reply #41 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.

Offline daihard

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Re: Cycling Patella Fracture.
« Reply #42 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?
2014:
06-21  Fractured right patella
07-02  ORIF - figure 8
07-29  4-week post-op follow-up
07-31  Started PT - 60 ROM
08-07  90 ROM
08-14  115 ROM
08-21  Started bike trainer - 122 ROM
08-28  132 ROM
09-04  135 ROM
09-08  139 ROM

Offline MDAL

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Re: Cycling Patella Fracture.
« Reply #43 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.

Offline mjeffrey

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Re: Cycling Patella Fracture.
« Reply #44 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

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

I think hiring the CPM machine was the best thing I did after the MUA and I wish I'd done it earlier.
2014:
20 Feb: Comminuted patella fracture, 4 K-wires, Cercalge, Figure of 8
11 Mar: Staples removed Flex 50
22 Apr: Control Xray, flex 80, progress stalled
09 May: MUA: flex 120, 3 weeks CPM
23 Jun: Slow Running, Flex 135
06 Jul: Flex 140
08 Aug: Hardware removed
10 Sep: full flexion















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