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Author Topic: Cycling Patella Fracture.  (Read 18565 times)

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Offline daihard

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Re: Cycling Patella Fracture.
« Reply #60 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
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 mjeffrey

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Re: Cycling Patella Fracture.
« Reply #61 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.
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  ;)
« Last Edit: August 27, 2014, 07:55:23 PM by mjeffrey »
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

Offline daihard

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Re: Cycling Patella Fracture.
« Reply #62 on: August 28, 2014, 06:46:45 AM »
I guess yours is something like this? 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...
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 schecro

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Re: Cycling Patella Fracture.
« Reply #63 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?

Offline daihard

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Re: Cycling Patella Fracture.
« Reply #64 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
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 mtb1

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Re: Cycling Patella Fracture.
« Reply #65 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.

fractured r patella into 3 pieces 2014/01/23
surgery - k-wires, tension band, screw 2014/01/24
sent home, no cast/brace/immobilizer same day
follow-up with OS 2014/02/04
2nd follow-up 2014/03/11, ROM 90
3rd follow-up 2014/04/08, ROM 130
HW removed-2014/08/06

Offline daihard

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Re: Cycling Patella Fracture.
« Reply #66 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. :)
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 #67 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

Offline daihard

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Re: Cycling Patella Fracture.
« Reply #68 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
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 #69 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. 


Offline daihard

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Re: Cycling Patella Fracture.
« Reply #70 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.
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 #71 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 : )