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Author Topic: Cape Cod Half Marathon Running Accident on Sep 27th 2014  (Read 1717 times)

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Offline Cjbouchieknee

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Cape Cod Half Marathon Running Accident on Sep 27th 2014
« on: December 28, 2014, 06:35:10 PM »
On Sep 27th, I took a hard fall at the 2.5 mile mark during Cape Cod Half Marathon.  At 55 (woman), I have done lots of Halfs and lots of other runs.  This was my first fall during a run, and 4 other runners fell in the same area.  My fault, totally, not looking to blame anyone but myself.  I have re-lived the moment over and over.  Ended up being transported via EMT to Falmouth Hospital where xrays revealed patella fracture on the right knee, and a fractured 5th metatarsal on my left foot.  I was released from ER with immobilizer on my right leg and boot on my left foot.  Delta was great in expediting me and my friends back to Altanta.   On the 29th, I was able to get an appt with Pinnacle OS.  Had surgery on Oct 2nd, 2014.  What a roller coaster since then.

Sep 27:  Accident
Sep 29: OS appt
Oct 2:  Surgery - 2 screws and wire
Immobolized for 6 weeks and no weight bearing, had in-home PT to do some exercises
Started ROM after weeks, struggled to get past 80ROM with exensive PT
Dec 2:  Knee manipulation
Dec 3:  With nerve block, able to get to 115 ROM(however fell in the front yard when knee buckled with the nerve block)
Dec 4 - 12:  Struggling to get ROM, very slow, painful PT process
Dec 12: Started wearing dynaslpint at home
Dec 26:  Up to 105 ROM during PT - still really stiff and gait has changed

I have started noticing a lil bump on the left of my knee cap.  Seems that it may be the hardware?

What an arduous process this has been.  Constant pain, sleepless nites, can't get comfortable.  My first broken bone in my life and still have long way to go.  Would appreciate any comments and hints. 


Offline John42

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Re: Cape Cod Half Marathon Running Accident on Sep 27th 2014
« Reply #1 on: December 28, 2014, 06:50:50 PM »
Hi CJbouchieknee

Welcome to KneeGuru - am sure that you are going to receive some good tips, but would meanwhile suggest that you sleep with a pillow/cushion between your knees - I have been doing this for more than ten years - works wonders.

Best

JohnK/ Manchester UK
Ruptured Patella Tendon January 9 2003
Slipped on black ice.  Manchester UK

Complete Ruptured Tendon

Offline Cjbouchieknee

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Re: Cape Cod Half Marathon Running Accident on Sep 27th 2014
« Reply #2 on: December 28, 2014, 08:16:43 PM »
Thanks John.   I will try the pillow suggestion. 

Offline Scubagrl4

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Re: Cape Cod Half Marathon Running Accident on Sep 27th 2014
« Reply #3 on: December 28, 2014, 08:37:39 PM »
Cj, I'm so sorry you are going through all of this. It is the test in patience that none of us wants and is even more difficult to handle when you are in constant pain.
Have you talked with your OS about trying some different meds to control your pain? Adequate pain control and swelling management is the key to getting back your range of motion. My first doctor's unwillingness to work with me on this should have been a huge red flag, ultimately I had to change to another doctor to clean up the mess the first guy made.
Besides the dynasplint, what else are you doing for PT? I am asking because if you are going through overly aggressive physical therapy, it can actually cause you to lose range of motion instead of gaining it....it can increase heat and inflammation which can cause an increase in scar tissue which it sounds like you may have because of the use of the dynasplint, and manipulation. Are you using a cpm? That could help too.
If you feel like you are regressing backwards in rom, you also might want to be sure that arthrofibrosis has been ruled out as this would potentially change your entire treatment plan...there is an entire section on this on the board including tutorials on proper rehab and signs and symptoms. 
I hope some of this helps and that you find some relief soon....here is to hoping we all walk into the new year with healthier knees :)
« Last Edit: December 29, 2014, 03:41:00 AM by Scubagrl4, Reason: Accidentally made the message scroll...oops »
4/14/14 L ACL rupture, grade 2+ MCL tear
6/6/14 ACLr allograft
9/4/14 MUA
10/6/14 LOA/AIR, synovectomy, lateral/medial retinacular release, partial lateral menisectomy, chondroplasty, deep tissue
biopsies.
11/20/14 insufflation, MUA
10/19/15: LOA/air, PLM, chondro, synovectomy, med/lat releases

Offline Cjbouchieknee

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Re: Cape Cod Half Marathon Running Accident on Sep 27th 2014
« Reply #4 on: December 29, 2014, 01:01:31 AM »
 Thanks for your message Scubagrl4.  For some reason, the message is scrolling and I cannot get it to stop so I can read!     

Offline Scubagrl4

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Re: Cape Cod Half Marathon Running Accident on Sep 27th 2014
« Reply #5 on: December 29, 2014, 03:42:42 AM »
Well that was weird. I have no idea how that happened. The scrolling is cool, but make you a little dizzy trying to read it. I think it's fixed. Sorry!
4/14/14 L ACL rupture, grade 2+ MCL tear
6/6/14 ACLr allograft
9/4/14 MUA
10/6/14 LOA/AIR, synovectomy, lateral/medial retinacular release, partial lateral menisectomy, chondroplasty, deep tissue
biopsies.
11/20/14 insufflation, MUA
10/19/15: LOA/air, PLM, chondro, synovectomy, med/lat releases

Offline Cjbouchieknee

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Re: Cape Cod Half Marathon Running Accident on Sep 27th 2014
« Reply #6 on: December 31, 2014, 03:45:13 PM »
Scubagrl4, thanks for your message.   I think the ROM has been especially challenging because of the 6 week/non weight bearing immobilization so my fracture could heal with the wire and 2 screws.  i started in home PT about the 2 week mark, but not much to do.  Once the 6 weeks was up, I was able to ditch the immobilizer and begig ROM.  I got to 80 with some challenges, but was stuck.  That was when we did the manipulation.  OS said he was able to bend my leg all the way back and went through 3 cracks of scar tissue.  Is arthrofibrosis the same as scar tissue?  Interesting, my first weeks of PT after immmobilization and right after manipulation were very aggressive and painful to the point of tears.  My PT realized this was not working for us.  I spent the whole time in PT getting back the ROM that we acheived during the prior PT session, never setting a new bar.  Now, we are doing much more gentle PT, not cranking my leg back.  The swelling has gone done and I am continuing to make progress.  On Monday, Dec 29, I reached 111 ROM, during my session scheduled for later today, our goal is 115.   I still am having trouble with my gait.  The ROM does not seem to translate to walking.  I can sit here in my chair with my leg at 90 deg and then get up to walk and have to force a knee bend to walk.  Weird.   

Also, I ordered one of these:  Pull-On Knee Cushions from Amazon (Pallipartners)  and I love it!!!   My surgical incision is on the inside of my knee so it really helps while sleeping on my side.

Can you tell me more about CPM?

Thanks, Cindy

Offline Scubagrl4

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Re: Cape Cod Half Marathon Running Accident on Sep 27th 2014
« Reply #7 on: January 01, 2015, 06:40:30 PM »
Hey cj, glad to hear that you have made some progress since your last post. I would say that is a good sign. Also, kudos to your PT for recognizing that forcing the knee was not helping and being willing to make a change. I really think this change in his approach will give you a much better chance at recovery.
To answer your questions....arthrofibrosis is an excessive/abnormal formation of scar tissue that can be caused by a number of things. Genetics can be an issue, prolonged immobilization, excessive bleeding in the joint, severe trauma, inappropriate PT, and hardware problems are some of the causes. You meet some of these risk factors which is why I want you to be aware because early recognition and proper treatment is key in treating this condition. If you want more info. Check out some of the articles posted in the arthrofibrosis section... Dr. Noyes has a 12 part tutorial on here that is very helpful. The good news for you is that you are responding well to the change in PT and have not plateaued or regressed since your manipulation. That is a good sign :)
A cpm is a machine that you put your leg in and it keeps your knee slowly bending and straightening. It also keeps your leg elevated. The idea of it is really not to gain range of motion with it, but to keep the knee from getting stiff, and helps circulate fluid out of the joint. I slept in mine for 8 weeks after my last scope and kept it moving from -3 to 90 degrees. It isn't fun sleeping on your back all that time, but it's better than waking up with a stiff knee. You can usually rent a cpm through your insurance. Usually your doctor can help you get one.
As far as your motion not maintaining....that takes time and practice to rebuild muscle memory. But, if this doesn't improve over time, it could also require hardware removal and/or scar tissue removal down the road. After my scar tissue surgery, my gait immediately improved.
Congrats again on your rom gains! Keep up the good work :)
4/14/14 L ACL rupture, grade 2+ MCL tear
6/6/14 ACLr allograft
9/4/14 MUA
10/6/14 LOA/AIR, synovectomy, lateral/medial retinacular release, partial lateral menisectomy, chondroplasty, deep tissue
biopsies.
11/20/14 insufflation, MUA
10/19/15: LOA/air, PLM, chondro, synovectomy, med/lat releases

Offline Cjbouchieknee

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Re: Cape Cod Half Marathon Running Accident on Sep 27th 2014
« Reply #8 on: January 01, 2015, 07:56:18 PM »
Scubagrl, thanks.  I will ask my PT about the CPM machine.  Yeah, I was on my back for 6 weeks while I was immobilized.   I have not been able to stand to wear the dynasplint at nite, just not comfortable at all.  I am thinking hardware may be the issue.  I am seeing and feeling the top of the screw now that my swelling has gone down.  I rode stationary bike for 20 mins today and walked at a slow pace on the treadmill for 15 mins.  As soon as I get off of either one of these, I am still stiff.   I will look for the articles on arthrofibrosis section... Dr. Noyes tutorial and I will also mention this to my PT.  While in PT, we are focused on ROM, I am thinking I still need to work on my coordination and walking straight.  This is a marathon for sure.  I am starting back to work on Monday.  That should be interesting!   Happy New Year!  Cindy

Offline Heidi S

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Re: Cape Cod Half Marathon Running Accident on Sep 27th 2014
« Reply #9 on: January 04, 2015, 10:55:30 PM »
Hi Cindy,
I thought I would reach out as I have a similar issue as yourself, broke my left patella on 12/2/14 during a random slip & fall on icy pavement.  When you wrote that you've relived the moment over and over when you fell it really resonated for me, because I've done the same, maybe it's just a mini PTSD reaction & everyone does that (?).   I'm a runner as well, had just run a Thanksgiving 10K a few days prior - this injury has totally rocked my world.  The thought of not being able to go out and run if I want to pretty much breaks my heart...  Anyway, I should mention that Scubagrl4 on a different thread suggested I connect with you so here I am.  :)

As it happens, I'm quite a bit behind you in terms of recovery etc. - it will be 4 weeks tomorrow since my surgery on 12/9, also, my OS did not need to use hardware to reattach the pieces of my patella, he was able to drill holes in the patella and use sutures to secure everything back (ugh, what a thought).  Maybe a new technique.  I'm still in my immobilizer brace locked at 0, and have just been working on isometrics, knee bends & putting some weight while walking w/ the crutches.  I'm starting official PT tomorrow - both looking forward to it & dreading what I'm sure will be a tough day.   

I'd love to know about your progress during your 2nd month post-surgery...  what helped you?  How did you handle the PT?  It sounds like it was pretty aggressive.  I don't know how I'll manage extreme pain, to be honest.  I've struggled a LOT with feeling incredibly discouraged/disheartened by the day in-day out pain.  Thank you for sharing your progress because it's so encouraging to read that you can now walk on a treadmill and ride a stationary bike at this point, those things sound like a faraway dream to me!  It truly gives me hope, especially since your injury sounds more serious and complicated than mine.  If you end up using a CPM (I've read about it in a couple of places) I hope you'll share your experience with it. 

I wish you all the best as you continue to recover and regain your strength, gait and coordination.  Good luck tomorrow with your work  - I go back tomorrow as well, and yes, interesting is a good word for how it will go, I think! 

My best,
Heidi
12/2/14:  Fractured L. Patella, tore P. Tendon
12/9/14:  ORIF Surgery + repair p. tendon
12/23/14: PWB on crutches
1/5/15:  ROM 65
1/14/15: ROM 70
1/23/15: ROM 90
2/3/15: ROM 105; stationary bike
2/11/15: ROM 114; first steps!
3/3/15: ROM 121
3/24/15: ROM 132















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