Patellar Fracture Recovery: Pain Management and Rehabilitation Tips

Q: Patellar Fracture Recovery: Pain Management and Rehabilitation Tips

Hello： 1. You may consider seeing a rehabilitation specialist and ask them to teach you rehabilitation methods. 2. Swelling in the knee area and tightness when bending is a normal phenomenon, and it may take about 2-3 months for the swelling to subside. 3. Yes

Patellar fracture

Hello, Doctor! Thank you very much for your support over the past month and a half.
I have been diligently practicing the exercises you recommended, and I am pleased to report that I can now lift my leg and bend it to 90 degrees.
I am truly grateful.
However, I am experiencing significant resistance and tightness in my knee when bending, and the area around my knee is still swollen.

After my patellar fracture surgery, I had two follow-up appointments.
During the first visit, I was given a rehabilitation prescription and prescribed Tylenol for pain relief, with instructions to bend my knee slightly but not exceed 30 degrees.
At the second follow-up appointment, one month post-surgery (on November 22), I received another rehabilitation prescription and was prescribed Celebrex 200mg for pain relief, with instructions that I could now perform bending movements, and to take pain medication if I experienced pain while bending.
I have completed six sessions of rehabilitation based on the first prescription, but I feel the results have been mediocre.
Initially, I only received heat therapy and electrical stimulation, and in the last three sessions, I added cycling.
Due to difficulty bending my leg, I could only move forward and backward.
I mentioned this to my attending physician during my follow-up, but they reiterated the importance of continuing rehabilitation and scheduled another appointment in a month.
I have a few questions for you, Doctor:
1.
Can I switch to seeing a rehabilitation specialist for treatment? My attending physician only suggested that I could bend my knee.
How should I proceed with the physical therapist?
2.
My knee area is still swollen, and I feel tightness when bending.
How can I alleviate this condition?
3.
When sitting on a chair about 50 cm high, with my feet naturally hanging down at a 90-degree angle, can I use my healthy leg to press down on the injured leg to increase the bending angle, and then extend my leg straight afterward? Is this advisable?
4.
After bending my knee, I experience slight pain, but it subsides after resting.
I rarely take pain medication.
Should I apply cold or heat therapy for the pain?
Thank you very much for your help!

LKK, 60~69 year old female. Ask Date: 2018/11/23

Dr. Li Yongheng reply Orthopedics

Hello: 1.
You may consider seeing a rehabilitation specialist and ask them to teach you rehabilitation methods.
2.
Swelling in the knee area and tightness when bending is a normal phenomenon, and it may take about 2-3 months for the swelling to subside.
3.
Yes, this is a common approach.
4.
For severe pain, apply cold compress; for mild pain, apply heat.

Reply Date: 2018/11/23

More Info

Recovering from a patellar fracture can be a challenging journey, especially when it involves managing pain and undergoing rehabilitation. Based on your detailed description of your condition and treatment so far, it seems you are making progress, but there are still some concerns regarding swelling, pain, and mobility. Here are some insights and recommendations to help you navigate this recovery process.

1. Transitioning to Rehabilitation Specialists
It is entirely reasonable to consider consulting a rehabilitation specialist or a physical therapist. These professionals can provide a more tailored rehabilitation program that focuses on your specific needs, especially since you are experiencing significant resistance and tightness during knee flexion. A physical therapist can assess your range of motion, strength, and overall function, and develop a personalized exercise plan that may include manual therapy, stretching, and strengthening exercises.

2. Managing Swelling and Tightness
Swelling is a common issue following a patellar fracture and can contribute to the tightness you are experiencing. Here are some strategies to help manage this:
- RICE Method: Rest, Ice, Compression, and Elevation. Applying ice to the knee for 15-20 minutes several times a day can help reduce swelling. Make sure to wrap the ice pack in a cloth to protect your skin.

- Compression: Using a compression bandage can help control swelling. However, ensure it’s not too tight, as this can impede circulation.

- Elevation: Keeping your knee elevated above heart level when resting can also help reduce swelling.

3. Exercises for Flexibility and Strength
The exercise you mentioned—sitting on a chair and using your good leg to push down on the injured leg—can be beneficial for gradually increasing your range of motion. However, it’s essential to perform this exercise gently and avoid pushing through pain. Here are a few additional exercises you might consider:
- Heel Slides: While lying down, slide your heel towards your buttocks, bending your knee as far as comfortable, then slide it back out. This can help improve flexibility.

- Quadriceps Sets: While sitting or lying down, tighten the muscles on the top of your thigh (quadriceps) and hold for a few seconds, then relax. This can help strengthen the muscles around your knee.

- Straight Leg Raises: While lying down, keep one leg bent and the other straight. Raise the straight leg to the height of the bent knee, hold for a few seconds, and lower it back down. This helps strengthen the quadriceps without putting too much strain on the knee.

4. Pain Management Techniques
For pain management, it’s important to listen to your body. If you experience pain after exercises, resting and applying ice can be beneficial. Generally, cold therapy is recommended for acute pain and swelling, while heat therapy can be used for muscle relaxation and stiffness. However, avoid heat if there is significant swelling.

5. Medication Considerations
Since you mentioned using Celebrex, it’s crucial to follow your physician's guidance regarding medication. If you have concerns about pain management, discussing alternative pain relief options with your doctor or physical therapist may be helpful.

6. Follow-Up Care
Regular follow-up appointments with your orthopedic surgeon are essential to monitor your healing progress. If you feel that your current rehabilitation plan is not effective, don’t hesitate to express your concerns during your next visit. Your healthcare team can adjust your treatment plan based on your feedback and progress.

Conclusion
Recovery from a patellar fracture requires patience and a proactive approach to rehabilitation. By working closely with rehabilitation specialists, managing swelling, and incorporating appropriate exercises, you can improve your knee function and reduce pain. Remember to communicate openly with your healthcare providers about your concerns and progress, as this will help them tailor your treatment effectively. Stay positive and committed to your recovery journey!

Similar Q&A

Managing Pain and Swelling After Patellar Fracture Rehabilitation

I had a car accident on September 15, resulting in a right clavicle fracture and a left patellar fracture. I would like to ask about the rehabilitation; the doctor said I could do it at home. However, after almost a month of rehabilitation, I can only bend my knee to nearly 90 de...

Dr. Shi Guozheng reply Orthopedics
Patellar fractures, if not treated surgically, typically take about three months to heal. After approximately one month, achieving a range of motion up to 90 degrees is reasonable, and it can be gradually increased. For pain relief, analgesics can be taken, and alternating hot an...

Post-Patellar Fracture Rehabilitation: Managing Pain and Weakness

Hello Doctor: I would like to ask about my recovery after a patellar fracture surgery. I have a cast extending to my thigh, and when I try to do basic rehabilitation exercises, such as moving my legs side to side on the bed or practicing standing, I experience significant sorenes...

Dr. Shi Guozheng reply Orthopedics
1. It is normal to experience weakness around the joint after a fracture. 2. It is possible.

Understanding Patellar Fractures: Recovery, Rehabilitation, and Complications

Hello, Doctor! In September of this year, I unfortunately had a car accident that resulted in a patellar fracture. Initially, it was a hairline fracture, and the emergency doctor applied a cast, stating that surgery was not necessary and that I should wait for the bone to heal on...

Dr. You Dianqi reply Orthopedics
Hello, I would like to clarify that responses on the internet, without direct patient contact, should primarily rely on the opinions of the operating surgeon. If misunderstandings arise in the doctor-patient relationship due to online responses, it is not the intended purpose of ...

Effective Rehabilitation Strategies After Patellar Fracture Recovery

Hello, Director Chen! I injured my left knee patella due to a fall and had it in a cast for 6 weeks. After the cast is removed, what would be the best way to rehabilitate? Thank you!

Dr. Chen Xianchang reply Rehabilitation
1. If the wound is not healed, laser and ultrasound therapy (from the outside) can be used initially, along with strengthening exercises for the thigh muscles. 2. Once the wound has healed, hydrotherapy can be added to improve flexibility, gradually increasing weight-bearing on t...