Post-Fracture Knee Rehabilitation: Addressing Swelling and Stiffness - Rehabilitation

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Post-fracture knee rehabilitation can be a challenging process, especially after a patellar fracture. It’s common for patients to experience swelling and stiffness during the recovery phase, particularly after immobilization. Here’s a comprehensive overview of your concerns and some recommendations for managing your rehabilitation effectively.


Understanding Swelling and Stiffness
After a fracture, the body initiates a healing response that often includes inflammation. This inflammation can lead to swelling in the knee and surrounding areas, which is a normal part of the healing process. However, excessive swelling can impede your range of motion and contribute to stiffness. It’s important to differentiate between normal post-injury swelling and swelling that may indicate complications, such as infection or improper healing.


Is This Normal?
Yes, experiencing tightness and swelling in your knee after a patellar fracture is quite common, especially after removing a brace. The tightness you feel may be due to muscle guarding, where your muscles tighten to protect the injured area. Additionally, the lack of movement during immobilization can lead to stiffness in the joint.


How to Improve Swelling and Stiffness
1. Elevation and Ice: Elevating your leg and applying ice can help reduce swelling. Aim to keep your knee elevated above the level of your heart, especially after activities. Ice should be applied for 15-20 minutes every couple of hours, especially after exercises.

2. Gentle Range of Motion Exercises: Start with gentle range of motion exercises to promote flexibility. Simple movements like ankle pumps, heel slides, and gentle knee bends can help. Avoid pushing through pain; instead, focus on gradual improvement.

3. Strengthening Exercises: Once you can tolerate it, begin strengthening exercises for your quadriceps and hamstrings. Isometric exercises, where you contract the muscle without moving the joint, can be beneficial. For example, try pressing your knee down into the bed while keeping your leg straight.

4. Patellar Mobilization: If you’re experiencing tightness around the patella, gentle patellar mobilization can help. This involves moving the patella (kneecap) in different directions to improve mobility and reduce stiffness.

5. Physical Therapy: While your doctor may not have referred you to a rehabilitation facility, consider seeking out a physical therapist. They can provide a tailored rehabilitation program and manual therapy techniques to address swelling and stiffness effectively.


Home Rehabilitation
If you’re rehabilitating at home, here are some exercises you can incorporate:
- Heel Slides: While lying down, slide your heel towards your buttocks, bending your knee as much as you can without pain. Hold for a few seconds and then slide back to the starting position.

- Quadriceps Sets: Sit with your leg straight and tighten the muscle on the top of your thigh. Hold for a few seconds and then relax. Repeat several times.

- 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 moment, and lower it back down.

- Wall Slides: Stand with your back against a wall and slowly slide down into a squat position, keeping your knees aligned with your toes. Hold for a few seconds before sliding back up.


Conclusion
It’s crucial to listen to your body during this rehabilitation phase. If you experience significant pain or if the swelling does not improve with home management strategies, it’s important to consult your healthcare provider. They may want to evaluate your knee to ensure that there are no complications from the fracture or the healing process. Remember, recovery takes time, and gradual progress is key to regaining full function of your knee. Stay positive and committed to your rehabilitation exercises, and you will likely see improvement over time.