What exercises should I do after fractured patella?

What exercises should I do after fractured patella?

After patella fracture most common complication is the knee stiffness. So exercises play a major role in getting back to normal life. Patella fracture can be treated without surgery (if fracture is undisplaced) or with surgery (for displaced fracture fragments).

Exercises after patella fracture treated conservatively (without surgery)

If treated without surgery it should be immobilized in a knee brace locked in full extension (straight knee) for 4 weeks. During these 4 weeks you should do Straight leg raising, static quadriceps exercise, hamstring stretching and hip abduction and adduction exercises a given below. All these exercises you can do with brace locked in full extension on. You can put weight on the affected limb while walking.

Straight leg raising in sitting:  Sit and Keep your back straight in a a chair with legs hanging at the edge. Now straighten one leg out in front of you. Hold it there for 10 seconds and then bring it down to the floor. Repeat it with other leg. Do 10 to 20 times with each leg and twice a day.

 

Straight leg raising in lying down: You lie down on the mat and bend your both legs at the knee so that your both foot are on the floor. Now lift the leg you want to exercise up to 45 degrees. Hold it there for 10 seconds and then repeat with other leg. Do 10 times with each leg and two times a day.

Static quadriceps exercises:  While lie down in bed, keep your legs straight. Now as shown in the picture below put a rolled towel or pillow below your knee and presses the knee into it downwards by tightening the muscles of the front of the thigh.

Hold it there for 10 seconds and then repeat with other leg. Do 10 times with each leg and two times a day.

Hamstring stretching exercises:  keep your leg straight on a table and lean forwards as much as possible trying to touch your toes. Aim to stretch forward from the hip rather than the shoulders. You will feel a stretch at the back of the leg. Maintain this stretch for 10-15 seconds and do it for 3 times and repeat twice a day.

Hip abduction strength exercises- In side lying position wrap a thera band around your legs and then raise your leg against resistance of thera band. Hold the raised leg for a few seconds and then bring it down back. Do 15-20 repetitions.

After 4 weeks, start bending your knee. In the first week bend your knee up to 30 degree and increase knee bending every week by 30 degree to get full movement by 8 -10 weeks.
Exercises to be done after 4 weeks

Knee bending (passive knee flexion/active assisted knee flexion): Sit on the edge of bed/chair and bend your knee as much as possible. Take help of other leg to bend your operated leg. . Hold for 5 seconds after pushing and then relax for 5 seconds. Do this 3-4 times a day for 5 minutes at a time.

Heel slides: Sit on the bed and try to pull the heel toward the buttock with the help of a belt /scarf as shown in the picture below. Hold for 5 seconds after pulling and again straighten the leg by sliding the heel away from buttock. Again hold the straight leg for 5 seconds. Do this 3-4 times a day for 5 minutes at a time

Stationary bicycle riding: Start stationary bicycle 10 minutes a day between 7-14 days or when your knees flex to more than 90 degrees. Gradually increase by 2 minutes per week till 20 minutes per week.   Progress in this manner: high seat ½ circles forward/backward (pendulum exercises) to   full circles – lower seat. Initially start without resistance and gradually add resistance by the end of 4 weeks.

Mini wall squat (30°): Place feet at shoulder width. Initially you can take support of a wall and squat up to 30 degree. Hold for 10 seconds and then relax for 5 seconds. Do three sets of 10 repetitions.

Heel raises: Hold for 5 seconds and slowly get down. Do it 3 times a day with 10 repetitions each time.
After 6 weeks you can start prone flexion.

Prone flexion: Lie face down on the bed and bend your knee. You can take help of other leg or a belt/elastic belt to bend your operated knee. . Hold for 5 seconds after pulling and again straighten the leg and relax for 5 seconds. Do this 3-4 times a day for 5 minutes at a time

Keep continue these exercises till 8 weeks.  You should gain almost full knee range of motion by this time.  After 8 weeks start advanced strengthening exercises.

Leg press: These exercises help building your quadriceps (front of thigh muscles).You can find leg press machine at a nearby gym. Start with minimum weight and gradually increase weight 2-3 kg per week. Do 10 minutes a day. Once you are comfortably lifting weight you can progress to single leg press after 2-3 weeks.

Leg extension: This also builds up your quadriceps (front muscles of thigh). Start with minimum weight and gradually increase weight 2-3 kg per week. Do 10 minutes a day.

Hamstring curls: This strengthens back muscles of the thigh. Start this exercise at 6 weeks because your graft has been reconstructed using hamstring tendons which need 6 weeks to heal. Do hamstring curls in sitting position and not in lying face down position. Start with minimum weight and gradually increase weight 2-3 kg 4per week. Do 10 minutes a day. Gradually increase to20 minutes. If you develop hamstring pain (at back of your thigh and knee) then decrease the intensity of exercise.

Elliptical cross trainer: 20-30 minutes a day: This strengthens your hamstrings, quadriceps, calf muscles and also a good work out for upper limb muscles.

Continue these strengthening exercises till 6 months and then you can gradually return to sports.
Exercise after surgery of patella fracture
Continue these strengthening exercises till 6 months and then you can gradually return to sports.