Kneecap > Treatments
If your fractured kneecap requires
a cast or knee immobilizer, here is what you can expect
and how you can cope with immobilization of your leg:
first concern is to monitor pain and swelling for the
first 48 hours while wearing your cast. If your swelling
decreases dramatically, the cast may become too loose.
If swelling increases, circulation can be dangerously
cut off. In both cases, you should contact your physician.
your cast or knee immobilizer clean, dry, and intact.
Wrap it in a plastic shower bag whenever you may come
in contact with water.
most knee injuries, treat with R.I.C.E. (Rest, Ice,
Compression, Elevation). You may or may not be able
to put some weight on your leg, depending on your physician's
recommendation. Wrap ice into a well-sealed plastic
bag and drape it around the cast or knee immobilizer
at knee level for as long as possible.
the injured leg above heart level to help blood drain
towards your body. It often helps to sleep with pillows
or blankets under your ankles.
some pain for seven to ten to fourteen days after your
initial injury. If needed, take pain medication as instructed.
your toes as much as possible to help circulate blood.
you develop a rash or irritated skin around your cast,
call your physician.
you sudden increased pain, contact your physician as
early as possible. In general, do not try to "grin
and bear it" if pain does not go away within a
your leg to be immobilized for about four to six weeks
before you can begin range of motion and quadriceps
strengthening exercises. However, straight leg raising,
which exercises the thigh muscles (quadriceps), usually
is recommended as soon as the acute pain associated
with your injury allows it.
avoid complications, only your doctor, a physician assistant
(PA), orthopedic nurse, or cast technician should remove
the cast with a special vibrating cast saw. In most
cases the cast is removed after four to six weeks.
Once your cast has been removed or
use of a knee immobilizer has been discontinued following
a fractured kneecap (patella), your physician may recommend
physical therapy to help you move about with the aid
of crutches, a walker, or other assistive device to
maintain and improve your overall conditioning. Though
everyone's rehabilitation program is slightly different,
rehabilitation for a fractured kneecap after cast removal
or discontinuance of a knee immobilizer follows a general
pattern. The rehabilitation focuses on strengthening
the muscles around your knee and increasing the range
of motion of the knee. Rehabilitation can begin about
four to six weeks after the injury was treated. Range
of motion is extremely important. Movement may be painful
at first, but it is important to not allow the knee
to stiffen. Rehab then progresses to resistive exercises
- those involving weights - to keep the muscles around
your knee strong. You should eventually be able to resume
functional activities like stair climbing, single leg
support, swimming, and driving. You will be able to
begin more vigorous activities as your kneecap heals
and your leg gets stronger.
strengthening exercises: Kneecap (patella) injuries
Once your fractured kneecap has healed,
building muscle strength around your knee can help you
avoid further injury. Contact sports and activities
increase your chances of re-injuring your kneecap. A
kneepad can cushion the blow when playing contact sports.
Another way to help prevent further knee injuries is
to learn knee-sparing exercise techniques.
Living - the average person takes between 12,000 and
15,000 steps a day. Each step exerts a force between
two and five times your body weight on your knees. After
a knee injury, take it easy on your knees during the
day whenever possible to save them for activities and
exercise. Avoid stairs when there is an elevator, take
the shortest path when walking, and consider wearing
athletic shoes designed to absorb shock.
Strengthening/Conditioning - activities themselves are
not a substitute for conditioning. It is essential to
adhere to the muscle strengthening program you learned
in rehab throughout the remainder of your life. The
best strengthening programs are low-impact and non-weight-bearing,
like stationary bikes and certain weightlifting programs,
so that the knees do not have to absorb shock.
- your sport or activity of choice helps maintain mental
and physical well-being, but it is not a conditioning
program. Sports that require twisting and quick direction
changes put great strain on your knee.