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Patella fracture success stories....-anyone?
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Hi guys,

6 months ago I absolutely smashed my right patella in a (very stupid...) bike accident. Luckily I had a competent surgeon and he solved the puzzle with three pins and a wire. The recovery so far has been going well (relatively speaking...). I am at the point where I go to the pool 3-4 times a week for swimming and then some deep water running/gymnastics. I also walk about 3 miles a day and can do some very light cycling on my mountain bike. No big gears, no hills.

I am a 36yo female and have been running for 20ish years and dabbled in tris for the last few years. I am by no means an elite athlete (marathon PR of 3h 16min and my first, and only, IM was in the 11:30 range). My question is: is there anybody out there who has come back from an injury like this? My doctor is very optimistic. So far the articular surface looks good on X-ray. No steps etc. No MRI or CT has been done yet.Hardware is scheduled to come out in 3 to 4 months and I am determined to wait until then before I attempt a "real run". I have tried some very slow jogging on the track for about a mile and it feels okay but by no means great. I hate to think that my running days are over but right now I am not very optimistic that I can ever seriously (well, for me) run again. I would appreciate any advice/success stories! Thank you!
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Re: Patella fracture success stories....-anyone? [Hobbs321] [ In reply to ]
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Stick with it...it's a long process. When I broke mine, I also had a broken hip (and other injuries as well). What I thought was the least of my worries, the patella, turned out to be a pesky booger! My PT guy had me taping it to pull it medially. Don't remember if that was related to the hip fracture, but I do know I lost quite a bit of quad strength due to inactivity.
But, needless to say...a little over 2 yrs post accident (27 mo.) I did another IM.
Stay on course and do exactly what your PT tells you to. No more. It has to become your training day in and day out.
I still have some pain in my knee (and hip) if I want to get down on the floor mainly. But, it's manageable.
Bike and run are back to normal.
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Re: Patella fracture success stories....-anyone? [Mac] [ In reply to ]
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Split mine in half when hit by a car in 1977 !
Told by an orthopaedic surgeon i would never be able to run again
Another Doc said cycle a lot ( no hills) It took a couple of years to get back to normal but have done several Ironman, over 20 marathons and a few ultras since
None very fast but not related to the patella as i had that problem before it broke
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Re: Patella fracture success stories....-anyone? [Hobbs321] [ In reply to ]
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Broke it toguether with ACL and MCL 20 years ago (still have some metal wiring and a 1.5inch screw inside... old times).
It has never been the same, but I started running for the first time 15 years later. I run 5-6 HM x year (1h30ish) and 20-30 miles/week is the average.
Biking aggravates it more than running but kinesio tape helps a lot

best of luck
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Re: Patella fracture success stories....-anyone? [Hobbs321] [ In reply to ]
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Totally shattered mine in a bad cycling accident back in '97. My surgeon basically made a little basket of pins and wires to hold things together. It was six months before I was allowed to even attempt walking ... though I had other rehab work I could do. Was not a runner and didn't do triathlon. Just a fast recreational rider at the time. Ultimately busted all the pins and wires and had to have it removed after the bone was all healed up. That was a setback, but I was actually way more comfortable once all that was gone.

Just when I was getting back to "normal" I got hit by a car on a trianing ride and sustained a number of serious injuries including a nearly-severed femoral head on the same side as the kneecap thing. I now have all sorts of hardware holding my hip and ankle together. That was in late '02.

My doc said I'd be insane to attempt running unless I wanted a knee replacement, a hip replacement and an end to my athletic "career" in a few short years. But she loved cycling. (It was giving her a lot of business!)

Just started racing time trials in late '05 and have won the state TT championship in my age group the last 5 years. Also have been on the winning relay at Beach 2 Battleship iron distance all three years it's been run.

So ... you'll get through it and there will be an active life on the other side. Be careful with those pain meds. They're highly addictive!

.

Bob C.

The "science" on any matter can never be settled until every possible variable is taken into account.
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Re: Patella fracture success stories....-anyone? [psycholist] [ In reply to ]
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Thanks guys! Makes me feel better... I guess I will just try to be patient. It sounds like there is a chance to come back after this (although the people that haven't are probably not on this forum anymore). I don't have pain most of the time and can go cycling for a bit, the problem is the swelling that follows after. It is quite spectacular and does not respond very well to ice/elevation. Need to give it time by the looks of it.I appreciate your stories and happy racing!
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Re: Patella fracture success stories....-anyone? [Hobbs321] [ In reply to ]
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Hi everyone,

I just wanted to write a quick note, so that I can contribute rather than just being a net "taker" on the list.

I shattered my patella on July 4, 2016. It has been one heck of an injury, and I've appreciated the encouraging notes on this list. When you're in the middle of recovery, you think you're never going to recover.

My knee will likely never be the same, but it is now April 2018, and I still run for 20-30 minutes at a time. I also do Orangetheory once a week, and I can run full out at 12 mph for 60 seconds. Granted, my leg is always stiff and aches but it's functional which is what matters most. I find that doing leg exercise with weights is actually far more uncomfortable than running.

My quad muscle is still smaller on that leg. I'm not sure if it will ever return to the same size but it's not very noticeable. I worked with a trainer twice a week for a year to help get that muscle back.

So everyone should know there is light at the end of the tunnel! I still have my hardware (2 pins and K-wire) in my knee. Not sure whether I will ever get it out. I would like to avoid being cut open again if possible since I am functional. I am not a triathlon participant but I always enjoyed running the bolder boulder 10K every year. I had to skip last year. I think I will do it this year, however, I'm sure I'll pay for it the next day.

But no one ever told me I could NOT run again. To the contrary, they all said I absolutely would. Someone mentioned that an ortho told them they would never run again back in the late 1970s. I would assume the medicine has just gotten much better since that time.

Keep your head up!
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Re: Patella fracture success stories....-anyone? [ihateloginnames] [ In reply to ]
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Funny that you just wrote a response to this - I shattered my patella in December 2016. I will echo you - it's been one hell of an injury. I got my hardware removed in September 2017, and that was a game changer in my recovery - I was able to gain full range of motion back and build up leg muscles which was so difficult to do with the hardware in there. Cycling has been my saving grace, I'd say that I am now even stronger than I was pre-injury (with a sh*tload of suffering and hard work since then), but I miss running so much - like you (and anyone with a shattered patella) my knee will likely never be the same. My doctor has cautioned me against long distance running for pretty much the rest of my life - he thinks it just will not be worth it as it seems a knee replacement would be inevitable...I'm only 28 so I want to prolong that as much as possible. Perhaps shorter distances are fine, but I really miss marathon running.

Any others out there in this very special club of ours, please join this thread - would love to hear what it's been like years removed from this dark tunnel - I can say I am finally in the light it's just a different kind of light than I was in before. In some ways I am lucky that it wasn't worse and that I was able to make this kind of come back (I've done a few century rides on the road bike in the last couple weeks), but other days when my knee is bothering me from simple daily activities and I just want to go out on a run with friends it's hard not to feel sorry for myself.
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Re: Patella fracture success stories....-anyone? [wahoowatri] [ In reply to ]
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Hey wahoowatri,

Thanks for posting. I definitely understand what you're going through. I have left my hardware in for now. The reason is because I do have good range of motion and I've been able to build strength even with the hardware in. It seems the consensus is just to leave it in unless I actually start to feel the hardware itself.

I feel sorry for you that you were into marathon running. I was never a long distance runner so I don't think that the injury will affect my jogging too much. I just signed up for a 10k and that's the most distance I ever run at one time. You're only 28 years old, so can't you still run but just not as far? Ironically, running really isn't too uncomfortable at all. It's everyday life activities such as going up and down stairs or even just sitting on a plane with the leg in one position that sometimes cause aching.
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Re: Patella fracture success stories....-anyone? [Hobbs321] [ In reply to ]
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This is a brutal injury that takes a long time to heal and may never be pain free. Only being six months out, relatively young, and being able to run is positive however. It is important to note that the absence of mechanical abnormality on imaging does not equal a painfree and fully functional status. Take your time and let pain be your guide. Be absolutely sure you have full AROM equal to your uninvolved leg. Small losses of ROM can and do result in pain as you've permanently changed the mechanics and loading of the joint. Progressive loading is best and don't overdo it.

I'm a physical therapist and board certified in orthopedics.
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Re: Patella fracture success stories....-anyone? [AndrewL] [ In reply to ]
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Thanks, AndrewL.

My PT was very good about helping me get back my ROM in the injured leg. If I lost any range of motion, it's very slight. I spent months sitting on the floor and pulling my leg toward me with the stretchy strap. I'm sure you know which exercise I'm referring to. I definitely have discomfort in that knee and exercising is more difficult, but I can't complain. It's not disabling pain, and I'm able to run short distances fine. I can even do squat movements, though probably not as heavy of weight as before, but I don't care much about that at 42 years old.
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Re: Patella fracture success stories....-anyone? [ihateloginnames] [ In reply to ]
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Greetings all,

Im new to the forum and really appreciate this subject. I was wondering if anyone is experiencing similar to what I am. Heres a quick summary. Broke my patella in 3 places in Oct 2017. Surgery involved 2 screws. Did about 10 weeks of PT. I then started lightly jogging again in February of this year (about 4 mos after the injury). I found the pain to be excruciating, but I started off very lightly and slow. I jogged in intervals. About 200 feet, then rest, and then 200 ft again. I was actually jogging with a slight limp due to my knee. Fast forward to today. I am up to 3 miles. I am diligent about keeping my form, alleviating the limp, but the pain is still bad at the beginning. However, when I am finished from my run, the pain is not anywhere near the level it was at the beginning. Im really not sure whats going on in there. Should I be wearing a support brace? Or building my strength naturally? It will be a year in October, the doc said he will do another evaluation then. I last saw him in April and he said the pain is natural and I could end up with Post traumatic arthritis but give it a year and then consider injections to relieve it. But maybe Im jumping ahead since it hasn't been a year yet. So I guess my question is, since the pain starts at the beginning of my run, does that mean the muscles are still weak and need more strengthening and conditioning? Or is it due to damaged cartilage causing inflammation. And why does the pain begin to subside during my run?.

Thanks for any info!
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Re: Patella fracture success stories....-anyone? [Marc_FTL] [ In reply to ]
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Hey Marc,

These are complicated issues. Your injury is the same as mine, b/c I also had multiple bone fragments and I still have 2 screws and K-wire in my knee. There is no doubt that you have cartilage damage (as do I) underneath the kneecap.

However, I am 2 years from my injury and i found the strength in the quad has gotten better. It will never be the same but it really does take a long time get back to full function. I would recommend not running as much and working with a trainer to strengthen that quad and the gluteal muscles. that's what has helped me. I only run about 3 miles when I run and can do that now perfectly fine. Do i have some discomfort? Sure. But it's manageable. The more strength you get in that quad and butt, the better. I am not a doctor, but from my personal experience, you should focus on strengthening that quad and maybe back off the running a little for now.

As far as cartilage damage, I'm not sure what do about that myself. I'm getting by without need for pain meds so I'm doing nothing for now. I'm sure in several years if I develop more pain, I may need some steroid or other type of injection at some point. My injury happened at 40 years old by the way. I'm now 42.
Last edited by: ihateloginnames: Aug 7, 18 13:09
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Re: Patella fracture success stories....-anyone? [ihateloginnames] [ In reply to ]
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Many thanks for the quick response. I really appreciate it. I know they have made strides in injections such as gels which act to relieve the friction and pain for about 6 mos. Lets see. I am 47 now and this happened when I was 46. My doc says a knee replacement is inevitable but wont need it for another 10 years or so, depending on activity I am guessing. I have actually laid off running since the spring. Its brutally hot here in Florida but really want to pick it up again when the weather is cooler. I agree about your advice about the quad and butt, didn't realize they made such a huge difference. I do group fitness classes a few times a week, I believe that helps but perhaps i need to focus more on those 2 muscles.

Thanks and happy running!
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Re: Patella fracture success stories....-anyone? [Marc_FTL] [ In reply to ]
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Oh no! That's discouraging that a knee replacement is inevitable! I hope i can avoid that but I'm probably being overly optimistic. I hope I can make it to my 60s before that happens, b/c I like jogging as part of my overall fitness. I do orangetheory. I'm sure someday I'll have to switch to biking but I refuse for now. Thankfully, my pain is rather mild. My surgeon told me that he really doesn't know whether i'll need a replacement, but I'm sure he just doesn't want me to be hyper-focused on that. I didn't realize how major this kind of broken patella injury really is. I'm glad you're back to fitness classes. That has been a huge thing for me mentally to be able to function again even with some discomfort.
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