A fracture around the knee can take place on the patella, the osteochondral, the tibial plateau or the tibial tubercle. The latter two are the most common regions for stress fractures around the knee. A compressive force paired with pain around the knee and the inability to place weight on the injured leg indicate a fracture. If you are diagnosed with a fracture around the knee, treatment involving acute care and rehab should be done.
Acute Care
Fractures are treated promptly with immobilization of the appendage with a cast and crutches. Weight bearing activities should be avoided for about four weeks, with rest for the joint emphasized. If the fracture has not been displaced, surgery can be avoided. After rest, partial weight-bearing is allowable followed by rehabilitation with physical therapy.
Goals and Procedures
Goals of physical therapy should be to regain range of motion of the knee joint as well as to strengthen the muscles surrounding the knee, including the quadriceps and hamstrings. As physical therapy begins, sessions are centered around regaining range of motion. As your leg starts to feel stronger, strengthening exercises begin.
Range of Motion Stretches
Stretching is an effective means of gaining flexibility and range of motion back to the knee joint. Begin by stretching your hamstrings, quadriceps and gastrocnemius muscles. To stretch your hamstring, lie on the floor near a wall. Extend your leg up against the wall and straighten it as much as you can. To stretch your quads, use an elevated surface and stand in front of it with your back facing it. Lift your foot up onto it so that the top of your foot is resting on the elevated surface so your knee is bent. Gradually raise the elevation as you gain flexibility in your quads. For stretching your gastrocnemius, stand facing a wall and in a lunging position with one foot forward and one back. The forward leg should be bent, so that the stretch is felt in the calf of the back leg. Use the wall to increase the stretch. Stretching can be done several times a day and should not cause you pain. Hold each stretch for at least 20 to 30 seconds.
Short Arc Quad and Knee Extensions
This is a beginner strengthening exercise for the quads. Lie on your back with your injured leg on top of a foam roll or towel, placed under your knee. Slowly and in a controlled manner straighten the injured leg by straightening the knee and lifting the heel off the ground. As you progress, you can sit up and extend the knee in a full range of motion without a foam pad. Place a resistance band on the injured leg's ankle with the other end tied to a fixed object and use the resistance band as an opposing force as you straighten your leg. Try to perform one to three sets of 10 to 15 repetitions.
Hamstring Curl
This exercise will strengthen the hamstring muscles, located on the back of the upper leg. To begin, lie on the ground face down. Extend both legs out and slowly curl the injured leg in as far as you can, extend it back out to the starting position and repeat. As you gain strength, attach a resistance band to your ankle on one end and to a fixed object at the other end so you can use the resistance band as an opposing force to perform the curl against. Do this exercise for one to three sets of 10 to 15 repetitions.
References
- "Foundations of Athletic Training"; Marcia K. Anderson, Susan J. Hall, Malissa Martin; 2005.
- MayoClinic.com; A Guide to 10 Basic Stretches; February 23, 2011
- PhysioAdvisor.com; Knee Strengthening Exercises; 2008
- "ACSM's Guidelines for Exercise Testing and Prescription"; Mithcell H. Whaley, PhD, Peter H. Brubaker, Phd, Robert M. Otto, Phd, eds.; 2006.
