HOW LONG WILL I NEED PHYSICAL THERAPY

Most fractures heal on their own within 8 weeks. The healing time is different if the bones are stabilized surgically but rehabilitation is still an important component of recovery in those cases. While the bone is still healing, physical therapy interventions will focus on adjacent areas. Once healed, your physical therapist may recommend 4-8 weeks of rehabilitation to help restore normal function to the previously broken knee and surrounding areas. Once PT can target the previously fractured area, you should experience improvements in many symptoms such as pain and stiffness within a couple of weeks but returns in strength, flexibility and overall mobility and return to your prior level of activity may take longer. Achieving long lasting results may take some time, but dedication to your program will help you achieve these results more quickly.

BASICS ON BROKEN BONES

Broken bones, also known as fractured bones, occur when stress across the bone exceeds the bone’s tensile strength. A bone may fracture due to trauma, or in the case of a weakened bone, can occur due to relatively normal forces. Fractures can occur in different patterns. They can be stable and nondisplaced and treated with a cast, boot or splint or unstable or displaced and treated with either closed or surgical reduction followed by a cast or boot. A bone that is broken in several places or unlikely to heal well on its own often requires surgery to stabilize the fracture with some type of hardware.

Bone fractures heal in three phases. The first phase is the inflammatory phase which starts within hours of the break and is normally complete within a number of days. During this phase the body lays down a fragile matrix of new tissues to begin repairing the broken bone. During the next several weeks the reparative phase occurs in which a soft callus is initially formed by bone-producing cells and then transformed into a hard callus over time. The soft callus can easily be disrupted if the bone is not protected but the hard callus is much more durable. In the final stage, the remodeling stage, the callus is slowly removed and the bone is reshaped and smoothed out as it responds to the stress and activity placed on it by normal activity. This phase takes months to years to be completed but in most cases a fracture is considered healed in about 8 weeks.

The knee joint is composed of three bones. The end of the femur or thigh bone forms the top of the knee joint while the top of the tibia or lower leg bone forms the bottom portion of the knee. The patella or “kneecap” lies anteriorly at the front of the knee. When a person states they have broken their knee they may be referring to a fracture in any of these three bones. Signs and symptoms of a broken knee include:

• Pain, tenderness and swelling over the bone
• Redness and bruising
• Difficulty walking on or moving the knee
• Signs of deformity in the bone

If you decide to work with a physical therapist to help with a broken knee, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY FOR A BROKEN KNEE

Your PT will avoid manipulating or stressing the broken knee until the fracture is healed in order to prevent disruption of the healing bone. During this time, your physical therapist may recommend the following interventions:

• Strength training, stretching and range of motion of adjacent areas of the body to prevent stiffness and atrophy while the knee is healing
• Modalities to manage pain and promote healing
• Training on the use of crutches, cane, wheelchair or walker to offload the knee when it is painful or healing
• Education on the healing process of bones

After the fracture is healed, physical therapy interventions can be directed to the affected knee and begin to include motions or exercises that will place stress on the healing bone. Though your physical therapy plan will be individualized to your needs, these are common interventions used to facilitate healing and return to full function after a broken knee:

• Stretching, joint mobilization and range of motion to improve the flexibility and mobility of the hip, knee and ankle
• Soft tissue mobilization to address any adhesions or scar tissue in the area
• Strengthening of the foot, ankle, hip and knee to help normalize walking and prepare the knee for return to unrestricted activity
• Balance and gait training
• Sport and work specific training to help the injured knee return to higher impact activities like running, jumping, stair climbing and walking on uneven terrain.