When will I kneel again?
December 17, 2017 10:42 PM   Subscribe

I dislocated my kneecap last week in a freak accident. It's starting to feel like it's healing, but the ER doctors gave me very little idea of what to expect, and I won't get to see an orthopedist for several weeks. This is a really bad time for a disabling injury. I have a million things I need to do, but I'm worried about re-injuring myself. What can I expect for the next few weeks?

I mentioned my injury recently on the Blue (thanks for all the favorites). This kind of injury has never happened to me before, and while I gather from what I've read that a 4-6 week recovery period is typical, I don't know at what stages I'll be able to do what. It's been five days and I can almost stand unaided again (though it's very unpleasant to do so for more than a few moments), but I can get around okay on crutches. The ER referred me to an orthopedist, but presumably thanks in part to the upcoming holidays, I won't be able to see them until three weeks from now. They also suggested that the orthopedist may recommend physical therapy, which if true means I probably won't actually start PT for another couple of weeks after that.

If the problem were just limited mobility, that would be one thing, but my wife and I recently bought a house, and there's a huge number of projects that need to get done. We already decided to have one of them (tiling a floor) taken care of by a contractor, but we bought the place expecting we'd be able to deal with most of the various issues around the house ourselves, and we simply don't have the money to pay for professionals to do everything. My wife is also dealing with a debilitating injury, so we're really relying on me being able to recover to the point of be able to do electrical work, some basic carpentry, etc. again. This means I need to be able to stand for extended periods and move around on my knees while wearing kneepads.

You are not my doctor, and you're not giving me medical advice. But maybe you've suffered a full patellar dislocation yourself or know someone who has, and can help me get a general idea of what to expect while I wait for our overtaxed medical system to finally see me. When will I be able to do what I need to do around the house again? How much time am I losing by having to wait at least 5 weeks or so after the initial injury to start physical therapy? How much am I risking reinjury if I push myself before I'm fully healed? I really, really don't want to go through that again.
posted by biogeo to Health & Fitness (15 answers total)
It took me about 7 weeks to get out of a full leg cast for a broken kneecap. It took about 5-6 months of rehab after removing the cast, before I was able to use a bicycle and fully extend my leg again. I don't want to tell you that this will be your experience, except to say that I was as terrified as you, and I eventually got back use of my leg and was able to use it to bike again. For you, it may take less time, more time, or whatever time it takes, but with time and effort, short of some damage not described here, you'll more than certainly get back to some semblance of full normalcy. Give your leg time to heal, don't push yourself to ask more of your leg than what it can give, and do what physical therapy you can, is my advice.
posted by a lungful of dragon at 10:51 PM on December 17, 2017 [2 favorites]

Where I live (California), you can get up to 12 sessions of physical therapy without a doctor's prescription. Look into whether that's an option for you. I had a very positive experience with PT, albeit for a chronic injury rather than acute.

Pushing yourself before you're fully healed--that sounds like a pretty bad idea. Listen to what your PT and orthopedist tell you, even if it seems conservative. You will most likely get back full function, but probably not in the timeframe that you'd like.
posted by serelliya at 11:02 PM on December 17, 2017 [3 favorites]

Best answer: Sorry to be the bearer of bad news but I've done that maybe 5 times and it's going to take a while and you can't rush it. Depending on how badly you tore the soft tissue it'll be much more prone to re-dislocating again for a good while so take it easy or you'll actually be laid up for longer. Rest, ice, compression, elevation. I know it's annoying to have to camp out in a new house while waiting for upgrades and repairs but it'll be the cheapest and best option for you to wait a while.

Kneeling on it is going to be bad, don't do it. You need the swelling to go down and stay doe for knee stability. If you stress it out while it's swollen, you can get a Baker's cyst (which I have) which is a pita for life and weak ligaments or scarred and tight ligaments (which I had until a surgeon cut them) which is also no bueno.
posted by fshgrl at 11:32 PM on December 17, 2017 [5 favorites]

Best answer: I tore both knees up when I was 13: torn ligaments, tendons over-stretched, shredded cartilage. Nothing was ever done for them and this was long before the micro-surgery that's available these days. Please please give your knee lots of time, and don't push it at all. You can and should see a PT and do gentle exercise to strengthen the muscles around the knee to help keep the cap in place. If you push it, it'll never heal all the way and you'll be paying for it the rest of your life (ask me how I know). Chores can wait. Best of luck.
posted by MovableBookLady at 11:37 PM on December 17, 2017 [2 favorites]

Do either you or your wife have skills you can offer in trade (ones you can still do while healing)? And friends who would need these skills? Perhaps you can build websites, and you have a friend who can do handywork. Or maybe your wife is a photographer (whose injury doesn’t impede her work). Or you can tutor students (ok, not a great season for that one).

Better to spend some time looking for ways to trade the work you can do for the things that you cannot, if any of the things you cannot are urgent. Don’t reinjure yourself unnecessarily, soft tissue and especially weight bearing soft tissue injuries can be real life-long afflictions. (I have not had your injury in particular, though).
posted by nat at 11:55 PM on December 17, 2017 [2 favorites]

If you can't kneel, can you squat?
posted by rhizome at 12:19 AM on December 18, 2017

Best answer: I dislocated my kneecap a couple of years ago. I was told to avoid kneeling and squatting till it was mostly healed (at least a few months). Thanks to great PT, I am pretty much 100% now, but it still hurts to kneel on it. Don't try to push things - if it doesn't heal properly it makes re-dislocating the kneecap much more likely.
posted by kms at 12:20 AM on December 18, 2017 [2 favorites]

Response by poster: Thanks for the answers so far. I particularly appreciate the advice not to push it. The ER doc was a little vague on how much using the leg will encourage its recovery by exercise, versus how much it would risk a reinjury.

Fortunately I don't seem to have broken anything. I do plan on following the advice of my orthopedist and physical therapist, once I have it.

I'd particularly like to hear from anyone's personal experience about how long it took them before they could do things like kneel and work while standing for extended periods. Was 4-6 weeks about your experience?
posted by biogeo at 1:33 AM on December 18, 2017

Best answer: For a simple patella dislocation probably 3 weeks. Then again I never had to go to the ER and always popped it back myself or it went back on its own, yours sounds worse. You really need the swelling to be gone before doing much squatting or kneeling as that fluid has to go somewhere and synovial cysts or nerve damage or instability or circulation issues will result. Put it this way, I have and will ski all day with a knee like a cantalopue but I wont kneel or squat on the same knee at all. Squishing swelling is not good.

imho, you can greatly speed getting back to use by controlling the swelling. Eat super clean, drink water, avoid alcohol and ice, wrap, do calf pumps and elevate religiously.
posted by fshgrl at 3:03 AM on December 18, 2017 [1 favorite]

FWIW, I am large lady whose knees have not been injured, but do not take kindly to kneeling. Yes, it's awkward, but you can do a lot of things by sitting on your ass and scootching around in lieu of kneeling. I've even hand-painted a floor without kneeling.
posted by sarajane at 4:10 AM on December 18, 2017 [4 favorites]

Every injury and every person is so different... you might be able to get a ballpark idea from others, but it comes down to 1) exactly what happened to your knee (a broken bone takes far less time to heal than damaged ligaments and tendons need, because they're poorly vascularized :/ - if those were affected [probably] it could take 12-18 months until things feel close to right again. Did they take an MRI or ultrasound?) and 2) your other particulars (genetics, age, how well you heal)...

I'd plan around this injury for a few months, at least. (Meanwhile, move within whatever is a pain-free zone for you, that's what they tend to say.)

Can you think of new ways to do some of these jobs? Eg could you use a small stool and extend your leg out, if you have the mobility for that? Or do as much as you can seated at a bench beforehand? Rent or borrow a scooter?

Can you enlist the help of family or friends (maybe there's a niece or nephew interested in learning this stuff)?
posted by cotton dress sock at 4:30 AM on December 18, 2017 [1 favorite]

Best answer: Ouch, my sympathies! I managed to dislocate my knee 8 or 9 times as a kid and young adult (it turned out that my patella doesn't sit in my knee joint properly just by design) and will echo others who have recommended giving yourself plenty of time to recover and assiduously doing any strengthening exercises recommended to you in PT. Having experienced my dislocations as an impatient young person I think I wasn't great about this, and while it's been 13 years since the last time (on a hike in the middle of the woods!), I still don't feel totally confident in that knee, especially in situations where it's icy, there are twisting motions involved, etc.

It sounds like the timing is really rough, but I urge you to take the time your body needs to heal - best wishes!
posted by Synesthesia at 8:10 AM on December 18, 2017 [2 favorites]

Best answer: I hope I can be the bearer of some somewhat more optimistic news. I dislocated my kneecap 15 days ago. I spent a week in a rigid leg brace and a week in a more flexible t-scope brace and as of Friday my ortho freed me from any kind of brace and I'm walking and functioning pretty normally. The dislocation was, without question, the most painful thing that has ever happened to me, but the recovery started almost immediately when they popped it back in at the ER.

I did get an MRI and nothing is torn or broken, which is obviously a huge part of it. Is there really no way you can see an orthopedist and start PT sooner? I've seen mine twice since the dislocation -- once for an initial look and once to read the MRI results. Maybe your primary care physician could refer you for PT even before seeing the orthopedist.
posted by fancypants at 3:54 PM on December 18, 2017 [1 favorite]

Best answer: I've done this. It took me at least a couple of weeks beyond the six weeks of physical therapy before I could kneel without pain. (This was 20 years ago, so I don't remember the exact timeframe, but it was quiet a while.) And yeah, you really can't rush it.
posted by sarcasticah at 5:43 PM on December 18, 2017 [1 favorite]

Response by poster: Just in case anyone ever runs across this question when searching for information for themselves, I thought I'd give an update. It's been just over three weeks since I dislocated my kneecap, and I'm able to walk around pretty well now, albeit only at a slow pace and with a nasty limp. My endurance for walking is also pretty poor but improving daily. At the moment I'm generally feeling okay but stiff at the start of the day, and in some moderate pain and discomfort by the end after relatively light amounts of walking and standing. At my current pace of recovery, 4-6 weeks to being able to walk normally again sounds just about right.

However, I can still only bend my knee to about 90 degrees before experiencing significant pain, and this has been improving more slowly. Based on how things seem to be progressing, I think it will take a few weeks beyond the nominal 4-6 week recovery period before I'll be able to kneel and work on the floor again, more or less exactly matching what sarcasticah described.

Next week I'll finally get to see an orthopedist, just in time for everything to have healed on its own.
posted by biogeo at 9:26 PM on January 3, 2018

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