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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:

   The 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.

   Keep your cast or knee immobilizer clean, dry, and intact. Wrap it in a plastic shower bag whenever you may come in contact with water.

   Like 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.

   Elevate 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.

   Expect some pain for seven to ten to fourteen days after your initial injury. If needed, take pain medication as instructed.

   Move your toes as much as possible to help circulate blood.

   If you develop a rash or irritated skin around your cast, call your physician.

   If 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 few days.

   Expect 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.

   To 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.

RELATED TOPICS

   Knee 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.

   Daily 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.

   Muscle 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.

   Recreation - 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.