Q: I have fractured my right patella twice, first about 4 months back due to an accidental fall and again on the same place 2 months later. I had plaster for a months which was when the X-ray showed healing of my injury. I was advised rest for one month with normal activities. Unfortunately, my patella again got fractured, but this time it happened on its own. My knee was again plastered and it was opened a month later. Since the fracture did not heal fully, I was advised not to bend my knee for one month and a long knee brace was given. In this context I want to know what precautions I have to take while bending my knee; what exercises I have to do to regain strength and what excercise I must avoid? My right thigh muscle, in comparision to the left, has become thinner.

A:One way to avoid prolonged period of rest is to undergo an operation for fixation of your fracture and that way you can move your knee sooner. If you have been treated by plaster cast, then there would be a tendency for quadriceps atrophy - thigh getting thinner. You should start on quadriceps isometric exercises. Also you should start with gentle range of motion otherwise you might end up with a stiff knee. You should do physical therapy under supervision, so that adequate program is initiated. Once stretching is done and you have attained a good range of motion, then strengthening with weights should be initiated. Thus, there has to be a phasic rehabilitation program to get you going.