Tibial Plateau Fracture Recovery

**seanwieland** · 05-05-2012, 05:05 PM

Trying this again...

**lgillingham** · 05-05-2012, 06:33 PM

Hey. I have hopeful news for the runners in the group. I had surgery on march 7, and when I went in for my post six weeks check up my surgeon said I could walk because the bone had healed completely. So my 12 week hell just vanished as he gave me a six-week reprieve for good bones. The walking was easier said then done though. The next day I took my walker and did 1.2 miles in 65 min.....super slow but I was on the move. Next day....1.2 miles in 40 min with a cane. Each day.....more progress. I went 4 miles last week in 1 hr 50 min. And today. 8 miles in 2 hrs 25. I'm toying with walking the rock and roll marathon in 4 weeks if I can keep it up. I know it's crazy but I'm no worse for the wear and my pt is keeping a close eye on me. I am using the cane on and off again. I'm not pain free but it's bearable. My foot swells up but no worse than from a full day at work. I can't wait to run again but the walking is helping me feel heathy again.

**ZGHighlands** · 05-05-2012, 09:32 PM

Originally Posted by seanwieland

I'm no doctor, but listen to what your body is telling you. I think if ROM feels good, doesn't hurt, and you don't push it too much, ice it afterward, then any progress that is made now just gets you further down the curve. My doctor wants to see the "paint dry" (ie, bone heal) before I see a PT, but he encouraged me to take the brace off and work it. At 17 days post op, I have 70-80 degrees flexion. I'd call your doctor and challenge him/her on it. The Brigham & Women's care protocol for this injury says to start PT right away, with the goal of 90 degrees within the first four weeks.

Hey Sean,

Nice CT. Had to take a PK just for looking at that! I totally agree with listening to your body to know what's too much. As soon as your scar's allow, you may consider getting into a pool. The neutral buoyancy is great for ROM progression and it's pretty safe in terms of weight on your fracture. I was able to do a little swimming pretty early on and it was great for my overall attitude. Also, I can't say enough about trying to keep your foot and ankle moving as much as you can. Keep after it and good luck!

Travis

**meganoneill** · 05-07-2012, 04:54 PM

iwell i was given a few excer. to start. then progresses to all kinds of leg lifts...getting the quad to fire, and yes, shake. my dau. is a p.t. and gave be lots of nwb excer. after 4 weeks.

Originally Posted by krausedmb

I have a question for someone who is able to do strengthening on their leg. I am almost to 4 weeks post op and I still have the restriction of only bending my leg to 40 degrees. I am not able to do any strengthening yet. My leg has lost most of the muscle. Has anyone started strengthening and are you seeing/feeling any results? How long have you been doing it? For someone who is further out, how long did it take to get your leg back to a normal size? Thanks!

**meganoneill** · 05-07-2012, 05:12 PM

geez painful, i am sorry you are in this 'club'...but the light is at the end of the tunnel...miraculously...the pain goes (at least for me) at week 4....night pain but days were good. i was about to go crazy, but seemed to manage. i got a lot of sitting stuff done, like files and organizing...boring but nec.take care

**sudyshewo** · 05-07-2012, 06:41 PM

I miss my junkie shit. Its been since october and I can walk, except in the mornings still when I crack and limp and stumble. I got better for a while but since I got a high demand job thinking it would be good for rebuilding, its pretty much constant nagging pain and I can't really kneel to pull weeds, or bike for days on end...or dance. I used to love to dance like crazy for hours with running and intensity of motion. Now just thinking of the spirit lost makes me cry. I can't seem to make myself joyful. Oh well. avoid the club--it dosen't need me to point out the obvious. Nagging lament, sorrowful regret. I hate to waste a pill on sleep but maybe I will just for tonight. Maybe I'm in over my head with the new gardening job. It seemsed better to take it than bow down and beg with a lawyer for a disablility diagnosis and hope of metal removal. Nobody likes watching somebody in pain--and I like pleasing nobody, when its what remains, but I'm not doing anything today.

**SueBee** · 05-07-2012, 07:26 PM

Originally Posted by ZGHighlands

Hi SueBee,

Sounds about identical to my injury. Accident and surgery on 3/10, plate and 4 screws. I will say that my OS has been great in terms of progressing my recovery. He works with lots of pro skiers and other pro athletes (which I am not) so I'm confident in his judgement and recommendations. At 5 1/2 weeks, He cleared me to pwb up to 35lbs, with slow progression to 50% and use of 1 crutch. Yesterday I was allowed to make the transition to 1 crutch and it was great! I do have a slight hang up in the ROM flexion, which my PT has me working on 3-4 times a day for no more than 5 minutes. The exercise is simply sitting on the floor w my back against a wall, flex my leg from fully extended (flat on floor) to maximum flexion (knee bent)...I have to pull the lower leg with my hands, through the final 3 or 4 inches of flex. What I have found with most of my issues, is that as I become more active, the quicker the issues take care of themselves. As my PT says,"Motion is lotion." The biggest key is doing it without pain. If it hurts, stop. Best of luck to you as you move froward!

Travis

Nice! Thank you! It is similar to the exercise my PT has me do but I am using a strap until my ROM improves. We measured 65 degrees last physio but I'm working at it. It does feel like it is getting better.

I had to reschedule my six week follow up - so it was week 7 when OS felt the bone has healed and I was cleared for PWB. Originally was supposed to be 8 weeks, so feeling pretty happy about it. The weight bearing feels pretty comfortable.

Did you injure yourself skiing? I will search through for your intro post

Happy walking!

**SueBee** · 05-07-2012, 08:33 PM

Originally Posted by seanwieland

Hi SueBee -

I'm curious what your ROM is at 7 weeks. I'm 16 days today, haven't started "formal" PT yet, as my doc wants to wait until 21 days to do that, but has encouraged me to push to the resistance and back again. I've gotten it to about 10 degrees (extended) and 70 degrees (bent).

Thanks,
Sean

Hi Sean,

My brace was "unlocked" to 90 degrees at 4 weeks post op. I never did achieve that however. I was not cleared to start working on ROM with PT until week six post op. Last week (7 weeks post op) I was at about 65 degrees. I know I made progress this weekend- I feel like I'm at 90 or better now.

I see on this forum that there are almost as many different protocols as there are patients. I trust so far that the OS and PT have it sorted. My leg feels good. I am sure I will get there if I take my time. I will let you know after my next PT where I get to.

Good luck!!

-Sue

**Theena** · 05-07-2012, 10:08 PM

Hi, I have been lurking around for a few months and am finally writing my story. My story of my TPF is not sports related, but never the less is a story. I was at lowes and had just bought a refrigerator, they helped me load it but the kid that helped me was to busy to help me tie it down. As I was reaching around the back of the fridge, to grab the rope I was using, my feet tangled up with each other and over the side of the truck I went. Landing on my left leg and my right leg was stuck on the under ridge of the side. As soon as my left foot I heard the pop and the pain was there immediately and I was not able to bear any weight on the leg, and promptly fell on my tush. Several ppl came running to assist me and picked me up off the ground, saving my dignity a tad bit but not much. They helped me stand and wanted to sit me down on the tailgate but being stubborn I wouldnt let them, they then tied the fridge down for me and helped me get in the truck, hindsight being there now, I should have had them call an ambulance. I then tried to drive home, thinking oh well it is only 3 miles and I can get there and my husband can get me to the hospital. I made it driving about 6 blocks till I had to pull over as I was going into shock from the pain, and had to call for help. By the time they got me to the er I was hyperventilating and cussing every bump they hit.
Ends up that I had a tibia Plateau fracture, with a 3 cm depression and spiral fracture down the tibia that was about 10 inches long. I had surgery on November 11th to repair the damage, with a plate and 13 pins and nwb for 12 weeks. During the 12 weeks I ended up with stitch abscess infections in different areas of the incision.
During the first part of my 12 weeks I had pt come to the house to start with range of motion on the foot and ankle and rom for the hip. I at this time had the hinged brace and worked the bend on my knee and had no issues with getting the 110 degrees of bend, but the straight knee I am still working on. Almost there but not quite, the infections caused a delay in being able to start pt, and actual pt was not started until the middle of Feb, when I was at that time only toe touching with weight bearing.
I started water pt and that was awesome being able to finally stand and walk for the first time in almost 4 months. We noticed that when I was in the water that my foot and ankle were having issues and the pt was really trying work on that so that I could have a good gait when trying to walk, needless to say the os didnt want to hear there were other issues so he ignored the complaints even though they were voiced several times. During this time the leg was healing well, and we had some great new bone growth. However during the 2 months in between appointments that changed, even though pt was progressing and I was bearing more and more weight, I still was not up to 100 percent wb and still am not at this time.
Since this doctor was not listening to me I went for a second opinion with podiatrist since the swelling was increasing in the foot and ankle and the rom was decreasing. This was probably the most depressing appointment that I have had during this whole ordeal. This doc added to the diagnosis with osteopenia, post trauma osteoporosis, and Reflex Sympathetic Dystrophy Syndrome or RSDS for short. So now I am in a double compression sock, back in water pt along with land pt. I just hit 6 months of this injury and was told originally 6-8 month recovery for the severity of the break, however it has now been changed to 8-12 months and still on both crutches as they are afraid that I could fracture the ankle if I step wrong while I am trying to get the bone to strengthen back up. I can so relate to your stories.

**Shealynn21** · 05-08-2012, 08:31 PM

WOW! So glad i found this site!
I received my Tibial Plateau fracture among other serious injuries March 15, during a car wreck. I was immediately taken to the nearest Emergency Room. There they never discovered the fracture. They just thought I had severely sprained my ankle. I was sent home with crutches and was told if the sprained ankle did not heal in the next 7-10 days i should my physician. I woke up three days later in excruciating pain in my knee! I immediately made an appointment with my physician. He sent me to the local Ortho Surgeon. So, on my way i went to see him, thinking they will just put me in a boot or something (nothing major). That however was NOT the case! When the surgeon came into my room he told me I would need surgery to repair my broken tibial plateau. Not only fractured the platuea but split my tibia in half. WHAT?! I was scheduled for surgery the next morning.
I am now currently 6 weeks Post-Op. Just recently promoted to PWB. I was just wondering how you guys deal with not only the physical pain but the emotional pain? I was a very active person. Worked ALL the time, volunteered at my local church, and was a child advocate for CASA. Now, i haven't been able to do much of anything, mostly because of the pain and the frustration of having to rely on someone else to carry things since my hands are preoccupied with those stupid crutches!!
Also, I was just wondering if it is normal to have significant pain in the ankle area when starting to bear weight?
Thanks, Shealynn

**SoccerGirl** · 05-08-2012, 08:35 PM

Originally Posted by TPFxPilot

Both articles are co-written with Dr. Joseph Schatzker, for whom the whole classification system has been named, so I assume they are quite reliable sources of info:
http://olc.metrohealth.org/SubSpecia...rauma/ch56.pdf
http://://health-7.com/Skeletal%20Tr...au%20Fractures

Thanks for sharing these articles! you weren't kidding they're not light reading

... even a partial reading of one has given me plenty of new things to be anxious about (why didn't my surgeon do an MRI? should he have further assessed for soft tissue injuries? etc.)

.

TPFx -- i am worried about your not moving the knee at all too! def think about 2nd opinion, soon.

personal trainer -- thanks everyone for good feedback. I had a talk with him and now i've been pretty happy -- we do only upper body/ core stuff, plus the Rowing machine which my knee does fine with (3 months post surgery).
Exercise suggestion: If you're permitted to bike (stationary), add some light arm weights, doing every imaginable exercise/ arm circles continually; it's pretty good whole-body! I highly recommend. Personally, not being allowed to run or even do elliptical yet, this has been a great help and nice alternative to the pool. (PT lets me bike up to an hour, though not cranking up the resistance)

New gripe: insurance!! People be warned: I was pretty upset to discover today that a number of past doctor visits, like to the Surgeon and chiropractor, were coded as "PT", hence were deducted from my 30-visits-per-year limit... hence, to everyone's surprise, I am now down to next to nothing remaining, despite my medical necessity

I highly advise everyone, if you face limited visits with no chance of renewal (once they're up, I have to pay full price for anything PT, i don't even get the "allowed amount", and not even a doctor's request can obtain more visits): before you see any Doctor for anything remotely related to your injury, ask them how they will code it to insurance!!! I wouldn't have wasted my precious PT visits on several inferior things if i had known.

Has anyone out there run out of insurance coverage for PT but still needed it? how have you managed? just pay full price? (i wonder how much full price would be, yikes!)

**SoccerGirl** · 05-08-2012, 08:52 PM

Originally Posted by Shealynn21

WOW! So glad i found this site!
I received my Tibial Plateau fracture among other serious injuries March 15, during a car wreck. ...

Shealynn, condolences! I totally can relate to the emotional pain. And needing people to help carry everything. This lasted about 2.5 months for me. Sometimes, I would get so frustrated/ tired i'd just sit and cry instead of getting up to try to accomplish something, like fix myself something to eat -- a ridiculously complicated/ exhausting procedure when you have to balance on one leg and tote two crutches everywhere you move. Was hard not to take my frustrations out on my poor parents, whom i moved home with for awhile as i needed so much help. The injury fostered a lot of pain/ difficulty in my relationship with my parents, compounding the emotional trauma of the injury. I was very active too -- activity was my middle name -- so I felt quite lost/ battled depressed, esp. when i kept hearing about my friends doing all the things i couldn't. Plus i was so uncomfortable all the time/ so ancy but not able to exercise, that trying to do things like read books or whatever was pretty hard for me. Even movies got old! But take courage, it won't last forever, God willing! I feel like a new person now that i am able to drive a bit, and ditch the crutches (usually). Freedom!! It's going to be hard. I am sure there are lots of things you could think of to do during this time, or try to, but, my advice, be gentle on yourself. Allow yourself to just rest. God has made it very simple right now: your duty is to get better and to rest and rehab! Definitely don't isolate too much... it was really bad for me.
About the ankle, yes, my foot/ ankle are actually what often hurt the most when i try to walk much... at least at first anyway. Now it's my knee that starts to hurt more than my foot/ ankle.

**Nurse Nina** · 05-10-2012, 08:43 AM

Yes, we all feel this emotional and frustrating ordeal. I am now on partial weight bearing 7 weeks postop and although I am happy to have a little more balance, I still can't do much without my hands available to hold anything bit the darn crutches.
I tried a back pack, but it has to be light. Yesterday, I went to my office (I am a nurse education professor) to work on the test bank, something I can't do from home. My daughter was waiting in the parking lot to drive me home, and most of the faculty had left or were in meetings and the admin. assistant was no where to be found. I stood at the large suite door and could not for the life of me open it so I could step out and get to the elevator. I just stood there and wanted to cry. My back pack was too heavy to carry and I couldn't turn the handle and push the door open. And they say the building is handicap accessible?
The outside doors close by the time I push the auto button with the crutch stretched out and get to the door. Who designs these things?
I finally got out after texting my daughter and asking her to leave the car running to come and get me. Keeping the phone tucked into the Bledsoe brace keeps it pretty handy. I hate having to ask for help. I'm usually very active and completely independent. I am grateful my girls are grown up and still live at home where they can help. Just wish they would clean like me. I'll just have to deal.
In answer to those of you who are beginning to weight bear. Yes, the ankle and foot really hurt. I sprained the lateral or outside of my right ankle along with the Spiral fracture, but it hurts mostlly at the lower end of the tibia where it connects to my foot on the inside of my ankle. My PT says this is to be expected. The bottom of my foot gets puffy as well so i feel a crackly sensation across the bottom of the foot when I put some mild pressure on it.
Hang in there, every week there is progression even though it is slower than we want.

**tibfibxib** · 05-10-2012, 01:57 PM

Chiming in as someone who has just started bearing weight on their leg after 13 weeks... My ankle hurts a ton when I work on walking normally (using 2 crutches currently). I think a lot of it is me trying to work through the really poor ROM I now have in that ankle. Unlike it does for my my knee, ibuprofen doesn't provide any relief for my ankle when I've been pushing it. Icing has become a daily part of my routine. That helps a bit.

Not that I had any illusions about recovery, but it's clearly a long road, even after you're able to bear weight again. Having said that, I'll take walking in pain over not walking any day! My goal is to crutch free and comfortable walking by the end of the summer.

**SueBee** · 05-12-2012, 10:08 PM

Originally Posted by tibfibxib

Chiming in as someone who has just started bearing weight on their leg after 13 weeks... My ankle hurts a ton when I work on walking normally (using 2 crutches currently). I think a lot of it is me trying to work through the really poor ROM I now have in that ankle. Unlike it does for my my knee, ibuprofen doesn't provide any relief for my ankle when I've been pushing it. Icing has become a daily part of my routine. That helps a bit.

Not that I had any illusions about recovery, but it's clearly a long road, even after you're able to bear weight again. Having said that, I'll take walking in pain over not walking any day! My goal is to crutch free and comfortable walking by the end of the summer.

Congrats! What was your PWB date?
I am rooting for you!! My goal is also walking crutch free and comfortable this summer. I hope by mid July but don't really know what to expect yet. I want to ski next season. I am not experiencing the pain that you are. However, I do enjoy my ice packs. Ahhhh!

Yeah recovery is slow. Sometimes disappointingly so. Today my PT and I figured out, based on my current progress of about 10 degrees a week, I will be on stationary bike (120 degrees) in 4- 5 weeks. Sucks! I'm gonna try and beat that timeline... But it just reminded me how slow this is.
I am LOVING the PWB though. Tastes like freedom. I am able to ride the bus now. This already increases my mobility in a huge way. I am grateful that my city has an accessible transit system (HandyDart) but I am even more grateful that I have graduated from that much slower system. Next stop driving!

My foot is now swelling like crazy! That silly putty textured edema. I'm squeezing it along my leg like a tube of toothpaste. Nuts!

Thanks for sharing your experience here. I hope you have lots of great help at home. I've had to ask many people for help.

TPFX 03/10/12
Surgery Plate and 4 screws 03/13/12
NWB 7 weeks
PWB 30lbs 05/01/13
ROM 80 degrees 05/12/12
PWB approx 50-60 lbs today

**TPFxPilot** · 05-12-2012, 10:30 PM

Originally Posted by East Mtn

You don't need to wait for an appointment. Call his office and ask for a callback to discuss.

Originally Posted by seanwieland

I'd call your doctor and challenge him/her on it. The Brigham & Women's care protocol for this injury says to start PT right away, with the goal of 90 degrees within the first four weeks.

Originally Posted by SoccerGirl

TPFx -- i am worried about your not moving the knee at all too! def think about 2nd opinion, soon.

Thanks for all of your feedback and encouragement to challenge the doctor more aggressively about starting some range of motion PT. At my one week post-op appointment, I asked several questions about starting PT, ROM exercises, and expressed concern about long term rehab of an immobile knee - at the time I was satisfied by his answers, but now that I've educated myself much more on the injury, I realize his responses were far too general. In short, I'll expect him to provide some truly compelling rationale for why he feels my knee should be kept immobile while other more severe TP fractures are encouraged to move almost immediately, otherwise I will seek a second opinion immediately.

**TPFxPilot** · 05-12-2012, 10:52 PM

Originally Posted by SoccerGirl

Thanks for sharing these articles! you weren't kidding they're not light reading

... even a partial reading of one has given me plenty of new things to be anxious about (why didn't my surgeon do an MRI? should he have further assessed for soft tissue injuries? etc.)

.

No problem! I felt like I had a McMedical degree in TP fractures after reading them! Great reading to help formulate good questions for the doctor both before and after surgery. Sorry for any additional anxiety...I wanted to help minimize insomnia, not make it worse!

**TPFxPilot** · 05-12-2012, 11:31 PM

I got into a weight room for the first time since injury on Thursday night - I just used about six or seven machines for some upper body work. It took some care to maneuver into and out of a couple pieces of equipment, and I kept the weight relatively low since I could only use my right leg for counter balance support, but boy did it feel great to be doing some real exercise again! Certainly tired me out just the same

Anyway, my local community center was just fine with me coming in on my own and doing the work out. They didn't require a trainer to work with me or an official doctor's approval despite the knee brace and crutches. Kind of surprised me, I was really expecting them to turn me away for liability reasons, or at least require a trainer....then again this is podunk Ohio, so your mileage may vary!

Moral of the story...if you're itching to get off the couch and get some activity going, don't be afraid to head to the gym if you feel your body is ready for it. Obviously, make sure your doc approves, as well.

**krausedmb** · 05-13-2012, 10:53 AM

Originally Posted by TPFxPilot

Thanks for all of your feedback and encouragement to challenge the doctor more aggressively about starting some range of motion PT. At my one week post-op appointment, I asked several questions about starting PT, ROM exercises, and expressed concern about long term rehab of an immobile knee - at the time I was satisfied by his answers, but now that I've educated myself much more on the injury, I realize his responses were far too general. In short, I'll expect him to provide some truly compelling rationale for why he feels my knee should be kept immobile while other more severe TP fractures are encouraged to move almost immediately, otherwise I will seek a second opinion immediately.

They started me on PT 9 days post op 3 days a week. It was the best thing I could have done. I was under the impression they restricted my movement for 4 weeks to 40 degrees because of my femur and tendons that they anchored in. Had it just been the tib plateau fx I think I would have been allowed to bend earlier. Before the 4week appointment, of course, I checked to see how far it would bend without brace on. I was getting roughly 50-60 before it got tight. At 4 weeks they lifted restrictions. First PT appt that day I made it to 70 degrees (tight). Now 10 days later (5 weeks and a few days post op) I am 115+ extension 2 - 0 flexed. They also allowed 25% weight bearing at 5 week. Originally they said 8-12 weeks pwb. My ankle feels fine (ankle pump all the time, started calf raises at week 2) and there is no additional swelling(i wear compression sock all day and elevate/ice when not on). I have been doing 3-4 hours of bending/straightening at home per day. I take a percocet before and then go to town. It hurts but not in the surgery site and its dull/ache. You should be able to tell what is "good" pain. I started upper body and good leg within a week of surgery. I have been doing almost everything for myself with the exception of a couple things. I figured out how to carry things with the crutches (biggest challenge). Also, got back on the bike trainer 4-5 days ago. My peddle stroke is getting better every day.
So, hang in there. It will start improving. Definitely lay around and elevate, but if you feel good enough, get up and move. Get the blood pumping a bit. I think getting the body moving is good, AS LONG AS YOU'RE STABLE ENOUGH WITH YOUR CRUTCHES, and wear the brace when you do to protect your leg just in case.

**long road back** · 05-18-2012, 05:12 PM

Sounds like you and I have had he same break, I have a question im 7 weeks out the surgeon said to start putting wt on it after 3 weeks of 50 lbs 4weeks I should only be using crutches for Balance " thank goodness" what was it like to start FWB? im getting kind of nerves ???

**East Mtn** · 05-20-2012, 06:58 PM

My TPF really seems to be essentially healed at this point, although the spiral tibial shaft fracture is still in work. It swells quite a lot if the leg is dependent or heavily used, which was most of last week's trip to CA. My 12-week x-ray showed no evidence yet of a hard callus at mid-tibia, so I'm to stay max 100% WB without any impact sports.

That was good enough for a 30-mile bike ride today, which felt fantastic. It's got the mid-tibia fairly swollen, which I guess is the idea, to induce it to fill in. Ice works great.

In other news, I went looking for information on the Neurontin medication that I've been taking for nerve pain and found a treasure trove at Crazy Meds. The site is worth checking out, even if you aren't taking psychoactive meds. It has the most practically useful information, advice, and experience, in marked contrast to the drug information sheets which are frequently so full of legalese and laundry lists of unlikely complications as to be useless.

The "brain cooties" people are way ahead of us on community (and tee shirts), which I guess would be the case for chronic conditions that can often merely be controlled but not healed. And we have no patron saint and martyr to compare with St. Dymphsma. Ah well, count our blessings, and let's all try to "pay forward" the support and information we've gleaned from TPF-ers in prior months and years. I intend to hang around for a while.

Anyway, I learned that I might want to try weaning myself off the Morontin, as the "brain cooties" people refer to it. At the 600mg daily dose I've been taking, I haven't noticed any particular dulling of my reasoning, but then again, I might not. So I'm down to 300mg and will see how low I can bring it without trouble sleeping from the jangling nerves. The sensory part of the nerves do seem to be regenerating, but at an inch per month, it takes time.

**JKRomrell** · 05-22-2012, 06:54 PM

Hello Everybody,

I am new to this thread. I have read many of your posts and they have been both helpful and depressing.

I had a mountain biking accident 3 ½ weeks ago and suffered a TPF with over 1.5cm depression and tore my lateral meniscus completely off. I also broke a couple ribs in the process to make sleeping even more of a challenge. I was less than ½ mile from the bottom of Mount Diablo on a fire road I have descend at least 1000 times. I know every twist and turn, rock, root, loose spot, etc. on this descent. I am a competitive mountain biker and was descending fast but was completely in control.

There are seldom hikers on this fire road and visibility is good in all but two spots. I guess after a 1000 descents the law of large numbers put a hiker in one of the two blind corners at exactly the wrong time. Had I been 10 seconds earlier, I would have seen him before he entered this blind spot. Had I been 10 second later, he would have been far enough in that I would have had time to better respond.

Even with all of this, the hiker was actually fine right where he was because I had plenty of room to go to his right. This was my only option at the speed I carrying which was approximately 40mph. Unfortunately, he was startled and ran to the right, directly in front of my only route around him. I was left with the split second decision of taking out this innocent man at 40mph or going airborne into a ravine. I chose the ravine and rag-dolled it about 30 to 40 feet down the ravine. I knew my leg was broken before I stopped rolling down the ravine. I also knew my ribs were broken because I could hardly breathe.

Truthfully, I am lucky I wasn’t hurt worse. There were no trees or rocks in this particular area. It was very steep but just brush and soft dirt. Had I hit a tree or big rock at that speed, it could have been catastrophic. I will recover from this TPF but wouldn’t recover from a head or spine injury. I keep telling myself this on my bad days.

My brother-in-law was behind me and he helped me get out the ravine. I am lucky he was there because if I were alone it would have taken me at least an hour to get out of there. I would push with my good leg while he pulled me from behind and we would go up about 2 ½ feet. He would then let go of me to go higher and due to the soft dirt and the steepness of the incline, I would slide down about a foot. We eventually got out and then I got on my bike and rode down the last ½ mile with my broken leg hanging off to the side.

Being a competitive mountain biker, I have had a number of crashes. I broke my other leg 7 years ago which required surgery (plate and 6 screws), have broken my ribs twice, had a concussion, too many scrapes, scratches and bruises to remember, etc. I have a pretty high tolerance for pain so I was doing fine. I thought I would be off my leg for 6 weeks and then on my bike again the day I could bear weight. When my orthopedic surgeon told me in the ER that I had a serious injury and would be NWB for 3 months this inflicted pain 10x the crash, the roll down the ravine and the journey out of the ravine. I am a very active person and if I go 3 days without a mountain bike ride I go into withdrawals, so the thought of going 3 months seemed unbearable to me. I am glad now that he didn’t tell me the full recovery time at that moment because I would not have been able to handle it.

So here I am, 3 ½ weeks into what my surgeon says is a 9 month to 1 year recovery. I have another 8 ½ weeks of NWB and no driving. I have to rely on people for everything. I am lucky to have a wonderful wife and kids who are happy to help out. I hope they have another 8 ½ weeks in them 

I am getting to the gym and moving the parts of my body that will move. I have been working from home as much as I can. I went into my office in San Francisco for the first time yesterday. I was amazed at how tired this made me. I have an hour commute each direction and taking the train did not seem like an option. I took a car service in and got a ride out. I only worked a half day and took an hour long nap right when I got home. I wonder if I am turning into a wimp. When I broke my fibula at the ankle 7 years ago, I had a surgery to repair it with a plate and 6 screws. I only missed two days of work. But this TPF has knocked me down.

In general, I am a very positive person and have been able to remain upbeat most of the time. However, I have had a couple days of being depressed and feeling sorry for myself. I am trying to focus on my recovery and look for the silver lining in this accident. I have an opportunity to reallocate my time and focus on some things that I would otherwise not do because I would be running around like a madman working, doing the family thing, riding my bike, etc. I just need to identify a few important things I can accomplish that I otherwise wouldn’t do and do them.

What I don’t know is what I should expect of the next several months. I don’t know if my meniscus will heal. It seems like there is a good chance it won’t. What will that mean? I have been told skiing this winter is out so I will be calling Squaw Valley in the next couple days to get a refund on my season pass for next year. I love skiing (not as much as mountain biking…but still love it). Is skiing a realistic sport for me with my injury? Any thoughts, suggestions, comments you have would be helpful.

**seanwieland** · 05-23-2012, 11:50 AM

JKRomrell - Wow, what a story. Hang in there. I'm only 3 weeks ahead of you in this ordeal, and live right across the bay in Marin. My advice is get off the drugs asap (if you are not off already), they mess with your head. Keep a daily journal, take a pic of your knee and record the ROM on a weekly basis so you can prove to yourself the progress that you are making. Eat healthy, drink milk, take your vitamins (incl Magnesium and Calcium supplements). Work on ROM for at least an hour per day (total) - 5-10 minute increments is fine. At five weeks post surgery today, I am at 114 degrees and 2 degrees straight, with PT to begin in earnest in a week. Others on this forum have said that at 120 degrees you can start spinning, so work up to that. Get into a pool and swim some laps (with a pull buoy between your legs so you don't kick) - it was liberating to be 25 yards away from the damn crutches. My doc tells me that PWB will start a week from today, which I'm looking forward to as a huge milestone. 12 weeks NWB sounds like a long time and may prove to be conservative if you let the bone heal. Don't cancel your pass - use that as motivation. I ski squaw also, and I'll be damned if I'm stuck on Shirley all winter - I'm not going to let that happen. Stay positive!

**JKRomrell** · 05-24-2012, 04:49 PM

seanwieland,

Thank you for the encouragement. I am off the drugs and like your other suggestions as well. I am looking forward to swimming.

Regarding the weight bearing, I hope to be PWB before 12 weeks but my surgeon doesn't seem willing to budge on this. The reason is the bone grafting he did. Since my TPF was caused by my femur being driven with great force into the top of my tibia, I had a depression of over 1.5cm in addition to the split fracture. Apparently the area the surgeon lifted up with the bone grafting is susceptible to compressing if weight is applied too soon. Did you have a depression as part of your TPF? If so, how depressed? I am interested in this because if my doctor is just being extra cautious, I want to push him on this issue.

Regarding Squaw, the reason I think the doctor is correct on this is the fact that my meniscus was torn completely off. Based on what I have read and the knowledgeable people I have spoken with, it is very unlikely my meniscus will live. Being torn completely off almost certainly resulted in a complete loss of blood supply and sewing it back in place is not likely to result in it healing. Skiing double black diamonds and moguls won’t feel good without a meniscus. I generally don’t like to be wrong but sincerely hope I am wrong on this one.

Jeff

**JKRomrell** · 05-24-2012, 11:11 PM

seanwieland,

Thank you for the encouragement. I am off the drugs and like your other suggestions as well. I am looking forward to swimming.

Regarding the weight bearing, I hope to be PWB before 12 weeks but my surgeon doesn't seem willing to budge on this. The reason is the bone grafting he did. Since my TPF was caused by my femur being driven with great force into the top of my tibia, I had a depression of over 1.5cm in addition to the split fracture. Apparently the area the surgeon lifted up with the bone grafting is susceptible to compressing if weight is applied too soon. Did you have a depression as part of your TPF? If so, how depressed? I am interested in this because if my doctor is just being extra cautious, I want to push him on this issue.

Regarding Squaw, the reason I think the doctor is correct on this is the fact that my meniscus was torn completely off. Based on what I have read and the knowledgeable people I have spoken with, it is very unlikely my meniscus will live. Being torn completely off almost certainly resulted in a complete loss of blood supply and sewing it back in place is not likely to result in it healing. Skiing double black diamonds and moguls won’t feel good without a meniscus. I generally don’t like to be wrong but sincerely hope I am wrong on this one.

Jeff