Tibial Plateau Fracture Recovery

[Skiobsessed]

Do you ever have a day where it seems like you went backwards on your PT? I am heading into my third week of being able to do some light PT (bending, iso quad flex, straigh leg lifts) and until now it seemed like I was improving each day, but today all of a sudden it seems like Im going backwards. I was not able to do as many leg lifts as yesterday and I dont think I was bending as far as yesterday either.. Its making me worried if I did something wrong but idk what it could be.. Is this normal?

[RegCT]

I am 2 weeks post op. 2 breaks, 2 plates, lots of screws.

Doing pretty good. I haven't used a brace at all.

11 weeks no weight bearing. 9 to go.

Can straighten my leg out flat, and am at 70* on my CPM machine.

Feeling pretty good I guess. Hoping to be off pain meds this week.

[Little Bike]

I'm not sure about the "dirt bike in 2 months" part after you are weight bearing. I am pushing the envelope hard right now and I hope to get on skis again before the season end. Approximately 2 months after being allowed to be weight bearing. But I fully don't expect to ski hard. Maybe one or two groomers with no jolts and at relaxed speeds.

My surgeon is very sports oriented and deals with athletes all the time. He is fully on board with doing everything to get me back to form quickly for sports. However, he is also cautioning me against any impact activities for at least 4-6 months after being weight bearing. That means no hard skiing, no road running (maybe not even trail - I'll have to ask), etc. My familiarity with motocross is that it is like dropping 10 foot cliffs over and over again. Definitely on the list of impact sports.

As my doctor and my physical therapist say multiple times during each visit - "this injury sucks, be patient." Good luck!

I'm hoping to just ride easy dirt roads to begin with (I don't ride motocross, just dirt - when I registered I think that was the closest choice to my sport ) and work back up to some harder rides over time (and definitely wear a brace). Or, I'll just be riding on the pavement for awhile until I'm comfortable giving the dirt a shot. But, you're right, depending on the route the knees can take a beating. I imagine I'm in for choosing routes very carefully from now on.

Next week is going to be hard - there's a dual sport (dirt/road) event next week that I went to last year and I'm going to have to miss this year. sigh. I'll be monitoring SPOT devices for people in case of emergencies, participation through satellite.

I tried to do leg raises yesterday - owwwww - not ready for that yet (I have a list of some knee exercises, but I need some supervision, I'm not sure how much pain OK and isn't).

Thanks for the advice of waiting 4 - 6 months, I'm only 2 weeks from surgery and still don't have much information from my doctor about what to expect over the next year or two. I see my surgeon in a couple of weeks, I'm definitely going to be bugging him about supervised pt (he originally said no pt until I was walking - uhuh, no way, he needs to get me into pt) and what's going to happen by the end of summer!

I hope you get to go skiing!

[Little Bike]

Do you ever have a day where it seems like you went backwards on your PT? I am heading into my third week of being able to do some light PT (bending, iso quad flex, straigh leg lifts) and until now it seemed like I was improving each day, but today all of a sudden it seems like Im going backwards. I was not able to do as many leg lifts as yesterday and I dont think I was bending as far as yesterday either.. Its making me worried if I did something wrong but idk what it could be.. Is this normal?

I've been in physical therapy for other injuries and I think you'll find your pt person will say it's normal to have off days.

[Skiobsessed]

Thanks, yeah just had PT today and that is what she said.. I still improved my ROM a little bit.. Got to 121 degrees today, was at 116 last week. I feel like I should have improved a lot more than that tho, I think I am being too cautious in my excersises at home. Im so scared of messing something up so anytime I get pain or swelling I ease off and just rest it.. But maybe I need to push a little more on the bending.. Idk.. This is week 6 of non weight baring for me, still 6 more to go I think..so Im half way!! Im hoping things get a lot better once Im allowed to weight bare!!!!

[SkiTurtle]

If you get pain or swelling - ease off and just rest it! Until the bone is healed, that pain you are feeling is from the bone. The bone is still soft while healing - that is why you are non-weight bearing.
Wait to push the PT until you get the ok from the doctor that you can't do any more damage to the bone.

[Skiobsessed]

Ok cool! Thanks skiturtle!! I will keep being cautious then . Thats why I have been easing up any time I get pain/swelling so far cuz I am worried about that bone!! I see my OS on Thurs this week and will probably get new xrays then so hopefully everything will look ok!!!! Thanks again for the info
Hope everythings going well for you!

[Skiobsessed]

Hey, so what happens when you get to start weight baring? I still have 4 more weeks to go but just wondering.. Do you just start walking around normal? Or do you still have to keep the crutches? Does partial weight baring mean u can walk normal but just not too much, or it means you have to still walk with crutches but you can put your foot down?

[Ryan7878]

OMG... I can't believe I found this forum. I broke my tibial plateau on march 3rd. Had surgery on the 11th. I have just been laying here getting depressed and worried about my future. I didn't realize how many other people this has happened to. I am so worried about my recovery. I have a lot of posts to read on this thread.

[Ryan7878]

Oh and at my surgical follow up the OS was concerned that I couldn't extend to 0 degrees. I can go like 60 to 5 degrees using my other leg under my foot but can't extend all the way. Anyone think that is normal? And suggestions on how to get the leg to straighten all the way?

[Skiobsessed]

Ryan7878, I think that is pretty normal. Does your OS have you doing PT yet? At my first PT appt I could only extend to 9 but by the end of the appt I was at 4, by my 2nd appt 3 days later I was all the way at 0 with no trouble. I think one of the things that helped me the most was when I started sleeping without the brace. Also, if you sit or sleep with a pillow under your leg make sure the pillow goes all the way to your heel, not just under your knee.
In PT they have you try to sit with your heel on something elevated and you just try to let your knee hang and stretch. That really gets the extention going.
Dont worry if it seems like you arent gaining enough motion. I was really freaked out when I started trying to gain flexion etc..because it started off so far from being "normal", but it will come back.. PT helps a lot so if you arent already going I would ask your OS when you can start!
Goodluck and sorry about the injury.. I know it SUCKS!!!!!!!!!!

[Margosh]

Hi People, pls tell me Dome exercises which you are doing at you pt. I've started my pt on week 7 and it was 2weeks ago. Before that I didn't bend my knee at all. Week 8 -bend 65 , week 9- 82, my pt is only 1 time a week, and this week he wants to start wb, I'm afraid that it is to early. I want to walk but I'm very afraid after reading this forum that it may be to early. ... My next appointment with OS is at the end of April, and he wants to see me full wb... I'm confused..

[powdork]

OMG... I can't believe I found this forum. I broke my tibial plateau on march 3rd. Had surgery on the 11th. I have just been laying here getting depressed and worried about my future. I didn't realize how many other people this has happened to. I am so worried about my recovery. I have a lot of posts to read on this thread.

half of your recovery will be a positive mental attitude. don't lay around be active if you can even if it's on the crutches. this will help your leg and your frame of mind. there are ROM exercises you can be doing. this isn't the end of the world. make your future instead of worrying about it.

i know it's all easier said than done but it's what you have to do.

[powdork]

Thanks, yeah just had PT today and that is what she said.. I still improved my ROM a little bit.. Got to 121 degrees today, was at 116 last week. I feel like I should have improved a lot more than that tho, I think I am being too cautious in my excersises at home. Im so scared of messing something up so anytime I get pain or swelling I ease off and just rest it.. But maybe I need to push a little more on the bending.. Idk.. This is week 6 of non weight baring for me, still 6 more to go I think..so Im half way!! Im hoping things get a lot better once Im allowed to weight bare!!!!

i think its natural to have larger gains when you start ROM exercises and smaller gains as you get close to fully bent or whatever the goal is for you. diminishing marginal returns and all that.

[Tye 1on]

half of your recovery will be a positive mental attitude. don't lay around be active if you can even if it's on the crutches. this will help your leg and your frame of mind. there are ROM exercises you can be doing. this isn't the end of the world. make your future instead of worrying about it.

i know it's all easier said than done but it's what you have to do.

yup. Just gifted a friend w/TPF an hour with my trainer. Her theory is the PT is working hard on the injury, but her job is to work on the rest. And that increased blood flow will speed the recovery, along with the mental benefit of working out...

[powdork]

as for me i am told i'm doing remarkably well. i get in trouble every time at pt for pushing too hard. today i was reprimanded for showing up without crutches.
my injury was 2/11 and surgery was 2/13. got permission to slowly start bearing weight on 3/27 but i'm already in the 100% weight bearing range. i do believe in pushing the envelope on healing waaaaay past what the docs and therapist prefer or are allowed to say. for me this has huge benefits but it also carries a risk of reinjury so your mileage may vary.

[Skiobsessed]

as for me i am told i'm doing remarkably well. i get in trouble every time at pt for pushing too hard. today i was reprimanded for showing up without crutches.
my injury was 2/11 and surgery was 2/13. got permission to slowly start bearing weight on 3/27 but i'm already in the 100% weight bearing range. i do believe in pushing the envelope on healing waaaaay past what the docs and therapist prefer or are allowed to say. for me this has huge benefits but it also carries a risk of reinjury so your mileage may vary.

That is awesome that you are full weight baring!!!! My injury was on 2/12 and my doc said Im not allowed to start weight baring until my next appt with him on 4/24!! That seems so long, I am really temtped to just put my foot down and see what happens but then idk since he said no. PT has been getting alot better tho..My ROM has improved I can bend to 140 degrees now. It hurts to do that tho! Lol.. I keep wondering when it will just move without pain.
I like the strengthing excersises we do but I really wanna get back into the real gym and get a good workout. Do you know any way to get a good cardio workout without weight baring?
Also you got any tips/certain excersises that you think made you progess faster?? Id love to know!
Congrats again on full weight baring! I cannnot wait to do that!!!!!!!!!!!!!!!!!!!

[Margosh]

Can anybody tell how you are improving your ROM?
I'm stopping the exc right after it gets painful.
I'm doing:
Push the hill down while the knee is bend ( it's painful so I'm doing it 10 times)
Lifting the leg
Slide the knee to bend it and slide it back
Bicycle in the air
And laying on my Bally and bend the knee.
This are all exc. I've get from my pt.
My room was only 82 last week.

[Skiobsessed]

Can anybody tell how you are improving your ROM?
I'm stopping the exc right after it gets painful.
I'm doing:
Push the hill down while the knee is bend ( it's painful so I'm doing it 10 times)
Lifting the leg
Slide the knee to bend it and slide it back
Bicycle in the air
And laying on my Bally and bend the knee.
This are all exc. I've get from my pt.
My room was only 82 last week.

The main bending excersise my PT has me do is the one where you put a strap around your foot and use the strap to pull your foot in towards your butt and then slide back out. What really helped me gain ROM was when I would push a little past the point where it really hurts and hold it there for a good 5 seconds before sliding it out.. Im still doing that. I am at 140 right now but my good leg can go to 155 so I still have more to go. It gets harder but you can probably push farther than you think, I was scared at first because of the pain, but my PT says the pain is ok, no harm being done..it just hurts. (Im not sure if that is the same for you tho since I dont know your whole injury) but for me they said the pain was ok
Also, you have to be sure to do your PT at home every day, not just when you go to PT. I do my excersises at home 2-3 times a day every day.

[Margosh]

Thank you, I'll try to do this, I've started to bend the knee only 2 weeks ago, and the injury was at the beginning of feb. My pt is only one a week for 30 min, so I'm doing everything at home. Pt wants me to start wb, but I'm reAlly afraid. Want to wait 2 more weeks, I ll meet my os only at the end of month.. It will be almost 3 months since the surgery.

[Skiobsessed]

Thank you, I'll try to do this, I've started to bend the knee only 2 weeks ago, and the injury was at the beginning of feb. My pt is only one a week for 30 min, so I'm doing everything at home. Pt wants me to start wb, but I'm reAlly afraid. Want to wait 2 more weeks, I ll meet my os only at the end of month.. It will be almost 3 months since the surgery.

I would ask OS about weight baring. For me the OS is the one who decides on weight baring, not the PT. The PT just gives excersises based on OS instructions.. Thats how its been with me anyway.
Dont worry the bending will get better.. I was really freaked out when I first started bending because I couldnt believe how hard it was, Ive been freaked about all of the muscle loss as well but Im learning now that it really does all come back! You just gotta work at it, the more you move the better off you will be I think.

[powdork]

Yes generally the OS is the one that makes the decision when it's time to start bearing weight. However, your therapist is likely in touch with the OS regarding this so it wouldn't be that strange if he/she was the one that said it was ok, even though the decision was made by the doc.


As an aside, I went to the climbing gym two nights ago. It's also a regular gym so I thought I would do some pt and get a good upper body workout as well as belay my daughters and girlfriend. I ended up climbing too and found it to be very good pt at least for someone who is able to bear some weight. You typically have at least two other points of contact beside the injured leg so you're never bearing full weight, and if you're doing it right there are no harsh impacts, nothing that even approaches those created by walking. Just don't fall, don't lead, don't boulder, and don't use the auto belays. Top rope only.
I am so looking forward to some outdoor climbing this week.

[Skiobsessed]

Yes generally the OS is the one that makes the decision when it's time to start bearing weight. However, your therapist is likely in touch with the OS regarding this so it wouldn't be that strange if he/she was the one that said it was ok, even though the decision was made by the doc.


As an aside, I went to the climbing gym two nights ago. It's also a regular gym so I thought I would do some pt and get a good upper body workout as well as belay my daughters and girlfriend. I ended up climbing too and found it to be very good pt at least for someone who is able to bear some weight. You typically have at least two other points of contact beside the injured leg so you're never bearing full weight, and if you're doing it right there are no harsh impacts, nothing that even approaches those created by walking. Just don't fall, don't lead, don't boulder, and don't use the auto belays. Top rope only.
I am so looking forward to some outdoor climbing this week.

Awesome I wanna climb SO bad!!! I have 3 weeks left till I can start weight baring!! What was it like when you first got to put your foot down??
What does it feel like when you walk, does it really feel like an impact just walking? I cant wait! I keep dreaming about walking at night...lol

[powdork]

First off I should say that every body is different and responds differently and more importantly every fracture is different. In addition my method in some parts is not recommended by my OS or therapists and in other places is specifically recommended against doing. i wouldn't do this on pain killers either as I wouldn't want to miss any signals my body is sending me.

I was putting my foot down well before weight bearing, at 4.5 - 5 weeks. but by that i mean just the weight of the foot or lower leg. i also started walking on two crutches (no weight other than foot or lower leg) with the idea that i wanted to get my ankle into a walking motion and start the process of rejuvenating the foot pad (which i heard was another challenge). then i moved to trying to push off with the toes. and sharing some weight with the injured leg while having hands on a counter or something. one strange thing i found out is i could do push ups with both sets of toes on the ground with no ill effects. i'm guessing that had to help strengthen something on the leg.
walking is always impact, we've just adapted/evolved to deal with it with our ankle which will be stiff, and footpad which will atrophy. one nice thing is you should be able to put shoes on, which helps both with the foot and knee (avoid high tops since you'll want your ankle to respond to any uneven surface or steps rather than your knee). my first steps were awkward and hobbling around after one-crutching it for a day or two, which i was doing wrong (crutch goes on the good leg side). this was at 45 days. it slowly switched from hobbling to a limp. now (50 days) it's a slight/moderate limp until evening at which point its almost back to a hobble if i'm pushing it enough.

[Margosh]

Powdork I need to say-you are very brave . I'm now at 90 may be now a little more, yesterday I was 1time driving a stationary bicycle. It hurts a little bit, but is ok. And I' ve just started to do some wb exercises. Like standing and trying to seat down as far as possible ( at home with a walker), puting the second foot down ( pretending to walk ) with both crutches. It's good. But I'm not trusting my leg yet, hope it will come soon. During the day I've started to wear the anti-emb stocking and it helps a lot with swelling and with purple leg ( May be just because I can not see it)...