Physiotherapy

Physiotherapy is the single most important thing you can do to improve your recovery. Performing the exercises  as directed by your physiotherapist routinely and persisting with your exercise protocol will help your recovery be better, and less complicated, and much faster . It will also reduce chance of complications and different forms of long-term damage.

Physiotherapy after a TPF has te main objective of helping you heal. Throughout the recovery process there are many smaller objectives for the specific exercise you will be performing. The objective and thus the exercises will be changing over time. Some of the benefits and objectives of physiotherapy are improved range of movement, gaining and improving stability of the knee and the body, , prevention of adhesions, improving motor control, gaining muscle mass and more.

Physiotherapy might start as early as a few days following your surgery or injury, and sometimes even on the same day. It is very important that you start early, and are in tough with a trained physiotherapist from the very beginning. This will have a dramatic effect later on, so if your O/S has not yet discussed this with you, consider asking him about physiotherapy.

At first the exercises will probably be performed at home, later on at a physical rehabilitation center and at some point you might be referred to your local gym to continue exercising there. In some cases several of the exercises may be performed in a pool but this is not at all mandatory. While performing the exercises a good remember that the exercises can be uncomfortable and can also be lightly painful, but should not hurt a lot. If you are in serious pain from the exercises consider slowing down and doing things more gently. Also, try not to do the exercises under heavy painkiller medications (of course, during the first several weeks this is unlikely), as these might mask the fact that you are over-straining your leg. Remember – pain is your friend, helping you know when something is wrong (but unfortunately will probably also prove to be an enemy).

The main objectives of the exercises are:
knee stability –  Strengthening the smaller supporting muscles around the knee will contribute to a more stable movement as the knee bends and bears weight in the future.

Range of motion –  The knee will be losing ROM due to the surgery and adhesions which form thereafter. Part of the exercise routine is aimed at constantly increasing the ROM though gentle bending, going a little further every week. It is unfortunately unlikely that you will regain 100% full range of motion, but with early and constant exercise you can get a very good result, at almost full range of motion.

Motor control –  Some of the exercises will focus on regaining good motor control of the knee and leg muscles. This includes gentle movement exercises as well general stability exercises at a later stage.

Gaining muscle mass –  Leg muscle mass is lost in a moment and takes forever to ragain.  Many of the exercises will be focused on regaining muscle mass in the main and smaller muscle of the leg.

Below is the description of the different “periods” of physiotherapy:

First Week

During the first week or so exercise will concentrate mainly around “recovering” from the effects of the surgery. This means, for example – icing and leg elevation to reduce inflammation and pain, regaining initial knee range of motion and motor control (the ability to bend your knee), and getting used to getting around on crutches. You should not be alarmed if at the very start you can hardly bend your knee at all. This is quite a standard post-surgery symptom, and will soon improve drastically. Your ROM (range-of-motion) will continue to improve for months to come. Some exercises you can be performing during this time are:

  • gentle bending of the knee in the brace, as far as you can go with no pain, many repetitions at a time (tens of repetitions)
  • moving you ankle in circles in both directions.
  • putting a towel under the knee of a straight leg, and trying to press down on it- straightening the leg

NWB Period

During the NWB period the goal is to gain as much ROM as possible, prevent the formation of permanent adhesions, reduce muscle wastage and build leg muscle. All of this has to be done gently, without putting too much pressure on the leg, and therefore include gentle exercises. These exercises can be done solo, with the help of another person and with the help of accessories(link). Exercises should be performed every day, multiple times daily or as directed by your physiotherapist. A few exercises that can be performed at this stage are:

  • Continue with moving your foot in circles by the ankle. after a few weeks pass, use a stretch band (link) as a contradicting force to make the ankle work harder, by putting the middle of the band around your foot, and holding the ends stretched with your hands. Be very gentle as this is a form of putting some weight on the leg and you don’t want to do that too early.
  • lying on your back, try to bend your leg, moving the foot towards you while touching the bed, then straighten the leg and repeat.
  • lying on your back, try to bring your knee to your chest (obviously you wont be able to, but as close as your can), return and repeat. use your hands to help you go a little further.
  • Sit on a couch or the side of a bed, let the leg fall to the floor as much as possible, stretching the ROM. Do this gently, possibly with a pillow on the floor under the foot and/or your hands holding on to the end of your brace, and allow the leg to down so that you feel a stretch and possibly light pain but no more. Lift the leg with the help of your hands and/or stretch band and repeat.
  • While performing the previous exercise, try to force the leg to “fall” more slowly by holding it with your hamstring muscles (the top part of your leg). Also, try to straighten the leg from a bent position by lifting the foot and straightening the leg (you probably won’t succeed at first, you can use your hands to help).When you are able to lift your foot without any help (approx 3 weeks), continue with these exercises:
  • straighten it and hold it at a straight position for 5 seconds, let drop and repeat.
  • Use a stretch band to add resistance to all previous exercises.
  • Ankle alphabet – Sit on a chair with your foot dangling in the air or on a bed with your foot hanging off the edge, and draw the alphabet on the floor with your toe acting as a pencil, letter by letter (draw ‘A’, then draw ‘B’ etc..)
  • Try to pick up marbles or towels off the floor by flexing your toes and grabbing the towel with your foot.
  • stretch and flex your heels and toes against stretch bands and against your hands
  • Patellar mobilization – Twice a day, use your hands to gently push your kneecap up and down, and left and right. It is best if this is done under the supervision of a trained physiotherapist
  • Leg Stretches
  • Lie on your back, bend the leg and hold the stretch band with both your hands so that the middle is above the foot. Try to straighten your leg in the air so that it resists the bend and stretches it (a bit logistically complicated)
  • Hold the band stretched around the foot, try to bring your knee close to your chest and then push it back out, stretching the band.
  • Hold the band stretched around the foot, flex and stretch your ankle as if standing on your toes.
  • perform some exercises for the core body muscles as well if possible. These are the stomach and back muscles as well as all the muscles in those areas. This will not directly help the leg, but all of these muscles will also be weakening from inactivity and exercising them could prevent extra pains and strains.
  • When possible, begin stationary bike training

More Coming soon..

Initial WB Period

This stage starts around 6-8 weeks During this period you will be putting partial weight on your leg, learning to walk again and slowly raising the amount of strain put on your leg. Generally speaking, at this point in time you will be in less danger of harming or reopening the fracture, but still need to take things slowly and carefully. Some exercises are:

  • Continue all previous exercises, adding resistance and stationary bike exercises if possible
  • Move from two crutches and tiptoeing to one crutch to a walking stick and eventually unaided walking within 4 -6 more weeks.
  • possible.practice very slow, mindful walking, focusing on walking form.
  • Use weight machines and ankle weights (link) to strengthen all the muscles of the leg. Practice both legs separately when possible, but don’t forget to train both legs and not only the injured one. Also, make sure train all muscles of the leg
  • Stretch often and especially after weight training
  • To gain stability and strengthen small muscles stand on a stability board (link) or bosu ball (link), at first with both legs. Try to stay stable while standing. When this is easy make it harded for yourself by bouncing a ball, leaning left and right or light squats. When this is also easy, try standing on just one leg.
  • Leg press, heel raises, hamstring curls, Squats (one and two legs), lunges, knee extensions
  • When you are able to walk, make sure you walk as much as possible
  • Perform advanced Rom exercises such as trying to sit with your buttocks on your feet or using your hands
  • A continuous passive motion machine may also be used if available in your physical rehabilitation center.
  • Consider trying Aphostherapy (link) to help prevent the onset of osteoarthritis.

Moving Forward

You will need to continue strengthening the leg, improving ROM and stability and performing other exercises for a while. A full year of training and Physiotherapy to some extent is not unlikely, and it might be longer. take in to account that as time goes by Physiotherapy will start to feel more like a Gym session then rehabilitation and you will be able to combine your exercise schedule with cardiovascular training such as stationary or regular bike riding.

Some good exercises are:

 

  • Elliptical trainer
  • Weight training
  • Leg press, heel raises, hamstring curls, Squats (one and two legs), lunges, knee extensions
  • Treadmill walking
  • walking in a pool
  • continue ROM exercises
  • Try to avoid impact exercise (running) as much as possible. Consult your Physiotherapist about when to start

Coming soon..

247 thoughts on “Physiotherapy

  1. Yes, it’s been 2+ years since my accident (similar non displaced fracture) and every now and again I still get that pain. If I sit too long especially. I’m told it is due to muscle weakness and tightness. My quads radiate pain just below the knee. Something’s that have helped are: rolling a tennis ball or racquet ball over tight muscles groups, Leg strengthening exercises such as squats (only pain free range of motion), getting up and walking around regularly, quad and hamstring stretches, and recently legs up the wall yoga pose.

    I would consult a PT as they are able to give better tips on muscle release and specific exercises for you. Oh and foam rolling helps too further down the line when you are more comfortable or stable.

  2. I had a non displaced tpf on 1/22 and I have full rom with pwb…Never did physical therapy it at home. My guestion is does anyone have patellar tendon pain while raising leg from knee?

    • Bob,
      Lately I’m having a lot of pain just as you described. I am 13 weeks post op and ago to PT 3x week plus PT at home. I will ask again when I see my surgeon on the 14th.

      • Bob, saw surgeon today (14 wks post-op). Patellar tendon can be caused from it having to work more if your muscles have seriously atrophied. In my case, I just started bearing any weight last week, and i barely have any hamstring at this point. Not sure if this applies to you, but it’s something to think about. OS also said that I will have more random pains as my muscles and joints come back from a very long vacation and now have to go back to work. I’ve already had such greater outer hamstring pain behind my knee that I couldn’t bend my knee past 90–20 degrees short of my 110 last week! One step forward, two steps back…for now!

  3. Hi reading all the comments on the website has helped me a lot. I had a TPF in October and had my surgery October 28, 2016. I’m on my FWB stage. I can walk normally with slight pains around the knee and waist region. My concern is that my knee still gets swollen after walking. I’m not sure what might be the reason behind the swelling. The injured leg is till slight thinner than the other leg though. I haven’t been seeing my Physiotherapist for 2months as the distance from me is far so I mainly exercise on my own or at the gym (which is much closer). Though I exercise at the gym, I try not to strain my leg muscles in order to avoid any complications. So far, I’m happy to see progress but I’m just concerned about the swelling around the knee.
    Your counsel will be greatly appreciated.
    Thanks.

    • Although your medical professionals are the only ones who can truly judge, I’d say that your swollen knee is probably normal for this stage of your recovery. You are still getting back all of your leg’s function, as the discrepancy in your muscles shows. Do you ice and elevate it? Does it swell up only after exercise or is it like that all the time, even when you get up in the morning? Can you call your surgeon or someone to ask about this?

      • Thank you Judith. It only swells after much exercise or long walks. Yes I do massage the knee with ice cubes and then elevate my leg. I usually wake up with no swelling or pain.
        I will also consult my doctor at my next appointment. Thank you once again.

    • The advice about swelling was to ice the knee at least twice a day for half an hour and to exercise less if that seems to be the cause and increase exercising time only after few days again.

  4. I suffered a minor Tibial Plateau Fracture on Dec 23rd skiing. At first the X rays didn’t show anything so they thought I had an ACL/ meniscus injury for the first four weeks until we got the MRI results. I have been fully weight bearing for a few weeks now, and my knee only hurts if I accidentally do something awkward on it. I am a downhill mountain bike racer and am signed up to race on May 29th. Do you think this will be too soon. A couple of weeks ago my doctor said I can pedal a bike sitting down so Ive been going on small road rides most days, and have done everything possible to be as strong as I can by this time. Do you think I will be able to go on May 29th, is it bad to push through the pain with this injury? It was very minor and was only suppressed 2.3 mil. in the worst spot and no surgery was needed.

    • Hi Shane

      i am interested to know whether you made it to the mountain bike race. How did it go ..Do share your experience
      Good luck !!

  5. Thanks for the information from this site. My 7 year old daughter got TPF(Type III), when she was skiing, The Dr. stitched the bone back to the position. As a mother, I am very frustrated.

    She is at her post 8 week’s Op now,she can start to walk 2 weeks after surgery with brace, but till now she can only ROM 90″ degree. When she walks the injured knee is not straight, The knee is still swelling. Is there anything can help her improve? Appreciate your help.

    • Have you taken her to an indoor pool. I have just started and others have said exercising in the pool was a big help. She also needs to work on her extension exercises–straight leg suspended by foot so there is room for leg to give when pressure is applied just above the knee. My physical therapist does this with me when I have a hard time getting it straight again. BTW I am 11 weeks post op, still NWB, and only at 104 ROM. It is a tough process–hang in there! Best wishes for your daughter’s recovery!

  6. I have enjoyed reading the supportive comments and advice. I suffered a TPF of my right leg December 27. Out walking with a friend and my golden retriever and two others – the dogs were playing and one ran full impact into my knee. At first I thought I had torn something but soon realized something far more serious had happened. I was airlifted by helicopter because we were quite isolated in a canyon. I was in the ER within 90 minutes of the accident. I had surgery December 29 – a plate and 6 screws, NWB 12 weeks and am just about to complete 10 weeks. I have tried to stay positive and have had help with meals and rides from friends and family but at times get frustrated that I just can’t get outside, go to yoga, walk my dog, cook a meal etc. I started PT at 6 weeks working on ROM and strengthening – I am at 120 degrees and have very little pain but lots of swelling and pain on the inside of my knee and tingling in my foot. From what I have read the tears to ligaments are common but don’t seem to be the focus of the surgeon. Sleeping is difficult, I sleep with the brace and even if I use a pillow something seems to trigger the pain on the inside so I can’t get comfortable. I find if I am diligent on my ROM, stretching, icing and not leaving my leg down too much I feel good. I used a wheelchair mostly at the beginning but have moved on to crutches when I go out. The wheelchair is still useful at home in order to carry stuff about. I appreciate all the tips from the site. I see the surgeon March 29 and hoping to be given the green light to PWB. My PT is fabulous and so encouraging. She definitely knows if I am doing my exercises – the progression only happens if I do them. I fear that getting back to normal walking will take time but I try not to think too far ahead and I try to celebrate the small accomplishments I am making.

    • Hi Sheila- I appreciate you sharing your story. You are 4 weeks ahead of me and I would really appreciate keeping in contact and reading any updates you have, especially once you begin weight bearing. I am 6 weeks pos-surgery and my OS has me NWB minimum of 12 weeks (fingers crossed not any longer!). Do you recall what your motion was at 6 weeks? I’m only at 80 degrees and realize I need to start pushing it a bit. My OS only wanted me to work until 90 degrees for the first 6 weeks.
      Any other advice, exercises or survival tips are appreciated! This has been very stressful and isolating, and the time has really slowed down. Oh and I have three young children. Wishing for summer! Best, Erin

  7. I am 57, very active and fitness driven. I suffered a TPF (type 3) during Nov 2016 when standing from a kneeling position. Started PWB at 12 weeks. Suffering from pain in my ankle, leg hip and back, worse during the night. Surprisingly I have little pain in the knee. I am at 17 weeks now and am visiting my consultant today, still not FWB. I am gradually getting used to crutches but I am a bit unsteady and need to practice more before I venture out. My PT set me some exercises to do, which I do twice a day every day and more. He has advised that I do not go back to the gym until June at the earliest. I have been so frustrated throughout the whole 17 weeks as I am a very active person normally, I know it will be a while yet before I make a full recovery. I just keep telling myself to stay positive and focus on the end game.

    • Maxi, it is indeed a long journey. You probably have an advantage in that you were fit to start with. But, 12 weeks without weight bearing is a long time not to use all those muscles — now they have to work again and they are complaining about it. I had a similar experience — once I was cleared to bear weight, because the fracture was healed, it wasn’t the knee that hurt, it was everywhere else. It should get better with time — can you take anything for it, such as ibuprofen?

      I hated the crutches and used a walker instead, the kind with four wheels and brakes –I felt much more secure, especially in my house with pets and rugs, and outside on uneven pavement. It was not very long before I could ditch that for a cane, and then put away the cane — hope you can do the same. But the key is in doing your exercises faithfully, I think. Can you keep a record of your incremental improvements, to help you stay positive? My PT people would remind me, when I complained about what I still couldn’t do, of what I couldn’t do a week or two before. Good luck!

  8. Hi everyone – hoping to get some feedback – I suffered a dislocated kneecap (have done this 5 time previously, first time I had a break), MCL tear and TPF (no surgery) – I was NWB until last Friday – with minimal physio on my ROM. I am still using a walker. I had physio this past Wednesday, and when he stretches my leg it so tight over the knee cap, likes it going to pop – my ROM has only increased from 60 degrees at initial injury to 68 now. I am now having pain in my kneecap, and it is pretty steady (along with intermittent pain on the right side, and left side behind the knee) … how do you trust your therapist is doing the right thing? Dr. said if ROM doesn’t get better he will have to go in and clean out the scar tissue.
    Any feedback would be greatly appreciated. This has been a challenge to say the least.

    • Deedee,
      I hope you are doing better now. I know exactly how you feel, though. I have extreme tightness running up and down over my kneecap and on the inside. When I asked OS, he said the pain was normal and I wasn’t going to hurt anything–just to push through to increase ROM. I have been slow to make progress, too. I am around 105 at 11 weeks; at 9 weeks I was 90. My OS has not been happy with my progress, but hasn’t mentioned going in–he said it’s up to me to break through the scar tissue. He gave me 3 more weeks to get to130–I’ll be happy to hit 120. Hang in there and do your exercises!

    • It is normal, i guess, I trust my PT but it feels the same if he bents the leg to get ROM. To avoid him doing the stretching, he advised me to push my injured leg with my good leg towards my back, facing down on a mattress. It takes a lot of will power but it hurts less and i do it twice a day with some easy warming-up movements before. It is a slow process though. Good luck.

  9. Hi
    I am a 78yr old active senior ,I am 6 weeks post surgery for TPF,1 plate 4 screws,ski fall no binding release.Swelling in my leg and ankle has gone but not in my knee even though i ice religiously,i am still NWB of course.i Hve read my injury report from the MRI tech with no mention of ligiment damage but I am having some sharp pain in the MCL area,will see my Doc next week.Would welcome any comments
    thx
    Hugh

    • Hi Hugh,
      First off, I am impressed that you are still skiing at your age! My injury happened the same way as yours, but I had some minor tears in my ACL and meniscus and needed a bone graft and 8 screws. I am about 8 weeks post op and my knee is still very swollen. My physical therapist thinks this is limiting my ROM, as is the sharp pain at the inside of my knee. They say this pain is common with knee injuries, but are a bit perplexed that it persists. I will see my surgeon next week and plan to ask about both of these issues, as I am stuck at 90–yesterday only got to 95 with manual force and much pain. Now my knee is locked up today. I hope your doc has answers for you. Hang in there!

        • Nice! We moved to Germany last summer and I was so looking forward to skiing the Alps…last day of first ski vacation ended in TPF. Not sure how much more skiing I’ll do..☹️

  10. I am shocked how different everyone’s experience and recovery has been. I did my TPF almost 5 months ago and am still PWB and going up and downstairs using arms. Not allowed to do this with aid of crutches. My PT has only been to show me how to use crutches. The hardest part has been the mental/emotional effect of not being able to get out of the house unless there was someone to lift me out in a wheel chair. That lasted 3 months. I can now manage to get out on crutches and have changed my car for an automatic. The freedom has been fantastic. I’m back at hospital in 10 days and hoping to loose the leg brace and become FWB. Can I “demand” active PT or just accept a leaflet and get on with it the best I can? Does the amount of PT vary according to area? Is it up to Hospital or GP to organise? Would be glad of help for my next “step” so I know what to expect.

    • Hello Fliss, where do you live? If its the UK there is something of a postcode lottery on how good this might be. However, you can get your OS or GP to reffer you to your local NHS physiotherapy centre. You can even reffer yourself. Alternatively if you can afford it go private. There are aslo a couple of good wesites with first rate PT advice. By the way I was 18.5 weeks NWB. Best wishes, Marilyn

    • I think it would vary depending on each patient’s situation and progress. Can you ask your medical team why they have put these restrictions on you? It could be helpful to know more about how you are healing up. I didn’t get any PT until I was FWB except for the 3 weeks I was in the rehab center — they gave me twice daily sessions there, to exercise all of me (I felt silly doing the little arm cycle thing but I got used to it :-), also one-legged elliptical) but there was no urging to keep it up once I got home.

      And I hear you about the miseries of having to go up and down stairs sitting down. I went outside that way (no fun in winter snow/ice/cold steps), with my son there to pick me up at the bottom of our steps and hold the wheelchair. Then we’d get in the car, go to the doctor, and do it in reverse on the way back. For 3 months that was the only place I went. Then the week before I became FWB I went to a political meeting in my town — same deal, had to go up the stairs sitting down. But I got a lot of support from the attendees for doing that.

      A big help was the idea of putting a chair at the top of my stairs inside, so that I would not have to get up from the floor — a tip from the rehab PT. But it all got old really fast, with my kitchen, TV and workspace downstairs and my bedroom and bathroom upstairs.

      In my situation, with pets and throw rugs (yes, I took some of them up) I would not have wanted to risk crutches on the stairs. I used a wheelchair downstairs and a walker (“hopper” actually LOL) upstairs. Maybe you could ask if it is because of the risk that they don’t want you using crutches on the stairs?

      Good luck with your convalescence!

      • Thanks for ideas Marilyn. I’m going to hospital (UK) on Wednesday and made appointment to see GP in a week. Will seek PT from them. Went to local Leisure Centre today and managed to do Aqua fit and Jog. They do a 10 week support course for people trying to improve fitness. Very helpful, but I am suffering tonight from hip stiffness. Going to need determination.
        Thanks Judith. Tough going upstairs on bottom especially in public. I chickened out and used crutches at weekend to climb 6 steps at hotel to get to the lift! I’m becoming a disability campaigner. Hired a mobility scooter for sea front 7 mile “walk”. Think my fracture is taking longer due to previous cancer treatment damage. I had a violent reaction to osteoporosis meds to strengthen bones. Doc took me off them and then I broke leg! Happy days. Case of kill or cure.

        • Good luck! I think perhaps the USA is more accessible to people with disabilities, at least for “public accommodation.” I only had to use the bottom-on-stairs in private houses (that’s where my political meeting was)– everything else had ramps. And when I did, I must say I got plaudits for my perseverance (or foolhardiness, whatever 🙂 — anyway people were very helpful and nice.

          I may have osteoporosis drugs in my future so I guess I’ll see — what meds and what reaction did you have, if you don’t mind saying?

  11. Starr,

    We used to live in Germany. Schwimmbods in Germany are amazing. They have so many pools to choose from under one roof. They will have a saltwater pool for sure which makes you even lighter in water. We lived in Heidelberg and I swam all the time while I was pregnant. Good Luck to you!

    I’m still NWB for 2 more weeks. I had a TPF Dec. 20th. Surgery Jan. 5th. I can’t wait until I can get in the pool and walk.

    Erin

    • Erin,

      Heidelberg is one of my favorite places, but we are in the Stuttgart area. I didn’t find a saltwater pool, but a Thermalbad at a nice 34C. I’m looking forward to trying it once I am cleared PWB, although it will be hard to fit into our schedule. BTW, we had our ORIF surgeries the same day (but my injury was 30 Dec and I had an ex-fix first). I am supposed to be NWB for 12 weeks and it is hard to be patient. I am going to try to return to work at least part-time this week as I am going stir crazy–stuck on the 3rd floor of our 4-story house. I’m sure you remember that from Germany–lots of stairs. Even my work is on the 3rd floor of a building with no elevator. Europe is definitely not handicap friendly!

      Let me know how it goes when you are allowed to bear weight. Wishing you a speedy recovery.

      Starr

    • Erin,
      Any luck bearing weight yet. Have you made it to a pool? I had 8-week post-op appointment today, and although still NWB for 4 more weeks my OS agreed I could start exercising in pool to include walking once I feel comfortable enough. He is disappointed in my lack of flexion (I’m between 90 & 100). I’m really hoping the pool helps me as much as if has others. I’m hoping you have progressed over the last few weeks!

  12. Starr, your situation sounds distressing. I would be very cautious about how far you push — you are not allowed to be weight-bearing, so your injuries are still vulnerable. Can you check with your doctor or other professional about how much effort you should make at this point? In my situation, I did not even get the go-ahead for PT until they declared me ready to be weight-bearing. By that time, I had little pain in the course of regular activities (some of the PT exercises they did with me were another story, though :-().

    • Judith–thanks so much for the concern! It’s actually my surgeon and the PT that both say I need to be pushing through the pain to get to 90 ROM and beyond, and I am just 5 weeks post op. I see surgeon again in 4 weeks and he set the new expectation of 120 by then…with any luck maybe he’ll allow PWB at 9 weeks vice 12. Based on everyone’s advice, I have found a pool nearby to use once I am cleared for it. Trying to stay positive–I did hit 90 yesterday at PT so it can be done!

  13. I have recovered from two tibial plateau fractures, exactly one year ago, and was told 12 weeks no weight bearing. It was about 11 weeks before I even tried as I was given strict instructions that the surgery had repaired the damage and any weight bearing too early might mean my weight imploded on the repaired section. Don’t be in a rush to get active – it all happens in time, and aqua aerobics or similar is a great help. I’m still extra careful on steps, but I get there.

  14. I had a tpf on the 29th November and surgery on the 2nd of December, my surgeon only allowed me to start bending my knee 6 weeks post op and I can’t get it past 60 degrees. I’m a 26 year old fitness geek and I’m getting so frustrated…..will I be able to squat again? When will I be able to train again? X

    • My advice would be to get yourself some professional physical therapy. I got my full range of motion back with their (sometimes painful) help — on my own, I probably would not have pushed myself as far. Are you full weight bearing yet? If you weren’t able to do any exercises for 6 weeks you will have lost a lot of muscle tone, as I am sure you are aware, as a fitness geek. If you are not yet full WB, your doctor may still want to limit your exercising, so I’d consult with him/her.

      As for squatting, that activity was part of my rehab, so I’d say Yes. Regarding training, I’d seek the advice of the professional PT people — that’s their job. My insurance paid for more than 6 months of PT, maybe yours will, too? If not, then you might want to spring for a couple of sessions on your own dime — this is so important, it will be worth it to get hands-on expert advice.

  15. This has been one of the most helpful sites I have come across.

    I got bowled over by a couple of dogs in the park and broke the tibial plateau; A single break, fortunately, so I feel reasonably lucky. Also a cracked fibula, but that is a minor issue. It took weeks before I got surgery – they didn’t notice the break immediately. I was sent home with instructions to be NWB for six weeks. Then went for follow-up X-ray, and was told to start weight bearing as tolerated. I an now walk without crutches, but am following the physio’s advice to use both crutches when out walking. She was right. Walking without crutches for any distance hurts my back. Too much strain and concentration on balance. I am now walking over a mile at a time, and much of his feels good.

    What does not feel good is the sharp pain on the inside of my knee; it is particularly aggravating at night; and I prefer not to take pain ,killers more than once every five nights or so.

    Reading your advice suggests to me that this is just one of those stages that i shall have to go through. I do note, however, that putting strain on the knee when doing flexing exercises definitely provokes the pain – so I have been easing up on those. In any case, getting the leg to straighten feels more urgent than getting a full bend, and stretches help. I suspect that the body is quite good at telling me what works and what doesn’t.

    What I find is that there are days when it feels as though progress has stopped; and then I suddenly realise that I can do something which I just couldn’t do 24 hours previously. So, patience and discipline combined with realistic optimism seems to be the balance that’s needed.

    • You have such a great attitude! I’ll bet that helps the healing process as well as benefiting your mood.

      About the knee pain, is it possible you tore a ligament? What you describe sounds like what I experienced. My TPF was so severe that they did not even mention the ligament damage to me until I brought the pain on the inside of my knee to their attention, and then they told me about it. It was not serious enough to need surgery itself and it did eventually heal. But I think you are wise to avoid doing things that give you pain there, until you can get a medical opinion about it.

      My pain was also bad at night and so I slept with a pillow between my knees, don’t know if that will help you or not.

      • Judith, I had the same experience in that my TPF was so severe (2aplits with depression) that the surgeon wasn’t concerned with the slight tears in my ACL and meniscus. However, I am now 4 weeks post-op (from 2d surgery) and my ROM is limited by swelling and pain in my inside knee. Like your case, they told me the ligaments will heal on their own. I’m just frustrated because my PT start was delayed 2 weeks and now I’m not quite to 90 ROM and the surgeon expected me there 2 weeks ago! Oh, and I am NWB for 12 weeks. I try to remain upbeat like William, but there are days…and William, I too hate taking medicine but am learning that I have to take some pain meds in order to more effectively PT. If I’m in too great of pain, I hold back which limits progress.

        • Starr, I fell from an electric scooter, split my tibia with one side needing plates and about 14 screws and the other plateau completely mashed so that the surgeon just pulled out the little bone fragments and rounded off the bone where it was. This happened on Oct 15 and it is now Feb. I was lucking to have homehealth nurses for the first month along with physical therapy 3 x per week for the first 2 months. I am 2 weeks into weight bearing and my leg does not support my weight without pain. The best thing I have found is the swimming pool and a swim noodle. I bicycle in the pool and do every exercise I can think of. I walk the pool and use the noodle to stretch my leg to the back. My flexibility stuck at 80 for a long time, but after the pool work is about 120, but I’m still stiff as a boot until I work it and swollen afterwards. Sometimes I don’t think it will ever get better, but then I see a little progress. The worse pain I have is when I bend my knee it feels like a rubber band is snapping and sliding across my kneecap. Hurts like a bugger, but once it slides over, the knee bends. I only use half a pain pill if I can’t sleep or and hour before the PT shows up (I swear they get their training in a torture camp) 🙂 Anyway, I think I’ve resigned myself to a multi year recovery which may never be complete. I’ve always been very active, hiking, riding, etc, but I do not want to go through this EVER again, so I’m going to be much less adventurous.

          • Carol, thanks for sharing! Your injury sounds terrible, and I am glad you are making progress. It sounds like I should find a pool to try to exercise once I am allowed to bear weight. I have only lived in Germany for 6 months and am still learning what’s available to me. Like you, I was pretty active and unfortunately this injury is limiting my family’s ability to enjoy living here (we have 2.5 more years). I need to be able to walk and climb stairs, so I will try to push through the pain–it really does feel like the knee is going to pop. All the best to you!

          • That sounds dreadful, and so difficult to deal with. Especially the part about your kneecap — that doesn’t seem right. Can you check with your medical team on whether all your ligaments are in the right place? As far as I know, nothing should be sliding across your kneecap. Of course, I am not a doctor, so I definitely defer to the experts.

            And, yes, you will very likely have a multi-year recovery. But there’s a good chance it will be complete if you persevere. And I hear you about being less adventurous — I don’t take any chances with my horse now, so that part of my life is pretty circumscribed. Still, compared to being in a wheelchair, even cautious independent activity feels terrific. You’ll see!

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