Recovery


A Tibial Plateau fracture is really not much fun, but it helps if you are prepared and in many cases doctors will not prepare you properly for daily life after your injury. If I had to give you only one piece of Advice on Tibial Plateau eracture recovery it would be: be patient. And in the end, it’s not as bad as it looks.

Below is a more elaborate list of time-tested knowledge and information on different subjects related to your Tibial Plateau fracture. There are also separate sections for the different stages of recovery (from the menu above choose “1-8 weeks” etc.)

*Note: this website is not intended to provide medical advice. Your doctor is a much better source for medical advice.  This information is based on firsh-hand personal experience and research*

What to expect – overview

You will be leaving the hospital on crutches, usually with a hinged brace. For the first few weeks you will experience quite a few different uncomfortable symptoms but these all pass quickly. Natural symptoms include limited range of motion in your leg (in the knee and ankle joints) as well as pain, heat flashes, edema and stiffness Some of these will be caused by the fact that you are not completely mobile. Things will progress from here until in the end you are (in most cases) completely able to do your everyday activities, but it will take some time and hard work.

Time to recovery

Recovery from a Tibial Plateau fracture is different from person to person. It depends very much on the exact type and specifics of injury, your age, prior issues, level of physical activity, physiotherapy, nutrition and many other factors. Given all of these differences it is still quite safe to say that for most people, if you the injury was treated by surgery, you will still be in some kind of recovery for a complete year after your injury¹. In most cases it will be more than that, Improvement showing up to three years after. This sounds like a lot, and it is, but I can assure you that it does get better and that for most people after a few months your the injury will not prevent you from continuing with you daily life and you will be able to do all your daily activities to some extent including walking short distances, going out, meeting with friends, going to work etc.

Weight Bearing

For a period of about 6-8 weeks after the surgery you will be NWB (non-wait-baring), this means that you can not put any pressure on your knee and leg and will need to use a wheelchair, crutches or both. For some injuries it might take up to 12 weeks until allowed FWB(Full weight bearing). Depending on your doctor and your specific health condition you will be moving from NWB to PWB (Partial Weight bearing) or FWBAT (Full weight bearing as tolerated). This period of NWB will cause many mobility concerns and will affect your daily routine.

Mobility

You will be spending a few days in a hospital bed then progressing to a wheel chair and crutches, which you will be using for about 2 months, possibly followed by a single crutch and walking stick (see paragraph above – “weight bearing”). It could be up to 3 months on crutches, and up to 6 still using a walking stick (but usually much less). Also expect that initially you won’t be able to bend your knee much for a few weeks. This is called limited ROM (range-of-motion). Crutches are hard to use at first, and may be painful on the hands and shoulder, but don’t worry you will get used to them very quickly. And as a bonus you will develop very strong arm muscles. In some cases, overuse and pressure on your hands can cause secondary injuries to your wrists, arms or shoulders. If you are in pain from using crutches take it easy and use a wheelchair for a short while. You should also consider testing different types of crutches. Forearm crutches are usually more comfortable (then underarm) and come in ergonomic varieties. Today many advanced crutches also support ergonomic designs, anti-slip, and special features (link, link). Underarm crutches are usually safer then regular forearm crutches (link), but tend to be less comfortable, and don’t come with as many smart designs. Platform crutches might be good for people with a poor grip, but I haven’t tried them myself. Some crutches will also have shock absorbers to help your wrists and arms absorb shock (link).

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All this will require that you prepare for a period of partial mobility. Things you might be limited in doing include – walking up and down stairs, house jobs (cleaning, cooking, washing), carrying things from place to place (no free hands when using crutches), reaching high and low cabinets, showering. At first, you might also have trouble getting dressed and undressed but this will pass quickly. The best way to deal with this is have friends, partners & family help you with everyday chores and prepare the house as much as possible to make things easier. A few things you could do are:

  • Get a shower chair so that you are able to shower without bearing weight (link) and possibly also invest in some big bags or drycast or other cast covers (link) so that you can shower without taking your brace or cast off during the first few weeks.
  • Be very careful when using crutches in a wet surface because you could easily slip. Even more dangerous is if the crutches are wet and the floor is not. Make sure to dry the bottom of your crutches on a towel before leaving the shower.
  • If your crutches are very old and the tips are cracked, replace the tips with new rubber tips. The come very cheaply (link)
  • Use a gripper (link) to be able to reach those unreachable cabinets and to be able to grasp and retrieve items you would not be able to otherwise while on a wheel chair (link).
  • Make sure that someone prepares food and goes shopping for you. Other options include ordering in prepared food and ordering groceries online.
  • If your bed is on the second floor, Consider sleeping in a different room if you find it hard to get up the stairs. You can also climb stairs with crutches, or sitting down.
  • High and low cabinets are are hard to reach. Try moving things around so that they are easier to reach. Doors on low cabinets can also be unhinged to allow for easier access with a wheel chair. They can easily be put back on later.
  • More useful ideas can be found in the “logistics” section and “Tips & Tricks

Physiotherapy

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Physiotherapy is going to be a regular part of your life. The are several goals: increase ROM, increase muscle-mass, teach your musculoskeletal system to operate as before and increase your stability. It is very very important that you start physiotherapy as early as possible and keep at it until you are completely better. This is the one factor that will affect your recovery more then any other and it is completely up to you. I’ve written a complete section on physiotherapy alone. Usually you will be given exercises to perform from your physiotherapist. At the very beginning you will probably not be able to bend or straighten your knee at all. This can be quite frightening but don’t be alarmed. Initially exercises will aim to teach your neurological system to control the leg again. It might even only be hours before you will start to be able to bend your leg, or it could be a few days.  After this, during the NWB (not in all cases) period you will be performing gentle exercises to enhance your ROM, strengthen your muscles and reduce stiffness, sometimes using stretch bands(link). Exercises might be done at home or in a medical center. It is very important that during this stage you follow PT instructions and do the exercises as soon as possible and as much as possible. This will reduce stiffness, boost recovery and give you a better chance at developing good ROM. When you progress to WB, physiotherapy will include many exercises with weights and machinery with the aim of gaining stability and muscle and to exercise everyday activities like walking. I can not emphasize enough how important it is that you keep at it (even if it means you go to work less). To be able to do physiotherapy at home you can consider purchasing light ankle weights(link).  For more info and tips, have a look at the physiotherapy section.

Medical professional

Several medical professionals will be involved in your recovery process, including the radiologists, the OS (“operating surgeon”), Physiotherapist and sometimes others. You will be having regular checkups with them. It is very important that you make sure your OS is a good one, and that you consult with him on every question you have. Be curious and ask everything you want to know. Sometimes doctors will not be generous with information, make sure that you get your answers. You deserve them. Seek extra information in sites like this one (more sites in the further reading section). In many cases the PT and the OS will be discussing your condition either directly or passing notes through you. Make sure that they talk if they are not already talking, but remember that when they give contradicting advice – the opinion of the OS is always the one to go by. You might also want to consider getting a second opinion both before or after your surgery.

Diet

Bone healing requires quite a lot of nutritional help, especially during the first 3 months(This is when the bone is healing), so make sure to eat well, and consider supplementation. For your healing to progress well you need to make sure that you get a lot of Calories, Protein, Antioxidants and minerals. During the first few weeks of healing your body will consume about 2-3(!) times as many calories as normal. This is about 6000 calories per day, so no need to feel bad if you’re eating a lot and very hungry. It’s all going to healing.

Protein is an Important nutritional ingredient. By volume, roughly half of your bone is comprised of protein, and you will also need to get a lot of it to reduce muscle atrophy as much as possible. If you think you are not getting enough protein consider using protein powder to supplement your daily protein intake (link), or adding protein rich food to your diet (meat, eggs, milk products, nuts & seeds).

Minerals are very important for several reasons. By weight bone is about 70% minerals. These are the building blocks of your bones. The high need for minerals will mean you might no be getting enough of them, which can cause other problems. If you are depleted in magnesium for example this may cause muscle cramps which are not much fun during a Tibial Plateau fracture. Consider using a multi-vitamin(link) containing minerals during the recovery process just to be sure. Studies have shown a lower rate of complications in healing in people taking multi-vitamins (link). The most important minerals to consume are Zinc, Copper, Calcium and Silicon.

Vitamins are the catalysts for the process of healing and are also in high need during recovery.  Vitamins that play an important role in bone healing include: Vitamin C, Vitamin K, the Vitamin B-series. Be sure to eat a varied diet and Consider using a multi-vitamin for Vitamins and minerals (link).

Anti-Infalmmatory Nutrients help reduce inflammation and pain. Bone creates a lot of inflammation which causes pain.  Unfortunately it is not advisable to take NSAID (Non Steroidal anti-inflammatory Drugs) during the bone recovery process as these slow recovery. Natural Anti inflammatory agents that may work to reduce pain include Vitmain C, Omega-3 (link) and others.

There are many foods you should avoid. Some foods will interrupt normal absorption of nutrients and their consumption should be limited. Some of these are:

  • Salt or foods prepared with lots of salt
  • More than one cup of coffee or other caffeine beverages. If possible, avoid coffee altogether.
  • Sugar
  • Chocolate (because to caffeine content)
  • Soft drinks and carbonated beverages
  • Alcohol (it inhibits calcium absorption)
  • Caffeine (it increases rate of calcium loss and inhibits absorption)

Pain

Pain is an unpleasant but normal part of recovery. You will be experiencing different types of pain and discomfort throughout your recovery. Pain might be felt in different parts of the leg, and won’t neccesarily concentrate only around the knee. Most pain comes during the first few days and weeks after the surgery. Pain management is an important part of your recovery and you should not be in constant pain. You should use pain medication as advised by your OS or hospital medical staff. If you are unable to use the medication prescribed by your doctor or are more comfortable using a different type of pain medication remember that some types of painkillers should not be taken for long periods of time(read the label!), and that you should never take NSAID as pain-killer while the bone is still healing. These types of medications will postpone healing. Brands included in the NSAID group which you should not use include Aspirin, Motrin, Ibufen, diclofenac, naproxen and others. Don’t use these. Instead use what is recommended by your medical staff or another medication that is not a NSAID. In some case, mostly in the first days you might experience more severe pain that can be treated with stronger drugs. This is normal, but if you experience abnormally strong pain or other abnormal symptoms, get yourself evacuated to a medical center as this is usually nothing but could be a sign of a complication. Make that in the first few weeks you have a bottle or box of painkillers in your pocket so that it’s always handy. Remember – liquid pain medication usually act faster then the tablet equivalent of the same brand.

Staying at home/Mental Health

You might be staying at home a lot and will be quite immobile for a while. This can get affect your mood very much and can at some point get depressing, especially if you are used to being very active. There is no magic pill for this, choose a good book, and a good TV series and try to regularly talk to as many friends, family and close people as possible. The proximity of  friends and close ones is very important. You might also want to find a community of people who have suffered from Tibial Plateau fracture before who share your experiences and feelings. There are several such communities, and some of them they can be in the further reading section of this website. Also, try to do as much exercise as you possibly can. Even if this means exercising while sitting or lying down. This can give real boost to your mood. Another good Idea is to start watching a new TV-show you’ve never had time to watch, or subscribe to online video providers like netflix or amazon prime (link). If in need, consult a psychologist or mental health professional. It is quite normal to be affected by a prolonged period of immobility and recovery, and a psychologist will be able to help with this.

Physical Activity

You will eventually probably be able to do anything you were able to do before your injury. However, this might take a long time (1 or more year for some sports) and you might have to be careful when doing extreme sports. There is a limited amount of things that you may not be able to do exactly as before, for example some yoga postures will not be possible with limited ROM, but you can always work around these limitations by doing things slightly differently. Also, you might experience some pain which will be limiting. If you want to take up a fitness activity shortly after the injury bicycling and swimming are both good options which will also help with recovery. Upper body weight training might also be a good option but will not directly advance your recovery.

Work

You Might be dying to get back to work or could be in need for a vacation. Going back to work is something that very much depends on you and on your specific job and state of mind. Some people go back to work on crutches after 4 weeks (me, for example), while others might wait a whole 6 months.  There is a good side to going back to work (aside from money) since you will be interacting with people all day long and will not be bored. The important thing to remember is that you must avoid overworking and stressing yourself out. When you go to work it is important that you leave enough time and mental energy to be able to do your physiotherapy as much as you need, to rest, to relax and to visit your medical professional. This will allow your body to recover. You might be tempted to sacrifice your physio for your career. Don’t do that. Your career will still be there when you recover, the condition of  your leg is something you will be living with forever.

Sex

There is no physical limitation from having sex as soon as the initial pain has subsided, but this injury can affect your sex life, something which you will not find a lot of information about and your doctor might not tell you. Decreased mobility in one leg and one leg which is half the strength of the other can naturally affect sex. This gets better as your leg heals and strengthens, and you will need to ask your partner to be patient as you progress through the recovery process.

On a good note

Tibial plateau Recovery takes a long time but at the end of the process you are looking at excellent recovery and usually a fully functional life.  Moreover, trying to find the good embedded in the bad, this injury can help you put things in perspective and appreciate all the things you have in life: friends, family, health, a loving spouse. It gives you an opportunity to stop and think about what matters most.

1,637 thoughts on “Recovery

  1. Hi Mary! So very sorry about the discomfort you are experiencing!! I am not an expert but I would think that you should still be under your doctor’s care, considering that you are still in pain. At 6 months, I was feeling fairly well but by no means able to resume a totally normal life. I was able to get in and out of the car without help, go up and down stairs fairly easily, and take mass transit without a problem. I was much slower with walking than I was before my TPF, however. It took time to get better at that. Also, it was the summer for me at my six month mark and I love going to the beach but I wasn’t comfortable walking on the sand which is something that used to come naturally to me and I consider to be a normal activity. The knee moves in different directions walking on sand, I believe because the foot sinks a bit so it felt uncomfortable for me to do a lot of walking. I was still moving slower than normal. I was, however, still doing my strengthening exercises and still tired. Was also icing the knee from time to time when I was on my feet a lot.
    I would DEFINITELY get another opinion. If you are uncomfortable at all and your current doctor wants you to resume normal activities at this point, I think that is something to question. Are you still going for physical therapy outside of the home and also doing exercises at home? Are you able to do these exercises without pain? As to whether these doctors “stick together” I am not certain but I would seek another orthopedic trauma surgeon’s advice and, if necessary, seek a third. This is your body and your life. Yes, this is a long recovery but you should be able to return to a fairly normal life free from pain. To me, it doesn’t sound like you are pain-free. Also, I definitely felt something below my knee as you do. It always felt like something was pinching me. I am so happy that I had my hardware removed; no regrets at all!!!
    Please keep us all posted and good luck!!

  2. I’m recovering from a lateral break on on my tbf. I’ve previously had a bi- chondular tbf on my other leg 12yrs ago.
    Just had cast removed 2 weeks post op today and stitches removed. Now have a hinged brace set at 45deg. However can’t bend my knee at all. It’s still pretty swollen. I wasn’t told of any exercises to do, not sure if I should wait for swelling to go down and just try and flex the muscles for now to build them back up? Any advice welcome.
    My left knee never fully recovered and is suffering more and more these days, it’s extra hard now I’m solely relying on it whilst my right is knackered, hoping his oe as a enter outcome!

  3. Conan,
    I sustained my tpf on Jan 11th, 2016 and had surgery on the the 14th. My doctor mentioned my needing to bend it post surgery but by no means stressed the importance. I like my surgeon both professionally and personally a lot but felt he could have made more of a point in terms of bending it. I was partially weight bearing (with crutches) at 6 1/2 weeks but it wasn’t pretty and from what I gather, was earlier than most. At 8 weeks I was still hobbling severly. That said, my ROM was 45 degrees. My PT and my doc suggested forced manipulation under anesthesia, SO very glad I did not listen. I was grossly behind everyone else I’ve read about on this website in terms of ROM but got there eventually. Overall my point is this…you are not as behind as you think. Perhaps both our docs could have stressed the importance of bending more. You WILL get there. You will walk and it will bend. This is just a snail slow process. It’s a difficult injury. Hate you’re going through it and hear your frustration. Let me know if I can help in anyway in terms of advice.

  4. I had a TPF caused by an auto accident Nov 14 2016. I had my external Fixation done on the 16th. I had my surgery to fix my TPF Nov 28th with plates and screws. The doctors did really tell me anything about when I could start bending my knee. After four weeks they removed the stitches and was wondering why I haven’t been working my knee out. Well the doctor didn’t tell me anything not even some pamphlet. So without PT I tried to get my ROM back in my knee still can’t weight bare. I had to look on you tube to try to find an exercise I can do to get my ROM. I did the exercise for a month still can’t get the ROM on my knee. Right now my ROM is 50% straighting is only 10%. So I saw the doctor again and he was disappointed that I don’t have the ROM. So finally after 8 weeks he is recommending PT. So I just started PT this week. I cannot weight bare until the middle of Feb. So what the PT is doing is pressure points. Which seems to relax my knee. He also gave me muscle tension exercises and heal slides twice a day. So six weeks after surgery I’m finally getting physical therapy. So I feel that I have been gypped out of a whole month of recovery.

  5. Hi Susan! Anti-inflammatories are generally not given after this type of injury/surgery because they slow down the healing process of bone. I took 2 Acetaminophen (Tylenol), 325 mg., twice per day. My surgeon also had me take enteric coated aspirin (325 mg.) twice per day for 6 weeks, to prevent blood clots as with this recovery, you aren’t moving as much as you would be normally. Good luck with everything!

  6. Wow! Excellent information.
    The only other information I would ask for (and I know you would worry about liability, is, what over the counter pain meds would be ok?). My normal go to, is excedrin.

    • Hi again, Susan! As a follow up to what I just wrote, always check first with your surgeon or orthopedic doctor before beginning any new medication. Although Excedrin has Acetaminophen in it, it also has aspirin and caffeine. As I stated earlier, I was also taking enteric aspirin to prevent blood clots but only for a short time and under my doctor’s supervision. I am 13 months post-injury/surgery (had a plate and 7 screws), and am doing very well now. Also had my hardware removed after 8 months. Keep us posted on your progress!

  7. Very useful information thanks to share .my age is 66 how much time required me to recover that fracture as well as use of walker to go toilet. 21 days gone after my surgery. I was very active man in this particular age . unfortunately depend upon my wife for toilet etc at almost at bed

    • When considering over the counter pain relief it is very important NOT to use an anti inflammatory like ibuprofen or Aleve. Swelling is a very important part of the healing process. As long as what ever you use for OTC pain reliever does not have an anti inflammatory then you are good to go. Tylenol is a dr’s go to but with all things you can take too many and over dose. Please read the label before using.

  8. My TPF on 6 Nov 2016..Type 6 Fracture
    Surgery ORIF .2 months over till now..Unable to bend my Knee properly.ROM now 50 Degrees.Fracture is cumulated one.Till now no wt bearing.PT is started..Approx recovery time..?

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