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.

2,131 thoughts on “Recovery

  1. Whats up people!
    Sharing my story that occurred to me on April 1st 2019, I was riding my motorcycle and I lost control and fell off while doing wheelies [ very idiotic ].
    But anyways, When it happened I was in shock and layed on the ground for easily 10 minutes, my coworkers were outside with me already,
    I was rushed to the hospital and they rushed me in fairly quick, They first did X-rays and after confirming i had a tibial plate fracture they put 4 big rods on me from the top of my leg to the bottom. This surgery was not too bad went smooth under anastasia of course lol.
    BUTTTT let me tell you about my internal surgery, when i came out of it JESSSSSUSSS christ never in my life do i wish this pain on anyone. 7 days in the hospital total.
    First nights after coming home were horrible, i couldn’t sleep and i was just overall in bad shape.
    luckily my family and friends were supportive and helped me get into the restroom and shower, I’m gonna be honest they even helped me wipe my butt..very uncomfortable but i was more worried about the pain.Im on my 9th week with Non weight bearing. But feeling and doing more on my own now…
    Overall don’t feel discouraged, you will get better.

  2. On the 4 March 2019 while skiing ,I fractured my tibial plateau, on the medial side of my left leg ,accompanied by an extensive spiral fracture down tibia . I had surgery the next morning 5 screws and plate. I have been totally non weight bearing for 10 weeks . Got the go ahead to start yesterday So exciting ! I still have pain in the knee and shin but nothing compared to the first 4 weeks . Used a game ready ice compression machine , infrared laser , bone stimulator and lots of Vit C,D ,K2,E ,mag cal and Bs.
    Pain management initially was problematic . Really enhanced by edibles at night, Don’t take anything anymore .
    Hang in there it’s a long tedious process but gets better all the time ,

  3. Hi I have a grade vi TPF and am now in month 4 and a half of recovery. I didn’t have surgery and had non weight bearing for nearly 3 months followed by leg brace etc. Been out of leg brace now for a couple of weeks and have no ligament damage. I haven’t had a complete nights sleep since the injury as I seem to have to get up and move the leg a couple of times in the night – did any of you have that? I have a very good physio who is trying to get me to use only one stick but at the moment but find it better using 2. Had a great day on Saturday walking a lot but since then leg has been very stiff I guess it’s a case of not overdoing it. I still have the heavy numb feeling and the foot swells but I am at 90 bend now. I’ve started to drive very short distances which is not painful. All usual exercise seems to result in stiffness but I am diligently doing all my exercises. I think losing weight would help but food becomes a great comforter when you can’t get around so much unfortunately. Any tips on how you got over this period of exercise then rest would help. I can see progress now but obviously like us all want to get back to “normal “ instead of always looking for somewhere to sit down when out! Would be great not to have to sleep on my back all the time but lying on my side feels weird – does that happen in time or do you always have to sleep on your back?

      • Hi. I had a car accident on April 25. I had a tibial plateau fracture that was non displaced but my leg was horribly bruised and swollen. My doctor will check for soft tissue damage at the 6 week point. I have very little pain but must keep my leg straight which limits any car rides or outings. (Not that I’m ready to do my much of that yet.). I was just wondering if anyone had issues with soft tissue damage beyond just resting it and if your leg p, at 7 weeks, still had numbness and some tender spots.
        Thank you

        • Hey Linda, Glad you’re okay overall.
          Im on my 9th week of NWB after a bicondylar tibial plates fracture done by a motorcycle accident, its the upper part of the tibia right under the knee.
          However YES I still have tender spots around my leg and also have some contractions from time to time, its a burning sensation. Thats completely normal since your leg is still recovering, infact its a good sign according to my surgeon.

          good luck and get well! I also have a instagram if you’d like to see the pics!

  4. I have a *very* minor tpf resulting from running. But I re-injured it recently – I guess I wasn’t completely healed before hitting the pavement again. My question is this: has anyone used a boot following nwb with crutches? For some reason, it seems to help. But it doesn’t make sense to me because I don’t see how the boot relieves pressure from the top of the tibia.

  5. appreciate the reading had my tibia shattered in a accident back in sept 28 , 2018 2 plates 19 screws. its been a whirlwind of a ride recovering still not there yet. and still have soreness around the knee area swelling. but I guess its progressing. still not able to walk that good with out assistance , walker/cane but trying to make it. PT is helping .
    i hear that it takes about a year or longer to completely heal and from what im reading from other post sounds to be accurate.

  6. I’m just heading into a year since my tpf after a skiing accident, plate and 4 screws with some mesh. I missed the backpacking season this summer and it was the first year in 20+ that I didn’t buy a season pass for skiing. I did most of my own PT on my stationary bike which was difficult in the early stages as I was not able get a full rotation but kept working on it. Clipping in with my bike shoes helped to keep my knee in riding position and not unconsciously twist to avoid pain. I’m up to 5 miles of trail walking but a long way from putting on a backpack and heading into the mountains. My trekking poles have been a huge plus hiking this winter and I found using a neoprene knee sleeve gives me some support without hindering my movement. Still find I’m not able to sit on my knees like I use to and continue to work on more flexibility there.

  7. Just found this site , I am 4 weeks post op. Left leg tibial plateau fracture, plate and 8 screws. I have another complication because I am a right leg above knee amputee due to cancer . My mother in law fell on my knee And basically crushed it . I wonder if I will be able to walk at all on this repaired leg ? Just seems so far away get some normalcy

    • I am almost 4 months Post op. This injury is so stressful. I cannot imagine how hard it must be on you. I am still struggling with trying to walk unassisted. Just know that what you set your mind to , you will overcome.

    • How are you doing? It may seem that you will never recover, but patience and resolve will help you stay on track for healing. I am 27 months post surgery and I am still experiencing healing and increase function. Just when I think I have reached my peak of recovery, I take another giant step.

  8. Smashed my Tibia Plateau 4 months ago hopping off a truck bed – 5 feet. Type 6 on the schatzker scale. First surgery was external fixators / Second surgery was 2 plates and 15 screws, both within 5 days. Fortunately I had no ligament damage.12 weeks of zero weight bearing / PT since mid Nov / Now I’m walking with and without a cane with a good limp and some discomfort, but getting around, going upstairs easier than down. Handrails certainly help. Still have swelling from the knee down to my foot.
    I can see dealing with this injury for at least a year before attaining some form of normalcy. Not sure how long the edema will continue. it’s aggravating.
    It will take some time – don’t push it – wanna get it right the first time. Good Luck everyone.

    • This was a great read for me too unfortunately I found it after I’d gone through most of it. I’m 4 months post op now and I find driving easier than stairs. All I can say is keep up with the exercises they give you. It does help in the long run.

  9. Driving? My op was on 20th September with plate screws and graft. I’m now hobbling on 2 feet around house but stairs are difficult due to foot pain. I keep asking professionals about driving as this is my profession but they won’t/can’t say. My insurance says when the surgeon says it’s ok to drive. So I’m in a catch 22. Anyone had experience of driving and how long after? The injured leg is my brake leg.

  10. I didn’t have surgery either. I was on crutches/wheelchair/splint for 12 weeks. Then the doctor weaned me off the crutches and I was still wearing the splint.

    • Are you walking now and how long since your break.. I was told l0 days ago that I could bear full weight. I have a lot of pain in my foot and on the inside of my knee when I try to walk without the crutches. Not sure if this is normal.

  11. I broke my tibia plateau on lateral side Sept. 17,2018 . No surgery with 2-4 mil. displacement. I had a splint on for 6 weeks, a lot of tingling and numbing sensation and swelling on the inside of my knee. Doctor is not concerned but I sure am.. Really is this normal? On my 7 week visit just said to take the splint of and start bending my knee and that may help. Now I am 9 1/2 weeks and its still the same. Doctor { orthopedic surgeon} also told me no weight bearing for 12 weeks. Its like in and out of the room in a minute or so and no time to explain anything to me. Now I am 9 1/2 weeks and its still the same. I mostly use a wheelchair because I fine that with crutches it is to much stress on my other leg. I was wondering if weight bearing before 12 weeks would damage the bone? I am 64 years old but up to now has been very active and love to walk and hike.. I did this break by tripping over my little dog in my kitchen. That’’s how fast your life can change,

    • I broke mine on the 22nd and just had surgery yesturday im in alot of pain today specially when i het up to us the bathroom. Everytime i put my leg down instant pain 🙁

    • Nov. 28th seen my doctor and he said the bone was healed and I could bear full weight on my leg. I started walking th the crutches and continue to do so. If I don’t use the crutches and try to walk on my own I am like a rag doll. My foot pains in through the heal and the inside of my injured leg pains. Hope this is normal. Tired of waiting to get back to normal.

      • Hi Beth
        I had similar break in September caused by my dog running into me. I am 54 and did have surgery and also nwb for 3 months. I also used the wheelchair as I fell on crutches and my broken leg took the weight. I did feel this put back my healing as the pain was much worse for a week after. However after my 3 months I was told to start putting weight down and once back on 2 feet it does get easier. I also get heal and toe pain and find tip toe excercises the hardest. I can now hobble without crutches. But was told small and often rather than pushing too hard Keep up the excercises as these are very important. And good luck

    • Hi Beth
      I had similar break in September caused by my dog running into me. I am 54 and did have surgery and also nwb for 3 months. I also used the wheelchair as I fell on crutches and my broken leg took the weight. I did feel this put back my healing as the pain was much worse for a week after. However after my 3 months I was told to start putting weight down and once back on 2 feet it does get easier. I would recommend you follow your surgeons advice but you also know your own body. Keep up the excercises as these are very important. And good luck

    • I fractured my tibia plateau on Friday, July 13thm, 2018 at a local Wellness Center, I tripped on their speed bump in front of the building, talk about how fast your life can change, I can feel for you. Went through everything you mentioned and still have a brace for every day. Just started driving about 2 wks ago. I actually went out for dinner Christmas with no brace on but had a little pain in the knee but managed to get through the night. It will get better each day. I had 2 – 10 weeks sessions of Physical Therapy which really helped. Still do my exercises daily. Good Luck

      • Hi – don’t worry, it will take time. I had my accident three years ago. I can now walk, run, etc and have no pain. It took well over a year for the swelling and pain to go away. I still have numbness in part of my leg and find it hard to kneel but apart from that I am fine.

    • Myofascial release, acupuncture and persistent range of motion exercises will help. Don’t give in and give up. Just keep working. I wasn’t able to walk for 6 months after my surgery. I was 67 when it happened two years ago. I still see improvement and I still have those days that I have to take it slow and easy but overall, I am walking almost normally without a limp.

    • Do you have a good physio . I find them way more informed and helpful getting ready to weightbear , once you start the light at the end of the tunnel appears . I walked today for the first time 10 weeks post injury and surgery . Felt weird but amazing . I’m 60 really active (did this skiing ) rode stationary bike for 1 hr today 👏

    • I am 63 and never had a broken bone or major health issue. I was in a traumatic car accident, my husband was going 60 mph and hit the back of an 18 wheeler with a trailer carrying oilfield equipment. Luckily we were not killed (large Yukon, seatbelt and airbags). But broke my bone with great amount of bruising and swelling. My doctor put leg compression and stabilizer knee brace with no weight bearing for at least 6 weeks.
      It was a non displaced fracture so no surgery. I’m using a walker since I find I feel more stable. My leg is still numb and some tingling in foot. The swelling is down and most bruising is gone. But I’m still worried about soft tissue damage and when I will expect to walk again.

    • How are you progressing? I’ve had numbness and tingling toes too. I’m going for my 6 week apt. And am anxious to see how I’m mending. I can’t stand this NWB much longer. I want to walk again!

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