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).
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.
Hey guys, looking for a reply and some assistance. I had my first surgery on 3/30 for an external fixator followed by the 2nd surgery 2 weeks later which involved screws, plates, and an internal fixator.
So surgery was a little over a week ago and I really can’t move my ankle. I can’t turn it to the right or raise my toes upward. There is still some swelling, I’m just wondering if anybody else experienced this and if it’s normal. It’s certainly frustrating!
I’ve also been dealing with eating because I was constipated due to the pain medication. I cut the pain meds and have been able to use the bathroom, but still have no appetite and have been nauseous. Again, is this normal and any advice on how to adjust? I know how important nutrition is to recovery..
Overall I’ve been extremely frustrated, having little pity parties for myself, and swearing I’ll never be able to move or walk again. I know it’s early, as my surgery was only a week ago and my follow up is next week, but it’s so hard to stay positive. Any help, advice, suggestions or support is greatly appreciated. Thank you.
– Cliff
Hi Cliff,
Judging by the method your surgeon chose to treat you, your fracture looks a bit serious (with the screws and internal plating ). It will take time for everything to be normal again. I had an open knee fracture in which the bones were completely shattered, extensor mechanism avulsed and multiple torn ligaments. I have an external fixator to stabilise the tibia and have 17 screws in my joint. Thankfully I did not have vascular or nerve injuries. Even i couldnt move the ankle freely / completely after one week. I had no sensation but over time it slowly started coming back. The first month post surgery i had similar symptoms as you have right now. So its completely normal. Take the pain medication only if required and you could ask your doctor to get you an antacid tablet or syrup prescribed. That totally works !
Fractures of the articular surface need patience and proper care and nutrition. So dont worry time flies ! You can focus all your energy in getting back all your strength in the injured leg.
It would be great if you could share the details of your injury. Get well soon mate. Cheers !
Thank you for the reply, Ashish.. I really appreciate the support and I’m happy to hear that most of what I’m going through is normal, despite the fact that we had to go through this at all. I’ll certainly try to stay positive and will do my best to update you on my recovery process. Thanks again for the quick reply!
Thank you both as Cliff I’m right along with you in how you are feeling. my injury occurred 4/17 and had an external fixation placed on for about 1.5 weeks then surgery, where I had a plate and 8 screws put in on May 3rd, I’m 27 days out and I’m right with you, I have had my pity party and swear I will never walk again to, which is hard considering, I broke it due to my active life ( softball injury). But I refuse to give up, so I’m doing my research to see what is considered normal and at what point. I want to have a realistic picture as to what is my new norm…. I’m in Houston and the weather has been terrible, I no longer take my pain meds for the reason someone mention with the constipation, but my leg aches to no end, I am not sure if it is due to the weather that’s making it worse or just the injury itself. I pray you recover well, and I’m here to tell you what my experience is if you would like to gauge your recovery since we are running neck in neck with the time we’ve been injured.
I was hit by a car back in December and suffered a Tibial Plateau Fracture, torn meniscus, torn ACL, and torn MCL. I was operated on and I have a plate and screws inside and was non-weight-bearing for the first 7 weeks, wearing a Bledsoe Brace. At 7 weeks, I was allowed to walk putting only 20% weight on the injured leg while using my walker. At 12 weeks, I became fully weight-bearing using a cane and I am now walking without the use of a cane. Your injury sounds a bit more involved than mine was. I was able to move my ankle and toes immediately and went home from the hospital with pages of exercises to perform by myself in bed and also went home with a CPM machine to help increase my ROM. What I have learned is that every TPF injury is different in one way or another. Yours sounds more involved than mine was so your recovery is going to be different. Don’t give up! You will get there, trust me. I can’t believe it is already 4 months after my initial accident. Between doing the physical therapy exercises at home and the physical therapy outside home, the time really went quickly. I also was very tired and took naps.
I wanted to comment on the nausea issue. I was sent home with pain medication, also, but besides the constipation, I also suffered with nausea from this drug. I stopped the pain med that the doctor prescribed and took Acetaminophen (Tylenol) and noticed a huge difference with respect to the nausea and constipation. (An ice pack works wonders, too, for the pain.) Once I stopped the prescription pain medication, the nausea and constipation went away and my appetite came back. I would also recommend taking a mild laxative and stool softener. I was actually sent home with those from the hospital because of the side effects from prescription pain meds. The last thing any of us need is to be nauseous and constipated in addition to all the other inconveniences that we had and have to go through with respect to recovering from this injury. Try the ice packs and speak with your doctor about taking Acetaminophen instead of the prescription pain meds.
Don’t give up – it gets better! Also, speak with your doctor with any questions that you may have. The doctors/surgeons may be excellent at putting us back together but unless they themselves have gone through this, it is difficult for them to totally understand what we are going through. This website has been a lifesaver for me and I am so thankful that I found it. Good luck and do the physical therapy once you have been instructed to do that.
Hi Barbara!
First I want to say I’m sorry to hear that you were hit by a car and had to go through your injury and recovery. Mine does seem to be much more involved, with doctors telling me this was the worst TBF they had seen, so it’s obviously very demoralizing. But I’m hoping to start physical therapy sometime soon. Hearing that you made such a quick and speedy recovery is encouraging and I do appreciate the support you’ve given me. It’s been very hard to stay positive, but I’ll do my best!
This website has been very helpful and informative for me, as well. Being able to communicate with people like you, who have gone through this, is special. It’s just unfortunate we had to go through it at all.
Thanks again for your reply, advice, and support. I’ll do my best to find my way 🙂
Hi barbara….am feeling sad that there is another person who is also suffering the same pain as mine….hi…am 28 yrs…i also met wth accident and got TPF…mcl tear….also havng acl partial tear from 2 yrs….now its 2 mnths aftr fracture surgey wth plate and screws…plz tell me if i can bcme normal again…if i follow my doctor advice…till now i was not given weightbearing may be due to my weight…but plz tell me if i wud b ok atleast aftr 1 year
Hi
I went hospital yesterday after one month of surgery. My doc was impressed with the x ray.right after he saw x ray,he ask me to walk with full weight on the injured leg.he told me to walk with crutches putting full weight for one more month.in the next review, he said that I can walk without support.my next review is on 22nd may.i’m very happy now!
This is an excellent article. Period! I needed this. Read this after 6 weeks of my accident and a week after I had an IM rod or pin inserted.
Thank you.
Hi went to hospital last week and doctor told me I would not be ever mobile as I used to be doctor said I would not be able to bend or straighten knee fully again due to the damage that was done had opration 7 weeks ago still keeps me awake at night aching has any body else ever been told this thanks John
I had my first surgery on 10/10 (fixator) and on 10/19, two plates and at least 10 screws. I was NWB for 3 months and started PT in January 2016. Using a walker and wheelchair for the most part. ROM comes and goes. I just recently started back at work…no time for PT. I actually stopped PT in March after my OS appointment. I could do the same exercises at home. This place didn’t have any weight machines other than ankle weights and bicycle. I was happy I was cleared for driving in March. Getting around has been tiresome. The more I use my leg, the more it swells. Short walking distance and standing is bothersome as well. I was using one crutch after i was told I can remove the hinged brace (YAY) but I found myself leaning towards the left. For work, I use both crutches and the elevator to the second floor. During the day, I use one crutch and started to use the stairs instead of the elevator. It’s taxing on the body but I was determined to not use the elevator. Going up wasn’t as difficult. Walking down proved to be difficult due to not enough ROM…however, I did it. Crutch and handrail is all you need. No more one step at a time. I too was told I would never get the ROM I had prior to my accident. No sitting on your haunches…that’s fine. And I do realize that the more you do the better off you’d be. The swelling is the last to go according to my doctor. Just be patient. I am 55 years old and it’s my first break ever. Always stay positive. I have nerve damage. I hardly feel anything on my shin. I can live with that. There are certain things you can control and others you can’t. For the spasm type pain I had in the beginning, I took 3 Tylenol or 2 Aleve. I still get the twinging pain which lasts a split second. It will take time… minimum one year or more depending on the severity of the injury. Stay positive… there is no other option. 🙂
Ok many thanks for advice I didn’t realise the damage I had done I too had plates and screws was in theatre for 3 hours many thanks John
My spouse and i judt have started participating in a casino game called Shadow Fight 2 and I still find
it so hard! But I have truly managed to discover an operating cheat tool
for that at this website!
Anyone have trouble with baker’s cyst pain? Any advice?
Hi Ruth, thanks, but no I’m not a nurse, but my Mom is a registered Nurse and her father, my Grandfather was a Doctor ( a small town Dr. who did everything from setting bones to delivering babies ). I have a dance and fitness background ( personal trainer, aerobic instructor, ect ) and have done endurance training for long distance racing. I’ve done a bit of multi day backpacking, primarily in New Zealand, and the West Highland Way in Scottland. So I know what it’s like to be active and fit, then to deal with this ‘game changing’ injury, and how scary the unknown can be. We all pray to be healthy again, and I try to give practical advise, and encouragement. I was lucky to have a good Dr. and PT people, and my husband is super fit too, he was the one that made me and took me to the Y pool everyday ! Good luck to you !
Fran,
Thank you so very much for replying. I literally can’t tell you how hearing your story has eased my mind. I’m hoping not to recreate your knee popping story, haha, but feel better knowing that ROM can increase over time in increments. I guess I’ve just needed someone to tell me that. I know others have increased their ROM over a period of a few months but it seems that most of the stories begin with them having 90 degrees at 6 weeks or a similar scenario. To hear that you were where I am at 4 months has given me hope. I needed that and I thank you! I’ll try to give the same encouragements to others where I can!
Hi Jen,
You’re very welcome. I found this site a few months ago, but wish I had found it earlier.
At six weeks, I was allowed to start bending my knee which was only at 30 degrees so it was a huge struggle for me and my therapist. The therapist was so thrilled when I finally hit 90 degrees (He was really worried). The knee popping story – I went to a restaurant and was talking to the waitress while I was sitting and didn’t realize the seat was so low. But, I’m glad it happened because I assume it broke the adhesions you and others had mentioned. It made physical therapy much more bearable.
Hi thanks back at hospital Friday my cartlidge does not feel right it keeps locking and getting pain aswell I well speak to doctor then many thanks John
Hi John, Your Dr. should be the one to tell you when you can return to work. I was told 6 to 8 weeks of NWB, then it was another 5 weeks to transition to walking ( 20% of weight a week till 100% ). I started PT 5 days after my surgery, 2x wk. Plus aqua PT / lap swimming 30 min. each every day, started that a month post op after the insision healed. I did a ton of home PT excersices too, NWB, for at least an hour a day. You may be experiencing a compleatly different scenario, nesassery to the type of injury you have. Be sure to write down all your questions for your Dr. and find out when you can start walking. Young people, under 30 ( it seems ) take 5-6 weeks for fractures to heal, older people 8 weeks or longer. And of course surgery can make things take longer to heal. And a persons general fitness/health. Good luck.
Rebecca, in your responses, you are so kind, thoughtful, reasonable and knowledgable. Are you a nurse?
This has been the most comprehensive recovery schedule I’ve seen! I love it! I’m 21 with a non-displaced tibial plateau fracture in a brace, is that young enough to have the hopeful 5-6 week recovery? How long do you think it’ll be before I walk completely normally again?
Hi Elise, your super lucky ! Not only ( I think ) you didn’t need surgery, there was no displacement, that and your young to boot ! Me I’m 57 – F *~’k ! You will be fine, and all I can really tell you is don’t rush it, eat well- lots of lean protean + fruit & veg. Don’t smoke, drink or do drugs. Stay away from soda type drinks also. Get moving as soon as you can, get that knee bending, ice it when it’s swollen, move your ankle around too. The more excercises you do during this NWB phase, the easier and quicker you’ll transition to walking again, and presto, you’ll be back to your old ( young ) self. Good luck.
I’m really hoping people will weigh in. Even if just an opinion, I’ll take it. So I’m 11 and 1/2 weeks post surgery for tpf and 3rd degree MCL tear. My ROM was hovering in the 60’s, went to PT and got it to 70 something. They thought they were not making enough progress and that I might need MUA. They basically just sent me packing back to my doc. I freaked out and worked hard to gain ROM myself. Name it and I’ve done it in terms of self-PT. Saw my doc at 9 and 1/2 weeks and was 84. I’m now at 90 though my husband says he got me to 95 one time. I read about others experiencing pain in PT as adhesions, etc are breaking up. Where does it hurt? I can’t seem to ever get past what I THINK is MCL pain to even get to “knee” pain. The inner part of my knee has what feels like one spot that always hurts as if being torn. I truly believe it’s what’s holding me back from gaining ROM. Yes, I will ask my doc. I see him on the 28th. In the meantime, I guess I want to know if I’m past the point of no return? Is there such a thing in terms of ROM? Everyone seems to have better ROM than I do at this point. I’m so freaked out that I’m not going to get past this. Has anyone been at about 12 weeks, post op with limited ROM and then made progress?
Thanks for your time!
Hello Jen, I have been experiencing a lot of the same issues. I am type VI. 5 plates 32 screws. I also broke my femur in 3 places. I rod is in the whole length of my femur and a small one goes into the ball. Anyway I was hospitalized for 65 days. I wasn’t allowed to move my leg and couldn’t for about 6 weeks. At 9 weeks PO I was at 15/55 ROM. That was February 1st. On Feb 23rd or 12 weeks I was at10/70 ROM. He did an immediate Manipulation on Feb 25th. He was only able to get me to 0/90 while I was under. So I knew I was going to have issues moving forward. 2 days after the MAU I started getting a sharp pain on the inside(medial) of my knee. It has progressively gotten worse. When they push down on my knee or push back on my ankle to get my measurements at PT I literally scream and cry in agony. It is so sensitive to the touch it’s not funny!! Anyway I have been able to push through somewhat and have gotten to 4/83. About 3 weeks ago I felt a pop in my quad muscle during PT. A spot above my knee balled up. I have regressed to 8/75. I met with my surgeon today. I asked for an emergency meeting because I wasn’t scheduled until May 31st. I am still in a wheelchair 90% of the time. He thinks the sharp spot is my MCL. Either torn or irritated. He mentioned the same thing you said about rubbing it 8-10 times a day as hard as I could even if it made me cry. Then he looked at the quad muscle problem and the way my knee looks and the lack of ROM. Long story short I am meeting the head Sports Medicine Surgeon on Tuesday. He will be scheduling arthroscopic surgery. Hopefully he can take care of he MCL, quad,scar tissue and adhesions through the small holes. Otherwise he will filer me open again. They can’t do an MRI because of all my hardware. I hope this helps you. There is a great TPF group on Facebook. I am on there 20 times a day. It is awesome. Please come and join. They make you qualify yourself because it is a closed group but it’s worth it.
Good luck,
Dennis
Thank you for responding Dennis. Sounds like you’ve had quite an ordeal and feel terrible for you. I guess the manipulation didn’t work as well as it should have for you and I hate to hear that you’ve regressed. Must be so frustrating! I wish you the best and hoe that it all comes together for you at some point soon! Hang in there and keep trying. I’ll do the same!
I was on a machine called a kinetec which bent my knee slowly at angle set by the physio , I has this ” B ” machine for 20 mins a day x 6 days a week for 9 weeks .I eventually got to 120° and said goodbye to it .I was diagnosed with CPS which is different from CRPS and I also has a pain deep in my knee as you described .It will get better over time ,for me it was a 7 months before I started doing gentle Aqua gym .Fortunately I have never limped or had an uneven gait .
Thanks for your time, Marion. So glad to hear you haven’t limped or have otherwise had gait issues. Bummer to have other accompanying issues though. I’m meeting with a new physical therapist next week. I’ll mention the kinetic machine or see if there is something similar that may help me gain further ROM. Good luck to you. I’ll try to keep a lookout for any progress reports posted from you!
Marion and Jen, I am guessing that this “kinetic machine” must be like our CPM (continuous passive motion) machine in the states?
https://www.youtube.com/watch?v=8z-wjHFiBq0
Hey jen,
I almost got full ROM on 3rd week of my surgery.
Mine is just tibia fracture. And there is no mcl tear.slight pain will b there on knee but I can fully bend.
I think u should consult with ua doc…all the best!
Hi Jen,
It took me four months to reach 90 degrees. I too had the inner knee pain which limited how much the therapist could bend my knee before I would tell him to stop. A couple of days before I had a MRI (4.5 months after injury), I sat down in a booth without thinking, and screamed out because something in my knee snapped. (I hadn’t been out of the house much since my injury). I had PT the next day and my ROM was 97degrees and the knee did not hurt nearly as bad while the therapist bent my leg. Three weeks later, I hit 104 degrees and then another 12 days I was at 110. Two more months I was at 125 degrees. So basically it took me 7.5 months to get to 125 degrees. I’m now at 13 months and still work on flexion and extension everyday. I still need about 8 degrees on flexion and 2 degrees of extension.
My MRI was pretty much negative – only a tiny tear in the meniscus. Knowing that there was nothing physically wrong, I figured there should be no reason why I couldn’t regain my ROM. I had multiple fractures but did not require surgery, but wanted to share about the ROM. Hang in there and keep working on it – it will get better.
Ruth, thank you so much for your response. My OS and PT have advised me to go to a pain clinic in case I have RSD/CRPS which you likely know is a serious progressive pain disease. But to me that seems like a slippery slope to embark upon. I don’t have all the symptoms, but the burning and sensitivity are two main examples. So I’ve been rather obsessed with the search to find reason to believe that those symptoms are not uncommon in tpf and will resolve in time. Given that recovery from tpf is so slow, it’s difficult not to worry when pain lingers! But I’ve read (exhaustively) that RSD symptoms increase in intensity over time, so even very gradual improvement would seem to indicate that RSD isn’t the problem. I have wondered if the hardware screws cause all this burning. Seems like it would! But even if they don’t cause the shin pain, the whole plate area and below on the side of my calf hurts too, in its own way. On the bright side, my leg is getting stronger with beaucoup pt and and I can finally walk, awkwardly, without crutches at home.
I had to pressure the OS to agree to take the hardware out…especially before 12 months po. But it’s my leg and I’m my own advocate, besides being too old to be told what to do!
I hate all this dreary broken leg worry and focus, and will be very relieved to be on the other side of it. Your improvement is a great encouragement to me and I’m so happy to know that you are doing better. I so appreciate your taking the time to share your experience.
Many thanks and my very best wishes for renewed comfort and peace of mind for us all.
Peggy, I had to look up RSD/CRPS. Yikes! That’s something to pray against having, huh? I too, wonder about screws and irritation from the hardware being the cause of the burning shin pain. I can’t speak to your pain, but if I had to live with this discomfort for the rest of my life, I could. Same with the running pain. (I have never been a runner) But, it would be nice to be free of both. You say you are at 5 months post op. I remember feeling pretty good at 5 months: I felt independent, able to do yard and housework, hopeful about the future. And, as I said, there was still more improvement after that – kneeling, squatting, stamina, strength. (now at 22 months) One little slip and our lives changed. I am grateful for good surgeon, PT, family and friends.
Ruth, I wish you continued progress and thank you again for sharing your similar “symptoms”. I am encouraged, once again, to keep believing that I can work through and overcome them. Much has come from this life changer….things I didn’t expect, things I could have done without! But I have had tremendous support from family, for which I thank them all the time. Very fortunate..
Be well all!
Thanks for your good wishes. I am glad you have a great support system. I had an appt. with my GP today and asked her about the shin/skin burning. She said it was probably from superficial nerve damage from the surgery. If it was a big, deep nerve (the one that the surgical report said they avoided) I would have muscle involvement. And, since it is still lingering after 22 months, it probably will always be with me. And, she said that the discomfort I have with running is undoubtedly due to hardware. So, good for you to get yours out. I may explore that option sometime down the road. Blessings.
Hi priyanka, your injuries- sound quite complex. You were hit by a car and sustained a PTF, and tears to your ACL, but also you have a 2 yr. old MCL tear that you’ve been living with un treated ? Golly, you poor thing, you must be in a ton of pain, I understand why your Dr. gave you 6 weeks of bed rest. You need to take his advise and do it. Everyone has different injuries on this chat site, some people recover quicker, some poor souls have worse and very complex problems, So don’t think you have to ‘keep up’ or do what other ( lucky ) ones are doing in regards to this type knee injury. Your injury needs to be managed in a way that addresses all the complex issues that are unique to what You are feeling. Don’t let what other people are doing confuse you. The ligament damage, with a PTF, makes your recovery different and you need to talk to your Dr. about it. If he can’t give you the answers to your questions, or explain well how to get your knee healthy again, you need to find a Dr. who will. Good luck, be pro-active in your recovery, and you’ll be fine !
i had my screws and plates taken out after 9 months of surgery that i had for my tibia plateau
The best thing I did was had it taken out, because my leg feels almost back to normal. Back to walking and running little bit. it is exactly a year when I had my surgery after a ski accident. So gald I had the hardware taken out. It was the best thing I ever did…
Hey marry,
I just wanted to know if ua leg is normal as before.Have u seen ua xray? Whether the bone is completely joined? Can u see any sort of marks there?
Hey mary,
Its good to hear that ua hardware is removed.i just wanted to know if ua leg is normal like before.hope u hv seen ua x-ray.is there any sort of scar marks?? I would like to know if the bone is completely joined? Is there any difference while walking? Can u walk normal without any difficulties?
Thanks for that information Ruth. My wife’s surgeon never mentioned doing anything like that but she’ll ask at our next visit.
May I ask how you’re doing after 22 months? Is your leg still tender around the plate area?
– Jake
Yes, still tender. Hurts to run-can’t do it more than a couple steps. And I can’t get a full squat. And I have some altered skin sensations over my calf – can’t stand anything rubbing. Other than that I am doing quite well. I have occasional knee discomfort with weather changes. After 12 months I thought I would never be able to kneel or squat at all; but now I can kneel and I can almost get a full squat, so I am STILL improving. I had great ROM early on-amazed the PT folks and Dr. 10 wks of no weight bearing. I am 62. Was 60 when I fell off a kitchen counter and shattered the top of the tibia. Like many folks on this blog, I was in good shape when I fell, praise God. I would like to get the plate removed, because I think it contributes to the running discomfort, but don’t think I want to go through the pez anserine recovery, again. The pronouncement (which I rebuke) from the Dr was that I will probably need a knee replacement, eventually, at which time they would have to remove the hardware. I have not seen the surgeon since 4 mo. post op.-which is also about how long I had PT.
Ruth, I am curious about your skin sensitivity…things touching your skin. I’m at 5 months post op and I’ve had this all along, plus burning along my shin that comes and goes, but is really miserable some times. I’m worried about permanent nerve damage, but maybe it is something that will resolve in time. Have you experienced burning during your recovery? I’m 64 and fell from a stool while painting. I’m wondering if the hardware contributes to these particular symptoms. I’ve arranged to have it removed at 9 months.
Peggy, Yes, I have had the burning shin sensation and sensitivity since the beginning. Sometimes it feels like a bruise. It is better than it was 6 months ago. We have a little, 6 pound dog that sometimes likes to lie on my legs. 6 months ago, when we first got him, I couldn’t let him do that at all. Now, it is tolerable, sometimes. A year ago, when I got a pedicure, I couldn’t tolerate the gal touching the front of my calf. Today I think I could handle that. My physical therapist suggested that I rub it – starting with very light touch and then increasing. I did that for a while, but did not notice any change. Perhaps I should have kept up with it? The surgical report said they avoided the nerve…. but I am doubtful. Sometimes I imagine that the nerve may be trapped under the plate. I am sure that is not true, but I imagine it. I know that nerves are very sensitive to manipulation and that they heal very slowly. I am hopeful that I will recover in time. I had not even thought of returning to the surgeon/orthopedic Dr, till I started reading this blog. Never considered having the hardware removed till now, either. I have my annual Dr. visit this week, so I will ask her how to proceed.