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.
My wife broke her tibial plateau February 23, 2014 and has just begun walking short distances with a walker. She had in home PT for 6 weeks after surgery and has continued out patent PT twice a week since. Its now been 6 month and still has horrible pain. We are going to obtain a 2 and opinion from another Ortho doctor. It seems like the pain should be letting up during periods of rest. Any input would be appreciated.
Jill,
Typically, they don’t want you to do PT until you are partial weight bearing. It has been nine weeks and three days since my surgery. I’ve been in PT for three weeks now with great results. The quad muscle is returning. Maybe you can find a PT, who will at least allow you do some e-stim in their office at a reasonable price, which will help bring the muscle back.
Holt
I fell on vacation 8-3-14 when my bike tire got caught in the San Fransisco trolley tracks. I went straight to the ER, had surgery the next day and now have a plate and 3 screws. The tibia was fractured in 2 places and I was told it might affect joint mobility. The surgeon said he thought I had soft bones too. I’m not taking a cal/mag supplement. I’m now the end of my 4th week of recovery and am frustrated by how long it seems to take for the atrophy in my calf to go away. Both the calf and thigh have muscle tightness. On top of that, the surgeon had to cut a muscle around my knee to get in the plate.
I’m working from home and going into work only for meetings. I’m normally a busy person and find it very difficult to be doing nothing. The ortho I’m seeing now (not the same as the surgeon since I don’t live in CA) didn’t want to prescribe any PT but I asked for some. He didn’t want the PT overworking me. All my PT I do at home since I can’t afford to go in multiple times a week. I wonder if it’s enough. I go to PT every 10 days. How much should I be expecting of myself?
Jill
You may not want to hear this, but you may be in for a long recovery.
I suffered a type 6 TPF in mid May. I have been in a wheelchair SINCE THAT TIME. TPFs are serious injuries and as such they take lots of time and TLC to recover from. There is a reason why the doctor is concerned about overworking the leg. The tibia plateau is a critical weight bearing point of the body. The more I research the details of my injury, the more I am aware how intense a TPF can be.
Do what you can with gentle exercising of the knee, but remember to be patient and practice self care. Learn ways to occupy your time that does not risk straining the leg. Visit this site regularly for support and validation and information. Find someone to talk to about the emotional stress this causes.
I truly do wish you the best!
I am on my second round of TPF. The first time was my left knee (a bit over 10 yrs ago). This one is my right knee and I am about three weeks post op. Both injuries were from the same situation – taking a bad tumble from my horse.The horses were unscathed in both incidents – the rider on the other hand now has a plate and 6 compression screws in each knee. Yes, I now have a matched set of knees- and the side by side x-rays look like something out of a bad sci-fi movie. My first round (at 36 yrs old) – I was walking with a cane at about month six, unassisted at a year, and feeling pretty normal at 3yrs. I saw continued improvement for another few years, until I was able to forget about it and was back doing all of my “normal” activities (competitive horseback riding, motocross, hiking, climbing, and the list goes on.). When I was injured the second time, I immediately recognized the familiar pain and knew exactly what I had done before having it confirmed in the ER. All I could think was “Seriously – again? Is there something I have done to earn this bad karma that I don’t remember????” Well, in honesty, the answer is that I choose to ride and compete in equestrian events – which means I choose to take some pretty big risk that comes with the sport. I am now 47, and facing another very long recovery period. This time it means taking extreme care and going back to the PT routine on my left knee to keep it healthy under the heavy stress, while getting ready to start the painful process on my right knee. Oh, and did I mention that I have a 6yr old, and we moved 2 weeks before this happened. Yup, house isn’t unpacked, and looks like it won’t be for many months. The bright side, my kiddo loves playing with the boxes!!!! Anyway, would love to hear from anyone who has also managed to injure both knees ? How are you coping? How is recovery going?
This is a great point about listening to the doctor. I was put on 50 percent weight bearing at 6 weeks. I am at 9 weeks and a day and will see the doctor at 10 weeks. He said at 6 weeks that he would probably release me at 10 weeks to FWB. Strong temptation to go FWB now, or at least move to a cane. But it has been explained to me that the cartilage and some of the bones are still healing and I could cost myself down the road. so I’ll hold off another week.
On the knee replacement, at 51, i have heard the same thing about delaying it as long as possible. Advances in medicine being what they are, it makes sense.
Careful of not listening to the Doctor. It all depends on where your injury is and how much damage was done to bone and soft tissue. They never said I won’t run again, but did say I shouldn’t. The reason being is that I damaged lots of soft tissue including cartilage. I am almost bone on bone and technically would benefit from knee replacement now but am too young. If I run (which I can’t now due to extreme pain 17 months out) it will speed up the need for the knee replacement. If I get a knee replacement now it will be too early based on current research as to how long they last. Once you get a knee replacement you can still run, but then you wear those out faster. They recommend lots of activities but not pounding on pavement every day, that doesn’t even make sense that that would be a good thing. BUT some have tpfs are in locations that were easy to reach, simple fractures that were easy to fix, and the surgery went perfectly. Mine was the opposite of that. Some say they had a tpf yet they are up and walking in three weeks like Kobe Bryant. My leg didn’t look like a leg for weeks as I shattered the tibial plateau with multiple big and small breaks all over. I splintered my tibia vertically from plateau to shin and broke my foot. My soft tissue damage was horrible but the bones were so bad they never really discussed that. They wanted to save my leg as main nerve damage was done and swelling was awful. If you have good cartilage, won’t develop arthritis too quickly, not recommended for a knee replacement, then I suggest carry on and run. But depending on your pictures and diagnosis, be careful of “the I can overcome anything” mentality if in the end you end up paying. I had a second opinion, and continue to see this guy as Duke is a bit of a drive. Don’t let anyone tell you that you can’t do anything, but be knowledgeable and make decisions you won’t regret. You need your knees as we have all learned. As for the marathon runner, I think that is awesome!!!! Congrats.
Eileen, I would agree with second opinions. I am 6 months in recovery. Once developing the confidence in my knee again, I have been successful with taking things slow during recovery. I am a marathon runner and have done the run/walk method for the 1st time during recovery. I am back to my 5K pace (pre-injury) and training for the New York City Marathon 11/2/14. I have had to make decisions of……I can’t do Step Class at this time due to the side/to/side movement makes the knee uncomfortable the day after. Without a 2nd opinion – I would have ended up with the “you will never run again” mentality. Move forward in slow increments – I had a great gal that had a masters in BioMechanics set up my training plan beginning at Week 4. The biggest thing is to be patient!
Debi,
I have difficulty following posts and just saw your reply. I got a second opinion who said “all the kings horses and all the…” However, he did say I may be able to run again, some.
Thanks for your encouragement.
Eileen
Eileen,
Nicest post ever. Thank you. I had a second opinion as running is something I truly enjoy as well as basketball. Both said no way. As I may have said, maybe I could, but it just means a quicker knee replacement, then if I run with that the quicker that wears out.
Are you in the tpf Facebook page also?
Joe
Hi Joe,
I just discovered your comment — as I said I have difficulty following the threads. Am I missing anything on Facebook? It seems there is enough on this site to keep me busy and informed.
Eileen
I am 17 months out. I had it pretty bad as I didn’t “just” have the tpf but splintered my shin vertically and broke my foot. My tpf was not only a clean break but eggshell breaks as well all in the worst possible part of the knee.
I still have pain and was told by Raleigh Doctor and My Duke surgeon that my running days have ended. It is so upsetting. They say I might technically be able to but my cartilage is almost gone and a knee replacement is not too far away but I am a little younger than he wants me to be for that.
So, It took me a long time to walk and now I walk but still have pain and don’t do well at all w going down the stairs and w quick movements. I have done everything right and was a great PT patient. Still work out now. I get pretty down about it but my family doesn’t know that. I am sure they are sick if hearing about it.
Joe
Joe,
(I find it hard to keep up with the posts on the recovery forum, but I saw yours and had to respond.)
Today, my OS released me and said to I should resume normal activities (I have been walking without crutches for almost three weeks.) When I asked when I could run and jump again, he said never. I told him those ARE my normal activities. I think non-active people do not understand why some of us want to run full-tilt up a rocky hill and down the other side. I am going for a second opinion and appealing to a higher authority. I hope you are able to find a bit of joy each day and keep trusting in the support of people who love you. I wish you well.
Eileen
6 months post OP. Still cannot walk. Had therapy but pain is still horrible. Thinking about 2 and opinion. want to walk but can’t. anyone experience this??
Alan,we need more info about your injury and rehab to give any feedback. Still cannot walk-does that mean you can’t bear weight at all? I had to have 3 weeks of pool therapy before I could tolerate weight bearing. 12 months since my surgery, and I can’t jog, run or even increase my speed in walking, but I know time will hopefully improve these activities. Some people don’t consider walking with a walker or cane to be walking but it is. I don’t know enough about your injury or rehab? What kind of rehab. If you truly can’t walk AT ALL after 6 months, something is seriously wrong. But again, your post doesn’t give nearly enough info to even offer advice. Are you still non weight bearing? When did you begin weight bearing? Are you putting weight on leg? Did you have aquatic therapy? Unless your break has not healed, something doesn’t sound right.
Looking forward to more info from you.
Thanks,
Chris
Hi Chris. Thanks for the post. Good to hear of your recovery. I too was hit by dog (not mine) and suffered TPF and an ankle fracture. 8/23/14 was my 6 month anniversary, so I can relate to your milestones – have checked all those off myself. I think we are both lucky to have had good support networks – it seems really important to the speed of recovery. I was NWB for 12 weeks and couldn’t drive – that was the worst part. I hated being so dependent on everyone and stuck in the house. Fortunately, I have a desk job and started working from home about 5 ot 6 weeks in, which saved my sanity. I am still walking with a bit of a limp and not moving terribly fast, but I’m doing almost everything I was doing before my injury. I’m back at the gym everyday and getting constantly stronger. My next big challenge is yoga, which will be a real test of my flexibility; like you, I’m still a little unsure about putting my full weight on my knee, though my PT says I can. Sometimes, I think the physchological barriers are just as enormous as the physical. And I too keep a close eye on dogs, including my own lovable 80 lb labrador retriever, a little tank. In fact, I’m terrified around dog clusters – hope the terror will dissipate with time. Again, thanks for the look back – really helpful to all of us as we continue to recover.
My TPF was exactly 12 months ago and this site gave me encouragement to cope with all the pain and misery we sufferers endure. I am now back to walking my dogs every day, although I do not go perhaps as far as I used to nor quite the distance! , but I feel more “normal” with everyday activities, i.e. shopping,driving, out with friends, housework etc. Although I hardly have any pain, I do find walking down hills, climbing up and going down stairs/steps more difficult. Someone told me my ligaments perhaps are not that strong yet. When I first had this inury I could not imagine doing what I do now. As others will know, the frustration is very hard to cope with, but, now when I walk along my street and someone says “hey you are walking better”, I feel I’ve joined the human race again! I will soon be 60 and thought last year this time “that’s it I’m finished, but now there is light at the end of the tunnel and I hope others with this frustrating injury will be encouraged by me and other fellow sufferers. You will get there, believe me you will.
Hope this helps, take care.
TPF-One Year Later
One year ago this weekend-8-23-12 I had TPF as a result of my new 80 lb English Labrador named Coltrane crashing into my knee. It was the 2nd day I had the new dog. We went outside around midnight for him to pee in his new yard. All of a sudden our motion detector light clicked off, spooking Coltrane, and he jumped into my leg. I never saw it coming. I knew I was in trouble before hitting the ground. I tried to stand up, and collapsed, sure my ACL and PCL were torn. It took me 20 minutes to crawl into the house, suffering the indignity of the leg breaking dog biting my ears and licking my face since I was down on his turf. An hour later I am in the ER. It was the night of a Miranda Lambert concert, so several rednecks were also waiting in the ER in handcuffs with police escorts bloodied from fights. The CT scan eventually showed the level 2 TPF with surgery scheduled for 4 days later.
When I got home, my church had dropped off a wheelchair, elevated toilet seat and armrests, as well as a shower bench. These items would be crucial for my “new” lifestyle. Two months of NWB would prove very frustrating. I was in great shape prior to the accident. Now I couldn’t do much of anything. My life consisted of waiting for my next percocet, and trying to get comfortable in my recliner with the exact height of pillows under my leg the most important daytime task. Bathroom stops consisted mostly of using the urinal and pleading with my 2 young boys to empty the warm container. I only had about an inch between my outstretched leg and the bathroom wall when sitting on the toilet, so that trip was only made when truly necessary.
Sleep was the hardest. Being a stomach sleeper was impossible being in a leg splint. The percocet would knock me out for 2 hours, and whenever I tried to roll over, my sleep was immediately halted due to the pain, leaving me up for hours watching every episode of Law and Order SVU, CI, or reading a book. I must have read a dozen books in the first 2 months.
Because the TPF was on my left leg, I could drive, once I learned how to navigate the 3 steps down into the garage to the car. Being September, and still quite warm outside, I often craved a slurpee from 7-11. My wife said if I wanted a slurpee I could get it myself. Getting to 7-11 was easy, but using crutches to navigate the curb, and then carry a big slurpee back to the car on crutches was problematic. So I usually waited in the car until I spotted a good samaritan and asked them to help me. Pitiful, but I did love those slurpees!
Finally my 2 months of NWB were over. Time to bear weight. Much easier said than done. When the therapist told me to lose one of the crutches and put weight on the leg, I almost collapsed. 3 weeks of pool therapy eventually got me to be able to bear weight with one crutch, then with a cane. As a physical therapist myself, this ordeal was an eye opening experience as to how important good PT is. Eventually after 4 months I was able to return to work.
Some important milestones in my recovery.
1. No longer taking pain meds.
2. No longer needing the wheelchair.
3. Being able to navigate the garage steps without help on crutches.
4. Going from crutches to cane.
5. Being able to stand up in the shower.
6. Being able to step out of shower without assistance.
7. Being able to step ln/out of shower without crutches.
8. Being able to step in out of shower without holding on to anything.
9. Being able to return the elevated toilet seat and armrests.
10. Being able to climb stairs to sleep in my own bed.
11. Forgetting where my cane was, signifying I was able to walk without assistive device.
12. Actually thinking about returning to work.
13. Getting clearance from surgeon to return to work.
14. Not having to wear compression stocking because my foot was no longer looking like it would split my shoe.
15. Actually feeling like I was stable enough on my feet to treat my patients.
16. Being able to stand on one leg and dry off the other leg.
17. Being able to put pants on standing up.
18. Being able to kneel on the ground and not freaking out that the plate will hurt.
This experience of the last year has been memorable. I don’t wish it on anyone. I’ve completed 4 Ironman triathlons, and the recovery from TPF make those events seem easy. But I got to spend 4 months with my wife and kids that I will always cherish. I am a much better therapist now. When I show my patients my scar and the outline of my plate, I have instant credibility with my patients, and they realize I have empathy for them as well.
The idea of running or jumping or playing basketball with my sons is a dream for now. The surgeon says I may never be able to do those things again. I may have premature arthritis. I may need a knee replacement many years before most people would. But surgeon also says to give the recovery 2 years to see what I will be able to do. I still limp at the end of the day. I have trouble going up/down stairs without a railing. I don’t have pain, but I still feel my left leg is about 50% as strong and stable as right leg. I feel like I’m 90 years old getting up in the morning to walk to bathroom. If I sit for more than 20 minutes I have to go easy the first 4 steps before my leg feels like it will support me. I still get off the floor slower than most of my patients. I sometimes step a certain way, and my leg feels like it could snap backwards like a tree branch. Very unnerving. I still have to strengthen the leg every day, so always remember to continue doing your exercises.
Ironically enough, Miranda Lambert was in concert again last night on the one year anniversary of my accident. I’m still not a fan of Miranda Lambert.
And I never go out in yard with my dog without knowing where he is at all times.
Thank you for sharing, Chris.
That post had my both laughing AND crying.
In about 10 days I see my doctor, and I hope I will be given the OK to start bearing weight after 15 weeks in a wheelchair.I, too, was very active until my motorcycle crash caused a type 6 TPF, knee dislocation, and multiple breaks to the fibia and tibia.
I wonder what walking is going to be like, and I grieve for what I may have lost due to this (Will I long distance bicycle ride again? What about mountain hiking? Running?)
And I am not a fan of Miranda Lambert, either.
Take care!
Hillary,
My injury was on June 23, too. Spent 6 weeks NWB and the last 16 days PWB. Dr. believes I’ll be full weight bearing at next appointment on 3rd. I believe I will be released then, too. Been to three PT appointments and the seem to help a lot. Besides the e-stem and quad strengthening exercise, he has had me on the “total gym” and recumbent bike. I really think massage can help, too and my PT (who was hand-picked by me because of his cutting-edge approach) confirmed that. He believes there is a lot of static waste from the injury in our leg and overall body. He believes it is important to lightly massage the lymph nodes.
Holt
I had my tibia plateau fracture on 8th June this year, totally random accident, was standing next to my horse when he was spooked by a football causing him to hit me side on leaving me to hit the floor! Weirdly there was no pain, I’ve always been under the impression that a broken bone leaves you writhing in agony but it just felt like a lead weight! When I was finally helped up (I had been on my own) as there wasn’t any pain I wanted to go home and sleep it off!! Luckily my friends ignored me and took me to A&E where I was xrayed and told it was a TPF, cant remember what level it was classed as but was told it was “quite a break” and it had fractured in about 4 parts. Surgery was a week later, 15th (I was bypassed for hip operations which can apparently be fatal) where I was told that they would be trying to lengthen the compacted tibia as well as they could, build up the loss with a bone graft and then a plate with screws. Was sent home after 3 days with a cast which came off along with the staples coming out on July 3rd where I was given a brace with 20 degrees motion. All this time being NWB. 2 weeks after (17th) went back in where they extended the brace to 40 degrees, at this point, they gave me directions on how to change the brace myself and told me to go up to 60 degrees in a following 2 weeks (31st). I had my last appointment on 14th August where they told me I could go PWB, have loosened the brace right off but was still told to wear it for slight support. It is frustrating as although I now have a “bionic leg” the ankle is as weak as jelly and always feels like its going to give out on me. I am not very confident on the crutches, as always feel they are going to slip from under me! I haven’t officially been given physio as yet and can only think its because its hard to give exercises to people that aren’t very stable. I have been doing the ankle flexes from the word go as was told the Achillies would seize up and possibly snap due to non use, so didn’t want to tempt fate! My next appointment is on 11th Sept so am hoping to be given some then, my parents are being very optimistic that this will also be when I’m told I can go FWB but I’m not so sure, although this will be just over 12 weeks post surgery I don’t want to get my hopes up!
I fractured my tibia plateau and fibula racing BMX at 49 on July 23, 2014. No accident foot just came off the pedal and hit the ground. I immediately knew something was wrong with all that pain. The medical staff wanted me to go to the hospital but my son still had racing to do…lol They took me to my truck on the ATV and when my son was finished I drove home. The next day I went to the doctor and after the x-rays he wanted to know how I was able to get to him on crutches, He said I would need surgery and he could do it but wanted to insure I would get back to my old self so he referred me to a doctor a Johns Hopkins. In surgery for three hours and had a bone graft, a plate and some screws put in.
After spending three days in the hospital I was discharged with a 61 ROM. I have started physical therapy and seem to be getting better every day. While there has been some pain and pain medication does not really work on me the most depressing part has been the two shots a day I have to give myself in the stomach to prevent blood clots. That and having to have others do certain things for me.
Well that is my TPF story and I hope all of you end up with a 100 percent recovery as well as any others who may end up getting this or any injury in the future. Patience, patience, patience with proper eating and PT and we should all prevail to at least a comfortable standard if not a complete one.
Emma,
While sitting or lying down, squeeze your abs, glutes, and quads to help maintain muscle and increase blood flow. If you can lift weights with your arms, that is good too. The more you use your body while you are injured, the better you will feel. I think it helped me a lot. Now that I am off crutches, I am doing stretching and strengthening 2.5 hours/day. (I have been missing riding but did sit in the saddle for a few figure-eights in the round pen.) Keep believing.
Eileen
Thank you Eileen, I’ll give those a go!