Fresh! Lateral Tibial Plateau Fracture - A few days post-op...

[TaniaSki]

Hi Julie -

I was in the conservative group too.  I was NWB for 3 months.  However, I started therapy 3 times a week immediately.  A year post accident/surgery, I now have full ROM and almost full strength back.  Did doing PT right away help that?  I don't know.  However, I agree with Mary - mentally, it helped tremendously.  It gave structure to the days - both when I had appointments and when I had exercises to do on my own.  I could see progress (slow, but progress) which helped my mental state as well.  I do think that the immediate exercises for the VMO really helped.  It will get better. 

[kariberi]

Hi Julie,
I was NWB for 14 weeks, followed by FWB with crutches for 2 before moving down to one, and then a cane. I started Physio at week 12.  It consisted mostly of ROM exercises. Once i was WB bike and treadmill were added. I was just discharged from Physio this week on my 5 month anniversary. One thing that helped alot was time spent in the pool. As soon as i was able to weight bear i tried water workout, and was told by physio to go to lane swim time and practice walking in the slow lane. At first people think you are crazy, but then they started cheering you on.  All the best and stay positive!

[jgabrils]

@maryc -  that website is so helpful! I've found way more things that I can do than just the 4 I've been working with. I'm definitely going to add upper body weight workouts, too - no reason to let the rest of me waste away with my leg!

@taniaski -  were you able to work on leg strength before you were WB? How long did it take for you to get your ROM back? I haven't started PT yet because I've been making progress on my own, but I don't think I'm going to want to do it alone for 6 more weeks. I'm definitely going to make an appointment ASAP.

@kariberi -  did you also use an aqua jogger belt? Also, how was getting in/out of the pool? I'm so excited to get the okay to go in the pool - the one upside to having this injury now (spring/summer)!


Speaking of water/spring/summer, how does one walk across sand with crutches? I'll be at the beach right after I'm supposed to start being WBAT (maybe one of those wheelchairs with the big inflated wheels?  )...

I'm doing okay with the ROM exercises, but I feel like I've plateaued about +/- 10° from achieving heel-to-butt. My OS wants full ROM by 5/12. I try to push it a little more each day, but I don't see progress the days after. There's almost no swelling left than I can see, just a little around where the screws are (as in, that area of my knee doesn't really look like that area of my other knee) - unless that's not swelling? Scar tissue? If you got stuck at a certain point, how did you break past it?

Also, is it weird that my knee never hurts (unless I'm trying to push the ROM as mentioned above)? I stopped taking painkillers for it about a week ago. If I'm up crutching around for a while (around a store or something), it gets a little achey, but other than that, it's like nothing is wrong with it. I'm not complaining, it's just weird to me that it's so ...unnoticeable.

& what was it like going from not walking at all for 3 months to using your leg again? I'm not using the 'toe-touch' method of NWB, so I'm not even fake-walking - & I don't ever even think about using my leg. Did it take you a minute to figure out how to walk 'normally' again? I'm assuming that's something that PT will address?

2 weeks until my second post-op appointment! Hope there's been some serious healing going on in this knee.

[maryc]

Julie -  you're doing great!!!  I wouldn't worry too much about the heel to butt measurement right now.  Just keep slowing working towards it.  I doubt that it will keep you from going WBAT, I think it's just a goal your OS gave you to make sure you're working on your ROM.
I too had little pain once I was past the first two weeks - not that I'm complaining.  Once I started WBAT I had new "aches and ouches" but nothing that an OTC pain reliever couldn't control.

I remember when I got home with the okay to WBAT. I was standing there with my walker (I was too much of a klutz for crutches) and I started to cry because I couldn't remember how to walk.  I was really devistated!  I couldn't bear to put any weight on my leg!  I made a call to my PT who came over and patiently showed me how to move my leg through the walking motion again.  I quickly moved from my walker to two crutches (it's much easier to "walk" with crutches than a walker), then one crutch and then a cane.  I probably used my cane longer than absolutely necessary, but it was a nice visual symbol to others and I was a kind of security blanket while in public.  All together walker to cane took about 3 weeks, than another month to get rid of the cane.

The "PT Slowdance" really help me regain my confidence in my leg's ability to support me again.  Basically you stand at a counter or strudy chair and slowly shift your weight from your "good" leg to your "bad" leg.  If you reach an "ouch" back off and hold for 10 seconds and then shift the weight back to your good leg.  Start with a  hold of 10 seconds and 10 reps, and increase to a hold of 30 seconds and 30 reps each time you are near a counter.  I was surprised how quickly I was able to put 100% of my weight on my leg this way.  Like I said it gave me the confidence that my leg was not going to collapse underneath me.

I don't know if I would trust myself with crutches on sand.  The uneveness of the sand might create too much of a twisting motion at the knee.  If you can get one of those big wheel wheelchairs I'd do it.  Check a medical supply store near the beach  you'll be at and see if you can rent one.

I do agree with kariberi - water walking once I was WBAT was wonderful.  Talk about a confidence builder. 
Getting in and out of the pool while still on crutches was a real experiment.  I was terrified of slipping on the wet tile, so my boyfriend walked slighly behind me in case I slipped,(we worked out beforehand that he would grab my waist to steady me.)  Once I got to the steps at the pool with his help and the stair rail I lowered myself to the top step and then "butt walked" down a couple of steps until I could float to the side of the pool.  After those first terrifying steps I didn't want to stop - a word of caution I was REALLY sore the next day.  Those muscles that I thought I was keeping in shape protested the next day.

Take it slow and easy and you'll be fine.
Sending healing rays your way

[MSD]

I'm 6 weeks in with my TPx and I have just the same situation with ROM. I just can't get the last few degrees. I think it will come in the end, but I don't want to push it too hard at this stage. I am now allowed PWB up to half of body weight but it will be 4 more weeks before my next check up. If that is ok, the OS said I should get the green light for FWB. Walking training in the pool is ok, so long as I don't exceed 50% body weight.

I managed quite deep snow without any problems on crutches, so sand ought to be possible. I think European-style forearm crutches are probably easier on rough terrain than American-style shoulder crutches. I suspect it's easier to move one crutch at a time and to place them carefully on the ground.

Mark

[jgabrils]

Been working on the exercises pretty steadily, I feel like I'm at least staying as stretched out/limber as I can with an immobile leg. I've been having someone push gently on my leg when I'm doing heel slides to get those last few degrees of ROM - I just didn't have the muscle/strength/ability to squeeze my leg all the way back (at least I think that's what's holding me back), but with the extra help, it'll get there soon.

@maryc -  as strange as it sounds, I can't wait to be sore! It'll be great to get this leg back in action. Sometimes when I'm just standing around on crutches, I put that foot flat on the ground and imagine what it's going to feel like when I can actually then press down with it. I will definitely be utilizing all counter/table/edge surfaces when it comes time to learning how to walk again.

@MSD -  I think I'll give those crutches a try, but am also going to try a walker, too - my grandfather has been using one to get across the beach for the past few years, so if he can do it, I can do it!


This is the current state of things:



Hello atrophy! Any tips on getting that last bit of marker off? I've tried everything - soap and water, exfoliating, etc.


I just realized I've had copies of my original (pre-surgery) x-rays and MRI laying around. When I go for my 6-week follow-up, I'll get copies of my surgically-enhanced, internally-fixated knee.

[kariberi]

@kariberi -  did you also use an aqua jogger belt? Also, how was getting in/out of the pool? I'm so excited to get the okay to go in the pool
 Sorry I haven'y been here for a few weeks, but no i did not use the belt. the pool that i most often go to is short and shallow. the deepest end only comes to the top of my head, and i am only 5'3. i would tip toe in the deep end.
getting in and out, again lucky as it is also in an old institution, and wheelchair accesable with a ramp as well as graduated stairs. i have been a little afaid to try a few of the other pools that are not as accesable.
Even after a month of walking, i still have a huge difference between the strenghth. and unfortunately i am not the most pateint person in the world. and the no pain i also stopped taking all meds until i started physio. I was also excited to feel something. the first time i had the start of a charlie horse from physio it was a mixed blessing.
As far as walking after so long, i did really have to think about it, but pushed it the first day on the stairs as i was sick of hopping on one foot down and butt shuffling to get up. i went through the steps very fast. 2 weeks with both crutches, 1 week with 1 and less than a week with the cane.  All the time on crutches and pulling myself up the stairs had aggravated an old shoulder injury, and PT said i limped more with the cane than without.
the first few steps without anything was SCAREY , but once i realized that i could do it it wasn't so bad. My PT encouraged me to not use it when doing my exercises in the building. Balancing one one leg was very exciting! but that took weeks. Best of luck!!!!!

[pinkjody]

Hey all -- Waiting on my docs appointment on Friday and worried I may have a tibial plateau fracture. Was wondering how painful it was when you did it and if you were able to walk on it? Also, where was your swelling? Was it bruised?

My leg looks relatively normal... there is swelling on the inside of my left knee and below it... on the tibial bone... i knew something was wrong when i initially hurt myself, but that was over a week ago now. I continued to "walk it off," but I know it's not getting any better. In fact, it feels like it's getting worse.  Just curious of your symptoms and how fast they came on, etc. Pain wasn't a factor until 4 days after the initial injury (which was only me kneeling at  yoga) -- go figure!!

Any info helps! Thank  you:)

Jody

[maryc]

Hi Jody - hopefully you've just bruised something - I'm not saying that to minimize your injury (sometimes bruises have a longer recovery time), it's just that a TPF is not an injury I'd wish on anyone.
How did you get your injury?  TPFs are usually caused by a jarring impact either by falling or running into something (aka bumper fracture).  They come in a wide range from non-displaced to almost completely shattered.  When I did mine I could not put any weight on it at all. 
Good luck on your appointment Friday

[pinkjody]

Hi Maryc...

I hurt mine at yoga. I've always had a numb left knee. I fell when I was little and had some nerve damage to the front and the feeling never came back. But just because there's no feeling there, doesn't mean there's no pain. If I kneel on that numb knee, there is something "off" about it.. so I've always avoided it. Well, last week at yoga, we were to kneel on our left knees. I did it without thinking and left there with a swollen knee and very minimal pain. It's still swollen today, but the pain has intensified over the past 8 days. I was walking fine on it for a few days after yoga, but come Friday, i was limping. Now when i straighten my knee, it feels like my kneecap is going to fall. Not sure if that's really happening or if it's just because of all of the inflammation in there, but it just doesn't feel right. The swelling is apparent on the inside of my knee, below the knee - on the tibial bone... i think. I wish I was a doctor. LOL

[jgabrils]

@pinkjody - I'm just going to hope that you don't have a TPF! they're no fun.

but this is how it went for me: it swelled up immediately after, & was huge by the time I got to the ER a couple hours later. I could limp around on it (which I did until the ER sent me home with crutches), but it was ridiculously painful & it just felt... different (I think the instability was noticeable). most of the swelling was above my knee & to the sides of it -- not much below my kneecap. the break was on the outside of my knee, & when that part of my knee was pressed, it hurt. I didn't have any bruising until after surgery. I think most of the limping/inability to walk was caused by the pain/limited movement associated with the swelling -- once that went away, it felt like nothing was wrong.