Bone breaks around the knee :

tpfx..ROM..HELP! - - Posted by scottie2t2 (scottie2t2), 19 September 2004

i have a posterior type 1 fracture of my left tib plateau. 9 screws and plates! i was playing softball and was running for a ball..tried to slow down and when i planted my foot...snap-crackle---pop!!

 now, 8 weeks post surgery and i am at 90 degrees ROM. it has been a struggle to get that. i have hit a wall at 90. has anyone else that had to have hardware and sugery been able to get past 90* ROM?

anybody with similar or better/worse experiences, i would like to hear about them. as most of you already know, this is a long and drawn out injury that seems to have no end.
Posted by hkssuppie (hkssuppie), 20 September 2004

Scott,

I had a plate and nine screws on my tib plat frature from a motocross accident.  I had about 135-140 at my 8 weeks.  I did alot of stretching in heated wather and alot of towel around the ankle pulling it toward my butt with the foot flat on the floor.  Not saying it doesn't hurt...but I think i recovered a little better than some.  Just about a few inches from getting the heel to the butt now.  Not without some pushing though.  Let me know if you have any other questions and i'll give you whatever info i can.

Alan
Posted by lizl (lizl), 20 September 2004

HI, Scott and welcome to the board.

I'm a patella fracture, rather than TP, but I really struggled with ROM.  One exercise that helped me increase strength and ROM was what I'll call a rolling chair scoot. While sitting on an adjustable, rolling chair or a stool (like you find in doctor's offices), use the healing leg to pull yourself from one end of the room to the other, and then use the same leg to push yourself back to the other wall. As you get better, adjust the seat level of the chair to be closer to the floor and really concentrate on bending the leg to the point of discomfort.

I'm a strong advocate of stopping short of causing real pain. I had plenty of pain without adding to the problem in therapy.    When I overdid it in therapy, the inflamation just seemed to increase my problems. The therapist with whom I made the most progress always emphasized the point. I was trying, after all, to get rid of a limp and to learn to walk normally. An overly-stressful workout resulted in more limping and more "favoring" of the leg, so it was a set back.

Of course you want to make progress, and that will cause discomfort--but honor what your own body is telling you. Good luck.

LizL
Posted by HHB (MHB), 21 September 2004

Hello Scott,

Like lizl, my injury was a patella fracture, not your tpx -- don't know if my experience applies to your situation. Was in an immobilizer, no bending at all, for 5 wks, fixture hardware remains (screws and wires).

I agree with lizl about stretching for ROM in a no pain zone. In fact, ROM rehab in my case was "on my own" -- the PT never touched the knee, so stretching sessions were nonstressful. During formal sessions, PT only asked me to demonstrate the home routine.

For the first two weeks after getting out of the immobilizer, PT assigned ROM stretching (wall heel slides) 5 x day, 8 reps per time, hold reps for at least 30 seconds. I think the frequency of it helped this knee go from 40 to 135 degrees by 7 wks.

Formal therapy was over at 8 wks, so remaining ROM has come without supervision, stretches performed from a variety of the "standard" positions. Moving from  the 135 degrees to the current 150+ (normal condition in both legs was very flexible) took a while. Worked at it 3 x dy for some weeks, then  2 x dy for some more weeks.

Currently (6 mos. from surgery), since I can now stand and pull heel on injured leg all the way to back, I just do that stretch before and after exercising. Have had some swelling, heat, inflammation all along the way, but it hasn't caused pain or prevented progress. In fact, some remains today, although very reduced in amount.

I dunno, seems to me that ROM progress is an individual kind of thing. I mean, rehabbing from 40 to 135 was rather fast here, but then the rest of it seemed slow slow slow -- made me ask myself "Oh patience, where ARE you?

Then one day, there it was, the full bend was back in a functional way -- i.e., one can use it comfortably in normal activities. The work performed was not painful (never cared for that), just uncomfortable at the high points of a stretch rep -- some tightness, slight burning sometimes, but the knee joint itself didn't hurt at all before, during or after the exercises.

Am guessing that most folks have different time frames for progress, and if you have no serious scar tissue holding you back, am sure you'll reach your goals sooner or later.

Piloting and powering lizl's "rehab racer" sounds like a super activity! Wish I'd known about it back when.

Best wishes for speedy progress and comfort too -- MHB


Posted by scottie2t2 (scottie2t2), 21 September 2004

MHB,

went to the OS and there is definitely a lot of scar tissue around my patella and the areas of the incisions. OS said that could be holding me back some. but good news for today....went to P/T and got past 90*. only to 95* ROM but i did see some progress and am confident that i will regain a lot more.

 i really appreciate your encouragement and tips. that goes for all the responses from the other "knee people."

i will keep posting my progress in hopes that it may help others the way you guys have helped me. thanks...scott
Posted by jennylind (jennylind), 21 September 2004

Scott-

I think I was slightly past 90 when I started PT (I think around 8 weeks). Once I started PT, my ROM improved dramatically and I'm at 135 now. I saw someone mention getting the heel to the butt--I couldn't do that before I broke my leg. I'ld judge your progress next to your good leg.

Are you doing PT? If not, ask your OS about it. My PT gave exercises to do at home that really helped my ROM.

I'm now about 5 months from my injury--I can walk without a crutch most of the time. It does get better, even though it may not seem that way now.

Good luck to you.
Posted by kgrosskurth (Kathy G), 4 October 2004

Hi, Scottie. I had responded to your post in my diary on MBL sometime back, and I was just wondering if you have any updates on your condition. I hope you are doing better with your ROM without having to resort to an MUA (and if you needed an MUA, I hope it wasn't as bad as you had anticipated).

At any rate, I continue to wish you all the best in your recovery!
Posted by scottie2t2 (scottie2t2), 4 October 2004

kathy....no manipulation needed. as of today i am partial weight bearing of 50% weight. i am at 110 degrees ROM. it feels weird to walk with weight on my leg. my foot is really feeling it. all those small tendons/ligaments are sore!! thanks for your words of encouragement!! i am 10 weeks out post op and donig ok. it does get better. thanks so much.
Posted by kgrosskurth (Kathy G), 5 October 2004

That is GREAT NEWS, Scottie - 110 deg. is great progress (and without MUA - YAHOO!!). You will continue to get better if you keep at it. Thanks for the update, and best wishes for continued success in your recovery!  

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