Proximal Tibial Plateau hairline fracture, question about walking

[niushaz]

Hi everybody, long time lurker and first time poster here! I thought that maybe I could use the help of some of you that might have gone through the same injury as me.

First let me give you a history of my injury. At the beginning of April I fell while bouldering and landed on a straight leg on the floor. My knee veryyy slightly bent backwards and it was painful but I could walk to my car and even drive myself back. I went to the emergency room that day and the doctor performed a physical examination of my leg and diagnosed me with hematoma in my leg muscle (did the sonography and everything) and bandaged me up for two weeks. He didn't think an Xray or MRI was necessary so I didn't get one. after those two weeks passed the pain in my knee persisted and since I was on vacation the timing was kind of messed up and it took me till the end of April to finally be able to visit a specialist back at home and get an MRI. Turns out I've been walking with a hairline fracture (like a fissure) on my proximal tibial plateau. The MRI also showed bone marrow edema in that area. Doctor ordered me to use crutches for four weeks and then come back for a follow-up. By the end of the non-weight bearing period the pain in my knee almost disappeared, except for some mild discomfort after I woke up in the mornings. And in the follow-up the Doctor told me that I could go back to walking normally and also wrote me 6 physio sessions to get my leg muscles back into shape. The first minutes of walking my leg muscles were cramping so much that I just wanted to cut it off and throw it away  but based on my experience in climbing and how the first few sessions usually hurt the most after going back, I decided to just complete my 10000 steps (about 7 km) a day goal (on level train and with a regular pace) until the muscle cramps got better. I've been doing this for the last 5 days and honestly the cramps have improved so much and my muscles don't feel so sore anymore but I feel like a dull pain comes and goes in my knee and am worried that I might have overdone it with the walking. The doctor told me that I can go back to walking normally again and didn't say anything about limiting the amount of walking (and I forgot to ask ), he only told me to refrain from high impact sports and activities that aggravate the knee for at least another four weeks until my fracture is completely healed and I've done all my physio sessions.

So bottom line is I cannot just call the doctor and ask him about how much I can walk and whether this amount of pain is normal during the recovery time or not and getting another appointment is out of the question because he's a really busy guy. From your experience how much walking is too much walking while recovering from a stress fracture in the tibia head? and if experiencing minor pain is OK or I should just sit down and do nothing?! and is the pain because of the edema in my bone or because I'm causing the stress fracture to come back just by walking? I'm kinda worried that I might have undone four weeks of non-weight wearing by a few days of walking too much. It would be great if anybody who has gone through the same thing would share their experience with me.

[vickster]

No experience of a fracture but to me it sounds like you’ve rather overdone it going from almost nothing to 10k steps for 5 days straight.

I would work up to 10k steps gradually with rest days between active days.
Make sure you’re stretching, icing and elevating after exercise. Get in touch with the physio as they are the rehab experts and not the surgeons. Surgeons are often unrealistic about recovery times, giving the best case scenario, everyone is different though.
Ask the physio what other activity you can safely do while recovering, maybe swimming, cycling, upper body work in the gym? If the fracture is on a weight bearing area you won’t want to be pounding it walking. Also pay close attention to your footwear, that it is supportive and cushioned. Maybe you need a knee support for this early stage, ask the physio.

Also, knee injuries can take months and months to resolve and recovery isn’t linear, you’ll have good days and bad days. It’s a marathon not a sprint, and can be mentally draining and frustrating unfortunately!

If it’s still not improving in a month or two, then that may be the time to see the Dr, get another scan etc. He may be busy but it’s his job ultimately to see patients

Good luck