So after nine months of rehabilitation, following tibial plateau fracture and re-constructive surgery, it’s worth an inventory of what is possible. I spent the afternoon in the gym and for the first time in weeks I was not in any pain, either from neck or leg. The spinal block appears to be working.
Why is nine months so significant? I was told at the start that I would be in for an 18 month programme if I wanted to achieve full recovery. I’m half way. There were no guidelines or signposts for this stuff when I started. I’m recording this so that those who come after may have some form of road map to guide them on their journey. I would have liked something to check my progress against, but nothing existed. I’m feeling my way through this, albeit with a fair bit of help.
I had some significant milestones this afternoon:
1) Got to resistance level 12 on a stationary bike for the first time
2) Increased weight to 35 kg on the leg curl machine for the first time
3) Increased weight to 45 kg on the adductor machine for the first time and
4) Finally managed to leg press 80 kg, which is my body weight
Nine months after surgery I finally manage to leg press my body weight, which I was very pleased about
The following is a guide, and it is a guide only, to what is possible after nine months of physiotherapy and personal training. This will not apply to everyone. Younger people will advance more quickly and will be able to do more in a gym at nine months then is outlined here. Older people may not yet be at these levels after nine months. Each recovery will be different but I suspect mine is fairly typical for someone in their 50s or early 60s who has been fairly regular in their exercise routine.
A TYPICAL GYM SESSION AT 9 MONTHS – EXERCISE TIME ABOUT 1.5 HOURS.
Bike……………………………10 mins on resistance 9, 10 mins on resistance 10, 5 mins on resistance 11 and 5 mins on resistance 12. I was able to get to 100rpms, five times on levels 10 and 11 and did one set of 100rpm at the new level 12. Increase in resistance
Leg Extension……………….20 reps x 30kg x 4 sets both legs
Adductor……………………10 x 40kgs
Adductor……………………10 x 45 kgs Increase in resistance
Freeform plate …………….20 lunges each leg
Freeform plate ……………25 one legged squats on each leg
Freeform plate ……………30 skates on each leg
Bosu ball skips ………….50 on both sides 100 in total
Jacobs ladder …………….5 minutes at 80 steps per minute.
Leg Curl …………………..10 reps x 30kg x 2 both legs
Leg Curl …………………..10 reps x 35kg both legs Increase in weight
Leg Press…………………..10 reps x 50kg both legs warm up
Leg Press………………….10 reps x 60kg both legs
Leg Press………………….10 reps x 70kg both legs
Leg Press………………….10 reps x 80kg x 2 both legs Increase in weight. First time I have been able to leg press my body weight.
The Jacobs Ladder, a safe but taxing exercise machine for a broken leg, once the initial phase of rehab is complete.
So I am officially half way through an 18 month rehab program. What else can you expect?
1) You should be free of pain in the injured leg when walking or exercising
2) There should be no residual swelling or heat of any sort in the injured limb
3) There should be significant recovery of muscle mass to the extent that, to the untrained eye, there is little difference between the injured and uninjured limb
4) You should be able to kneel on the floor supporting all your weight on the kneecap of the broken leg without experiencing any pain. Don’t try this in the first months after surgery – really hurts.
5) You should be able able to do most things with the broken leg that your unbroken limb can do. I can’t run and I don’t think I could twist out of a set of ski bindings or bike cleats. Beyond that I think I can do most things with my injured leg.
Belinda thinks that when I see Matt Lyons, the surgeon, in a couple of weeks, he will let me ski again. For the first time I’m having doubts about whether I want to. I still have 9 months of work in front of me. The body is willing but the mind is getting weary. With nine months still to go, do I want to go through all this again, if I hurt myself on the slopes?
A picture never lies. The weight rack on the leg press machine at Virgin gym French’s Forest with the pin set at 80kgs. Saturday November 14, 2015
Thanks for your blog. I fracture mine a month ago. Luckly no surgery not displaced so hopefully my recovery with be quicker. I can’t imagine not getting out there and doing even though I too have the trepidation of possibly having to go through rehab again which I haven’t even started yet. I thought fully healed bones were suppose to be stronger once healed. good luck
Carl,
Sorry to hear about your break. Doesn’t sound as if it’s too serious if they are not going to operate. As you suggest, this usually means that you have not had any displacement of the tibial plateau or the displacement is so minimal that surgery cannot be justified. Your comment about fully healed bones being strong does not define the problem. The bones heal fully about 6 to 12 weeks after surgery and continue to strengthen for a considerable period thereafter. The difficulty is the soft tissue damage incurred either through surgery or during the period of immobility that follows it. Often people can be immobile for up to 3 months following a break and surgery and this can lead to at least 50% loss of muscle mass in the impacted limb. Sometimes, particularly in older people, this muscle mass never recovers completely. I hope you are back to doing everything you desire very quickly.