As I’m now more than 11 months into a rehab program for a tibial plateau fracture I often wonder what are the keys to successful recovery. As most rehabilitation is based in a gymnasium, it is evident that if you are not properly directed or do not apply yourself in the gym, you will not get better. Part of this is having someone to assist you and guide you through the process. I noticed today in my fortnightly session with Belinda Van De Venn, my personal trainer, that it is more enjoyable doing gym rehab with someone. Just having someone to talk to while you’re doing the exercises, makes a difference. This is before consideration of the expert input that someone like that can provide. Doing exercises on your own in a gym and trying to design your own program over an extended period of time would, at least for me, be impossible.
Some people may be able to do it but I couldn’t.
Balancing on my broken leg on a Bosu ball. This is a lot harder than it looks
Today was one of the most difficult days I have had. The exercises are getting more and more advanced and increasingly difficult to do, although they are not particularly painful. The pain in my broken leg has now largely abated but it still seems weak when subjected to particular exercises. I did my usual warmup on the bike. When Belinda arrived at 1:15 PM she immediately got me doing one leg balancing stands on a Bosu ball. This was particularly difficult when I had to balance on my broken leg – much easier with the left leg. This is not due to pain but merely weakness and lack of coordination.
We then did a series of step ups onto a low gym bench before doing a series of jumps onto and off the same bench.
A two footed jump from the floor onto a small bench. I also did two footed jumps off the same bench as part of this exercise.
Landing during a two footed jump. The key is to land with both feet simultaneously and to keep your knees bent. This is a low impact exercise designed to strengthen the muscles around the knee.
Belinda then had me running backwards across the gym, stopping, then doing 5 one-legged hops forward on the broken leg and 10 on the unbroken leg. Hopping on one leg, especially after the fracture and surgery is psychologically very difficult, particularly as hopping imparts an impact (albeit low) to the broken knee and psychologically the reaction is to try and protect it. I also found this hard on my lower back which started to ache.
After that, it was the cyclist’s or skier’s squat on the small wedge – 20 times. This is a really great exercise. Stretches everything.
The cyclist’s or skier’s squat off a small, wedge-shaped bench.
But true to form, she saved the best till last. This involved standing on the bench and jumping off, not landing on 2 feet but landing on one and immediately going into a one legged squat. On my sound, left leg this was no problem. My brain just did not want any part of this on my broken leg. Strangely it didn’t hurt – it’s just that my brain didn’t want to experience all my weight landing on that one weak knee. As it turned out there were no ill effects from this session other than it made my back ache. My knees were fine.
The relationship between the post-surgical patient and their advisors, such as physiotherapists and personal trainers, is crucial to successful recovery. They are also critical in avoiding injury during rehabilitation. I was fortunate in encountering Belinda Van de Venn at the Virgin gym in Pitt St, Sydney. As of December 2015 she has been supervising my recovery for ten months. This photo was taken in the gym after our last session before Christmas in 2015
CAUTION: The exercises described above come 11 months after surgery for a tibial plateau fracture and about 9 1/2 months since rehabilitation began. These exercises are advanced and involve pressure on the broken knee and some impact. They should only be attempted under expert supervision. They should also not be attempted by anyone who has not had a sustained and progressive exercise program over many months. The risk of injury in these exercises is significant. Jumping backwards and downwards off the bench may cause injury if you do not land squarely with both feet. It is even harder when landing in the one-legged squat position after jumping from a bench. The above description of exercises should not be taken as a recommendation that this course of rehabilitation should be followed. You should consult your own expert medical and rehabilitation consultants.
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