On January 19, 2015 I suffered a tibial plateau fracture while skiing at Revelstoke in Canada. I was not able to have the injury surgically tended to until February 12 2015 on my return to Australia. There I undewent a surgical reduction with fixation by plate and screws. For the first six weeks after surgery I undertook non-weight-bearing physiotherapy based on regaining flexion and mobility in the knee joint. In mid-March 2015 I began a year-long program of physiotherapy and gym based rehabilitation aimed at a return to skiing in February 2016, approximately 12 months following surgery
The gym based rehabilitation involved one visit to the gym per week under supervision and one day per week unsupervised. This was carried out for the entire 12 month period until February 2016, without a break.
In February 14, 2016 I left Australia for Big Sky in Montana to test the recovery of my knee and to begin skiing again. I had hoped, due to the skill of the surgeon and the expert help I received during rehabilitation, that I would make a painless and complete return to skiing.
This did not turn out to be the case. I now understand that just wanting to return to skiing and working hard to do so with expert assistance does not guarantee anything. A 12 month program, in hindsight, is probably not enough. To ease back into skiing, possibly 2 to 3 years of rehabilitation with time on the mountain will be required.
Some lessons I’ve learned
1. You can come back after 12 months of rehab and ski again but you will not come back at the same level you were before injury
2. Some pain is inevitable as is some loss of strength and performance.
3. Pain will be worst on hard-packed, groomed slopes and particularly on rutted terrain. Pain will be less on soft or powder snow
4. All the above applies no matter how disciplined and assiduous you have been regarding physiotherapy and rehabilitation
5. There is no substitute for skiing if you want to get fit enough to go skiing. Belinda admitted on my return to Australia that there are certain mechanical aspects of skiing that cannot be replicated in a gym
6. Having some form of skiing plan which involves stretching, icing, anti-inflammatories and rest days is essential. This will be an ongoing feature of the sport for anyone who has suffered a tibial plateau fracture.
7. You will not be able to ski every day of a holiday no matter how fit you are.
8. Rehabilitation from a tibial plateau fracture will extend into the second year if you want to keep skiing.
9. Clicking into the heel binding of your broken leg will cause intense pain. It does for my daughter Catherine and it does for me. You will have to learn to live with this peculiarity of your injury.
10. It is not the surgeon’s fault that you cannot resume skiing where you left off. Nor is it the fault of your personal trainer or physiotherapist. It’s just how it is. You have sustained a significant injury producing trauma in the knee joint. You now have to learn a programme for dealing with it if you want to keep skiing.
Great Post! Thank you for this.
I fractured my tibial plateau while playing softball of all things. I surgery in May 2016, and I was non weight bearing for almost 16 weeks. The surgeon said that it would be one year before I was back 100%. I’m still not quite 100%.
So, I am going skiing in March 2018. I’m super nervous!
I have skied for many years, and I am a very skilled skier, but I plan to take it very cautious.
Did you wear a knee brace or anything?
Thanks again for sharing your experience.
Thank you for this open and honest description of your rehabilitation. However, it upset me greatly. Skiing is the major pleasure in my life and has been for over 30 years.
I fractured my tibial plateau in April 2018 which required plate, pins and a bone graft from my iliac crest. My surgeon is confident that I could do some gentle skiing in December 2018 if I make good progress with my exercise programme – which I am taking very seriously.
I suppose it is all do do with testing your body slowly and stopping if you are in pain. I suppose everyone heals and recovers at different rates. I am 59 this year and a good skier. I sincerely hope that this is not the end of my skiing days.
Couldn’t have summarized it better .I am an 82 year old retired paediatric general surgeon who volunteer coaches alpine racing in Fernie BC .Last winter suffered a R tibial plateau fracture non surgical ,caught in rut while coaching .Also have had a Right Hip Arthroplasty and broke my Right Femur also coaching .
Am back on skis and it’s coming along well but I now realize that I will never ski the same and certainly never run slalom .
Really glad I read your article and hope that when I am 83 will be skiing better .
Hello Kieran,
I posted the text below to a Facebook TPF support group below. I found your blog and would love to chat about recovery advice.
Hi all, I am new to the group but not new to TPF recovery. My injury occurred in Aug 2019-head on car collision. I had an open fracture and spent the first week in an external fixture awaiting surgery. The repair included 3 plates, including a staple in my patella fracture. This was followed by months of non-weight bearing, no flexion (wore brace) for 4 months. I was released to PT in December 2020. It was painful (of course) and a screw at the top of one of my plates backed out. This probably should have been a bigger red flag but I continued the PT course and got more flexion but with lots of pain and swelling and no full extension. By mid January 2020 it was deemed nonunion and I had another surgery to remove what turned out to be dead bone and was fitted with a temporary spacer and put back in the external fixator. The plan was to prepare my body for a bone graft (Masquelet technique). I was devastated and furious about the external fixator for another 12 weeks. Long story short, the skin on my shin never fully healed (spacer turned out to be too large) and I got a bone infection. By this point, my care was transferred to a trauma surgeon with more experience with TPFs at Duke Medical Center. I had an entire team at this point-infectious disease, trauma orthopedic surgeon and plastic surgeons. The previous group actually suggested amputation. This was seriously a horrible break/crush of my tibia. May 2020, I spent a week in the hospital-2 surgeries to clean the wound and remove all the hardware and they put in a pic line for antibiotics. This was one of my scariest, darkest times. Plus it was happening during covid so I was there along with no family support, no visitors, etc. 2 weeks later I returned for the bone graft. They drilled into my femur for cells to mix with the bone graft material, secured it with 2 plates, and used a muscle flap (part of my calf) and a skin graft (from my thigh) to ensure it would all close.
Fast forward to Jan 2021: I am 8 months post that surgery (9 in total). I continue to lay down bone, tolerate the plates and no sign of infection. I am able to drive again and started PT. I am walking unassisted (slight limp), already have 145 degrees flexion on my knee joint, minimal pain and swelling (no meds), can swim (gentle flutter kick) and bike (no tension). I return in 3 weeks for my 9 month check-up and expect to be released for additional PT. Right now the focus is still growing bone and building up muscle. I basically was non-weight bearing for over a year. I used a rollator walker (scared PT to death😅).
I am 47 and pre-accident was a 1,000 mile a year runner, hiker, biker, swimmer that lived an active life while working full time and raising 4 kids.
Those are the details of my physical recovery. The mental recovery from the trauma, the dependency on others, and the continued uncertainly of the future are daunting and at times fully depressing. I am working with a trauma therapist-helpful, relying on my healthy body and resiliency, family and friends.
I decided it was time to find some other folks that have had similar experiences, I am still trying to fit back into my life. I am also interested in those that may be further along in their healing to hear their stories, suggestions, what worked/didn’t work, PT experiences, etc. Basically just need to find some people who truly can relate.
If you are still reading, thank you. I have tried to give the basics, too many small step backs, and other sideways experiences to include here. My initial accident left me with a broken wrist, fractured sternum, and a concussion. Those all seem like nothing in relation to my TPF but were certainly a part of my healing journey. Appreciate your time and look forward to hearing about your journeys.
Hi all, I had a wonderful day of skiing followed by a tibial plateau fracture and tibia/fibula breaks above boot and a tibia break below boot. This occurred in February 2021.
The good news is I was on skis in November 2021. Not pretty but can ski.
My surgeon was kind and advised that I would make a slow progression on return to skiing. I matched this with rehab medicine, fitness/weightlifting and a slow return to cardio fitness (spin).
Keep the faith. It will get better
L
BTW, the comment on getting into your skis is so correct. Stepping into your bindings at the beginning of the day will be one of the most painful things you will do:)
Moggles are not a fun thing at the beginning either… I think we all get that.
L