Broken Leg - what to do
NickSeed
Posts: 8
hi, I broke my femur falling on the ice last tuesday. The break is near the top of the femur and the doctors have screwed a plate across the fracture and sent me home on crutches. I`m 49 and usually did 200-250 miles plus two turbo sessions every week. The doctor told me I would n`t be able to ride on the road for at least 3 months, if I fall over before the bone has fully healed I`m likely to need some serious surgery. I`d like to retain my current fitness so I`ll be using the turbo as soon as possible. Has anyone got any ideas how and when I might get started?
Thanks,
Nick
Thanks,
Nick
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Comments
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As soon as you can bend your leg enough to rotate the pedals. But I'd suggest you get used to using your crutches and keep mobile int he meantime. I'm about your age and got on the stationary bike after a couple of weeks after the op. I'd also recommend the cross-trainer if you can use one as this will help you get going again. The flexibility can take a while to get back. Keep moving and keep stretching. Easy does it you'll get there.
Bin0 -
I broke mine a couple of years ago, and i would say to ensure the quickest possible recovery, make sure you attend every physiotherapy session available to you. The muscle will inevitably waste whilst dormant, just take it gradually and don't do anything that may harm you long term.Don't rake up my mistakes, i know exactly what they are.0
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Thanks for the encouragement guys, helps a lot. I`ll try the turbo in a couple of weeks and in the meantime keep mobile and do a little bit with dumbells. After so many years of cycling my upper body is a tad under developed and getting about on crutches is proving quite an effort. One problem I can forsee is atually getting astride the bike, any suggestions?
Physiotherapy has n`t been offered to me, living in an isolated back water of North West England has it`s disadvantages. Do you think it`s worth getting it privately?
Thanks again,
Nick0 -
Sorry to hear about the break Nick; I'm about three years on from mine and completely back to what is known as normal - for a cycling obsessive. I hesitate to offer any advice about getting fit as your weekly mileages are way out of my league. But the only thing I will say is that be prepared for some degradation in what is probably a very high standard of fitness; not permanent but it will happen and it will be a bit depressing.
The thing I learned from my break (no plate but three compression screws) is that the body needs pretty well all its resources to repair muscle, tissue, circulation and bone. I stuck to crutches for quite a long time and didn't go near the turbo, just concentrating on keeping mobile, good diet and above all good rest. The main fear with most breaks is that blood flow can be interrupted by such a trauma and result in AVN (they've probably mentioned it to you) ie. failure of the circulation to return to the head of the femur.
I don't say what I did will work for everyone and I was about 6 years older and a lot less fit than you. But I made giant strides once my period of abstention was over, I had the pins removed after 16months and climbed Tourmalet and Aspin last year. BTW the advice about physio ^^ is good but make your own judgements about how cycling savvy your physio is..
This is all just my personal experience and only you can judge its relevance. Take care and I hope recovery is as swift as you want it to be...!
V-T
mox senex dormit0 -
NickSeed wrote:Physiotherapy has n`t been offered to me, living in an isolated back water of North West England has it`s disadvantages. Do you think it`s worth getting it privately?
Thanks again,
Nick
If you can afford it then definitely. It's an integral part of bringing the affected leg back up to scratch, with regards strength.Don't rake up my mistakes, i know exactly what they are.0 -
Thanks V-t, your comments are much appreciated.
I`ve always felt motivated to train regularly, not wanting to waste the efforts I`d banked previously. This will be my first enforced layoff for a long time and I`m concerned that at my age I might find 'starting again' very difficult.
The doctor did explain the need to take it easy until the blood flow to the head of the femur had been restored and that regular x-rays would detect when this occurs, he said it would take around six weeks. I did n`t realise that there was a possibility that it might not. What happens then?
Tourmalet is fantastic is n`t. I`ve had two attempts at the Aspin but a lack of time prevented me reaching the summit on both occasions.
Nick0 -
Mañana0
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Lets face it I've only been a patient and have no professional knowledge of the problem - but my understanding is that avascular necrosis is the denial of blood to the head of the femur following the traumatic dislocation of blood supply as a result of a fracture.
The head of the femur needs blood to keep strong, replace old bone cells with new - and repaire the fracture. After the break if the blood coming up the femur doesn't reconnect with the supply network in the head of the femur then there is no more nutrient for the femur head and the bone will gradually (gulp) stop growing. This can lead to the fracture not mending itself.
I think that in some situations eg. elderly people, this is resolved by a hip replacement to re-enable mobility and enable the femur to bear weight again.
The x-rays are important as you can see the formation of calcium across the fracture line (slightly whiter) and the professionals will, I imagine, compare the colour and texture of bone in the head with that of the shank of the femur.
You have fully exhausted my knowledge on this but I'm sure a 'professional' will be along in a minute to correct my syntax, spelling and facts!
When I was in your position my first aim was to give my body the best chance of mending the break and getting the blood flow going - hence I was most concerned with diet (calcium?), appropriate exercise and rest. Those who helped me through the dark days (you'll get twinges and phantom aches) made sure I didn't overdo it and suffer a regression.
By small steps of improvement - and never going back through over-exertion - I think I made the best recovery I could. But hindsight's wonderful ain't it....!
To actually answer your question: it will take time to get back to fitness and in my case this was at least a season but, as the consultant said as they wheeled me into the theatre, a key factor in recovery is how fit you are when the trauma occurs. Since you were fit, probably not overweight, with healthy muscles and a positive attitude you already start with a lot of advantages over most.
Sorry about the ridiculously long post :oops:
BTW chicks-dig-scars...even if you have to pull up your lycra to show them!
mox senex dormit0 -
V-t no apologies necessary, you`ve provided a lot of information from your own experience and I really appreciate it. At least now I know what to ask the doctor on my next visit to hospital.
I think I`m in good shape and the doctors were surprised how quickly I was up and about following the operation but I`ll take your advice and concentrate on getting the fracture healed before restarting training. Good point about calcium, funnily enough, since the operation I`ve had an absolute mania for yoghurt and milk.
Chicks dig scars eh? I`ve got to admit this is my best ever, should be at least ten inches long, "form an orderly queue please ladies".
Nick0 -
Nick, really do pay attention to the letting it heal properly idea. I'm 3 months out of elbow surgery from a break that happened 3 years ago. I used the arm too much too soon and really paid the price.0
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Thanks for the link Pb21, I did do a search before I posted my question, did n`t think to look in Cake Shop though. This is a more serious and common injury than I realised How`s your own rehab going?
Nick0 -
Listen to your doctor. You have broken one of the biggest bones in your body. If this were a sprained ankle you could probably get by on advice from this forum, however
simply wanting to keep riding is not nearly a good enough reason to not pay attention to what he says. You risk further complications and who knows what. Writing in to this forum and hoping that someone will tell you to go ahead and ride, no problem, is just
plain foolish. Sorry to sound preachy but there are times in life when you must do what the doctor advises. This Is one.
Dennis Noward0 -
Depending how they mange you ask when it would be ok to start pool running. If you take an elite middle distance athlete and replace running with pool runningn over a 6 week period the loss of fitness is negligable. Its good stuff...!Couple of 5 spots, a hummer and a handjob.....0
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dennisn wrote:Listen to your doctor. You have broken one of the biggest bones in your body. If this were a sprained ankle you could probably get by on advice from this forum, however
simply wanting to keep riding is not nearly a good enough reason to not pay attention to what he says. You risk further complications and who knows what. Writing in to this forum and hoping that someone will tell you to go ahead and ride, no problem, is just
plain foolish. Sorry to sound preachy but there are times in life when you must do what the doctor advises. This Is one.
Dennis Noward
Dennis, I appreciate you are well known on this forum for your forthright views but I think you may have misinterperated my posting. I do listen to my doctor, not easy given that English is n`t his first language, the only advice he has given me is to stay off the road for at least three months and to do some partial weight bearing on the injured leg. Do n`t underestimate the value of V-twin and Pb21`s experiences. They`ve been through a similar trauma and I appreciate their contributions. I feel a lot more confident and informed than I did before. I know that they are not experts and that we are all different but they really have helped.
Physiosteve - thanks for that, my local pool has pool running classes for disabled people and I`ll see if I can get along to these, once the wound has healed.
Nick0 -
Thanks for that Nick. I would also add that doctors and physios contribute different things to the mix. The consultants I dealt with were hot on solutions and on the strictly medical aspects, such as AVN and answering queries about pins coming out etc. But they had less knowledge of the actual recovery process and the best way of helping a frustrated, otherwise fit patient to make the best use of their determination and intelligence. This is where the physio scored.
Besides, most of the time - in my experience - you are on your own. You make hundreds of small decisions, just getting about, that you can't go back and ask a doctor about. You take their guidance, meld it with your own commonsense and do it. I would agree though that in those first weeks caution, exercise, diet and rest were pretty well the only things I thought about. Only when I was confident of what I could do, how my body was reacting etc could I move my 'operational horizon' onto more ambitious things.
(Homily over :roll: )
mox senex dormit0 -
You have my sympathies - I crashed off a racing bike in the wet by going at a stupid speed into a downhill corner during a training ride and broke my femur up in the hip. 6 months ago now. I needed a rod up the whole length, and broke the collarbone on the same side, so crutches were really difficult to use for the first few weeks
)
If I can offer some advice - you seem to have a positive attitude and high expectations, which are good things - but if it takes more time to recover than you expect - try not to get depressed / angry by it - it'll not necessarily be your 'fault'. Some bodies take more or less time to recover from equivalent trauma.
I was 37 and thought I'd be on my feet in "no time" and was quite disappointed that while I could ride my town bike as soon as the break healed enough to start slowly ramping up the load bearing (with a crutch strapped to the bike for walking at the other end, which used to get a few comments ;-), but it took me longer to hand in the crutches than the expectation I was given and I still limp occasionally when I'm fatigued.
I also second the advice about getting a good relationship with a physiotherapist. even If there's none local. You really only need a consultation every week or so - just often enough to get new exercises as your capacity increases, get some feedback and be able to get answers to questions that will come up. Medical doctors normally aren't very savvy about bio-mechanics.
Oh, also - consider the option of aquatheraphy - if it's good enough for race horses...0 -
Just to add some comments about how I am doing at the moment to hopefully boost your morale Nick.
I broke my hip in May. I had three pins put in then had three months off work resting and a total of four months on crutches with increasing weight bearing. I looked after myself regarding diet, exertion and rest etc and when I got back on the bike in September I was surprised at the level of fitness I had retained. I had some physio, although this was basically just exercises to strengthen the muscles that become weak with no use.
So seven months in and I would say that I have no 'problems' now. Sometimes there is a mild ache, mainly in the lower back/buttock on the same side, nothing that keeps me awake though. My leg is still weak when standing just on just that leg such as dressing etc but that is still improving, probably don't do enough exercises! I even crashed again and fell on the same hip 10 days ago and it is strong enough to have not broken again, although I don't recommend this ultimate test!
Saw my Doc today in fact and he said that in three months we will look into having the pins removed...
So, touch wood, things look OK and I expect you will be too.Mañana0 -
Good to see you are back to it Pb21. I think your crash test was a bit drastic but it confirms what I`ve been told, that once healed, the hip bone would not be significantly weaker than it was before.
So far things have been ok, I get tired just moving round the house and going up and down stairs a couple of times. Still having difficulty supporting my weight on crutches due to lack of upper body strength but that will come.
One thing I`d like to ask you and V-t is, when did you start going outside on your crutches and how far were able to walk? I feel a bit stale being in the house all the time, although a friend who is disabled has offered to lend me a wheel chair so we can go out for rides together. I think I`d like that.
Nick0 -
I have broken two collar bones and a pelvis over the last 4 years riding and racing, from experience I found it just as important to listen to my body I knew when I was ready to get back on the bike and I knew when it was good to rest. You do have to let your body repair itself and it will do that in its own time so be patient. One other thing i did learn is the irony of these injuries has been it has made me a stronger rider I feel like I can take more and push myself even further its akin to the cliche 'what doesn't kill you makes you stronger' Good luck and get well soon.'..all the bad cats in the bad hats..'0
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My break occurred in at the end of August 2005 and so the weather was good during the immediate period of recovery. Bullets:
1. Walked to end of road and back after 2 weeks (0.5 mile). Critical not to go further than you think you can get back :roll: and did not treat it like a challenge. I desparately didn't want to over-tax my good leg so limited distance even if I felt I could do more when I got back. Increased frequency of these short walks before increasing the range.
2. Extended the distance after 3 weeks - admired my increasing upper body strength...
3. Shopping trips for a bit of variety - driven by Mrs V-t
4.By 4 weeks I was up to two miles a day on crutches, partial weight bearing still, including gentle hills.
Some bits of experience from the University of the Bleedin' Obvious:
1. With crutches you are wider on a pavement than you might think; be careful your outboard crutch doesn't slip off the curb in the wet. I did that while trying to avoid a pushchair pusher with 9 whining, snotty kids, and really jarred my leg as it came down unintentionally hard.
3. Make sure the crutches are vertical when getting up from seated pos. Partic if wet as (obviously) ithey can shoot away as you put weight on them.
4. In getting out of car I used to swing my whole body round so that I could use the door frame for leverage and rise in one (fluid!) movement..
5. Let other people pick up your crutch if it slides down from where you've stashed it.
Sorry if it sounds like a basic training manual; I'm off to talk to my granny about those eggs....
V-t
mox senex dormit0 -
I did as much as I could on my crutches. Bit like V Twin I did mine in May so had the remaining four months of 'summer' on crutches so the weather was good to get out. I started off literally going to the end of my road ~ 50m and I was knackered! It only took a week though to be up to around 400m. Before I was allowed to put any weight on the bad leg I was up to, like V-Twin, 2 miles some of it off road, probably not a good idea but I was careful and it was fun. Some days I would do hill reps, just go as fast as I could several times up the local hill. Doing this really got the HR up!
When I started weight bearing I went back to short distances as it was quite hard to manage at first, but was soon up to mega distances like 5+ miles!
I didnt jump straight in though and my Doc probably would have said that it was not a good idea but I am glad I did. Its surprising what you will be able to do but be careful. I must have built up some good strength in my arms etc probably all gone now though. I actually didnt mind being on crutches too much other than when I stoped somewhere to sit down as they always get in the way. Walks to the pubs werent out of the question towards the end.
Just take each day as it comes, dont expect too much but at the same time set yourself targets.Mañana0 -
You may have seen this but i found it useful as there are usually folks with "similar" fractures who are at different stages in their recovery..
http://www.mybrokenleg.com/
Chris0
