Fracture of tibial plateau

[Helene2013]

The joy!

How to waste a winter training season!

January 10th I was coming down from bedroom floor to head to basement to do my MAP test on bike. Had been a great day so far and my winter training was doing well.

So I get to 3 steps to the landing and my left foot slipped and the right foot landed flat on two stairs below (the one before landing). THE PAIN I felt is undescridable. It is the knee I had a torn ligament reconstruction 12 years ago and my 1st thought was that it got totally teared and more again. Oh no! I could not stand up on the foot. hubby saw it all as he was at bottom of stairs. The sound it made when the right foot touched the stair is still buzzing in my ears.

I managed to skip to the sofa and applied immediately the RICE technic. Weirdest thing...I could no see much swelling. Hummmm. Painful, no swelling or minimal. For now anyway. It is a Sunday 4pm. So clinics are all closed and to me it is not an ER issue. I'm not gonna sit 18hours in ER hospital for this. So I'll wait in the morning to give my generalist a call. In the meantime, I write to my PT to let her know I'll need her soon. :) And my boss to tell him I'm in deep trouble.

Next day I see a doc. Xrays came ok and hard to tell fracture due to the pins in my fixed knee. So I am sent for an MRI 3 days later. Results came in: tibial fracture and medial meniscus tear and a referral to see an ortho.

But the night following my accident I was already into PT at 9:30pm. She did me some good and helped me see clearer until we get the full results. She tested everything and said my ligaments seemed all good. Once results came in, she said my symptoms did not match the results at all. hummm

I got to see quickly an ortho (he it can take months but I have excellent connections that helped me). He confirmed that my ligaments are clear. Yeah. The fracture is a very nice fracture caused by impaction. In the sense that nothing chipped. It is more like a nice crack but no fragments loss. It will be able to heal back on its own but in the meantime, I was not to walk on it, or minimal with help of crutches and then a cane. No going to walk in snow, no taking risks of slipping or uneven surfaces skid. I have been off work for 4 weeks now. Should be back after the 6 week mark. For the meniscus, it should not disturb me and repairing it may make it worst than better. So he will not touch it. My knee is extremely stable and he said my PT was right that the test results do not match my symptoms but he's very happy with what he sees.

He gave my PT a strict rehab plan, like no squats at all for 3-4 weeks, no over flexion (like pulling my leg towards my butt, no long walking distance, no wobble board, lunges, but I can do my indoor bike as much as I like, but 0 resistance and no kick of the foot for 3-4 weeks. I get to see him back for a follow up of xray 6-8 weeks (which is in 2-4 weeks from today). He wants to see how the fracture healed.

I do PT an hour a day and started aqua physio yesterday. So much easier in deep pool.

As this was not enough... my left knee started to swell and ache (from being the sole support for 4 weeks then). Ended up doing the RICE on that one too, saw PT and she did a taping again to help the fluids move away from knee. I see the ortho again this coming Wed and I'll see what he thinks of this now. I had been able to let go of the crutches...and I'm back on them. I do wear compression socks to help with the swelling.

It's been a hellish of 2016 start but there are worst things in life. I still signed up for a 110km bike ride in June. So I have to be ready. And ortho approved. :) At least my fractured knee is no longer hurting and swelling is gone. I am pampering the left knee as much as I can and I'll see what ortho will do with that one now. I'll ask him at same time to get some Synvisc One as the last injections were almost a year ago and with this freaky accident, I'm sure all that synvovial gel is gone. Must have been squashed out on impact.

What a winter! I feel I lost so much cardio and PT said there is not much I can do to get it back right now. At least I can do some muscle training (no choice to keep the legs very strong.

[OakLeaf]

Ugh Helene. Heal up fast.

Can you crank an arm ergometer - just for some kind of cardio?

[Crankin]

So sorry, Helene. But, you have a good attitude.

[Catrin]

So sorry Helene, I understand your frustration but you are handling this well. I concur if you've access to a gym with an arm ergometer that might be better than nothing.

[shootingstar]

I'm sorry to hear of this latest injury, Helene! Be patient with your recovery. Make your recovery a safe one a higher priority over the June bike ride. If you can't go, can you get a refund?

[Helene2013]

Thank you. I did not know about this piece of training equipment and since I don't do gyms I called two around here and none of them had something similar to this. I have not seen it at my PT's clinic but will ask. I'll try to dig the web to see how otherwise I can do something until I am allowed to do more without the use of knees. I'm sure there must be something out there.

As for the bike ride in June, ortho said I should be ok for it. And since this tour is made of a 50km and 60km loop I can always complete one and forget the other one. The 60km is more scenic with very challenging hills (and this is my favorite of the 2) and the other one is boring as it goes through rougher roads, more into some cities, etc. And my employer pays for it anyway so I would not lose much. And we can't get reimbursed either.

Since I'll be on week 2.5 since my last visit to ortho this coming Wednesday, and he had said 3-4 weeks without any resistence, he may decide from checking my knee that I'm ok to increase a gear or 2. That would help raise the cardio since I could get a higher cadence as well. But then, I still have that other knee now that is bothering me but since it is not a fracture - and probably just overuse from bearing all my weight, he may let me try something. TBC.

[Pax]

Dang, Helene! Sure hope you heal up without any issues, you've got a great view on all this, very impressive.

[Aromig]

How frustrating! Heal quick! Glad the bike ride in June gives you something to look forward to.

[ny biker]

Best of luck with the recovery, Helene.

[Helene2013]

Went to see surgeon today for my swollen knee. There was so much fluid that I could not bend or walk properly. I sleep on my stomach and the stretch of my leg was making it so uncomfy to sleep even with pillows under leg. As soon as he saw that knee he sent me right away into his surgery area. He numbed the area and then proceeded to remove two full syringes (those bigger ones) full of synovial liquid. It was weird to see the knee come back to normal size as he was doing the procedure. Also did an infiltration.

Still off work another 4 weeks (for the fracture of tibial plateau, and now this issue).

No physiotherapy until Monday. I can resume what I was doing, but for the bike training warm-up
No cycling (on trainer) for another week but we will be able to increase resistence from 0 to 1, if the leg with extra fluid lets me.
No aquatherapy until next Friday (of next week)
No walking on left leg for 24hrs. I can walk at home, with crutches but not go all-day shopping. :) Once the next few days of remaining "calm" are over, I can start to use 50/50 weight on the fractured leg but not overuse the left one either. So much fun figuring all of this out.

He wants to see me back in 4 weeks and at same time will take an xray to see how the fracture healed.

So some more boring and quiet time at home. I'm fed up but it is what it is for now and I should be ok for summer. If I don't abuse of the knees. osteoarthritis is no longer helping but can be controlled to a certain point.

I'm sure I'm forgetting things but overall, it's been a helly winter on that front. But there are certainly worst things in life and we'll deal with this issue one day at a time.

[Catrin]

Youchies Helene! So sorry you are having to go through all of this :( Hope things feel better soon!

[Crankin]

That must have been very uncomfortable. Two syringes :eek:? I fractured my knee, 40 years ago, and I had to drag myself to the ER to get it assessed. It was at a teaching hospital, where they promptly had a 3d year med student stick a syringe in my knee to drain it. That was worse than any other thing I've had done.
I hope you can abide by the brief restrictions for the next week. It must feel very boring, but it does sound like there will be complete recovery of the fracture.

[Helene2013]

It was so hard to leave foot down or flat in bed on my stomach. It was such a thrill just to sleep in any position last night. Their is a paradise after all. :D

No pain draining it out because he numbed the knee. Did not feel a thing but joy seeing the knee shrinked.

Should have told him that while at it to continue with a lipo suction in the knee area. Lol lol a 2 for 1. Lol

I tried thigh high compression, icing, Aleve, swimming to push the fluid away from area with water pressure. Nothing worked and was happy to have been able to see him. Great timing.

[OakLeaf]

Glad you're getting some relief.


FWIW for anyone else, or if it starts retaining fluid again, electrical stimulation has worked really well for me. There's only been once when I was on the point of having an effusion drained (a month after I'd smashed my knee into the side of a minivan at a combined 45 mph, sigh), so it could be that it was just finally ready to drain on its own the day after I applied the electro-stim. But it's also quickly reduced swelling in sprains and contusions, so I'm a believer. I just used the units you could buy over the counter 15-20 years ago, I know they've opened up more of the TNS frequencies to OTC sales lately.

[Helene2013]

When I go into PT, more often then not my PT does set me up on this current machine.
Someone also mentioned to me that I could try some BioFreeze. Available easily in USA but in Canada you have to go through some chiropractors, etc. Having it shipped to Canada would cost me a fortune in shipping, not counting the US$ vs Cdn$.
http://www.ebay.com/itm/271940954637?_trksid=p2057872.m2749.l2649&ssPageName=STRK%3AMEBIDX%3AIT%5dBio

So far so good. The swelling has not come back. I did nothing but sit or lie down yesterday as he requested it. Today did some light errands, with my crutches. Still good tonight. Hoping it stays that way now. No PT allowed anyway until Monday. And no indoor trainer either. So we'll wait. It is a lonnnng winter but you have only one body and need to take good care of it. As much as possible anyway.

[netskyblue]

Someone also mentioned to me that I could try some BioFreeze. Available easily in USA but in Canada you have to go through some chiropractors, etc. Having it shipped to Canada would cost me a fortune in shipping, not counting the US$ vs Cdn$.

I use Salonpas DEEP Relieving Gel (http://salonpas.us/product/salonpas-deep-relieving-gel/) and I actually like it a little better than BioFreeze. I feel like it's stronger and lasts longer, at least for me. Not sure if this is commercially available to you in Canada or not. I buy it at Walgreens here in the US. Might be an option, if you can get it.

ETA but whatever you do, don't apply it after a long hot bath. Or you'll feel like you've been lit on fire (ask me how I know!) It's fine applied to skin-temperature skin, though.

Another edit: looks like it is available in Canada, not sure if it's carried anywhere local to you: http://salonpas.ca/where-to-buy/

[Helene2013]

ah. that is interesting as I know salonpas patches as I have a box given to me by a friend when I had back muscle pain after a false move.

I was looking for that bio freeze at a drugstore tonight and did not see it but did see the salonpas stuff. So I may give it a try next time I go there.

[Helene2013]

Went back to surgeon this past Tuesday. Fracture is now healed. Xrays look good. Yahoo!

I have no restrictions in my training, but must do things progressively. Never push to the point of feeling pain. Inside still needs to heal. My patella slips up/down sometimes when I walk (no pain just a weird feeling) and he checked it all out and said it will be ok once healing is done. I may not feel the swelling but it is still there.

I go back to work as of Monday for 3 days a week for 2 weeks and then 4 days a week for 2 more weeks.

He'll see me back on April 22 and he'll do Synvisc-One injections in my 2 knees. He does not want to do it before as the knee still heals and there will be a lot of "movement" in it until then. So waiting will give me a better chance of getting the best out of the injections.

Tonight I did a 5km on bike trainer. Pushed as far as I could and no pain whatsover. It's nice to do something fun as the past 9 weeks were a pain in the butt. When you are an active person (not only for sports) it's a killer to have to sit so much and avoid walking, putting weight on leg, etc. But it is the price to pay to avoid surgery. Which I'm glad I was able to avoid.

So now I'm getting back in shape. Hoping I have not lost too much with those 9 weeks out of serious training. At least serious in my way. I still have aquatherapy every Friday for 2-3 more weeks. Still do my daily physio, but I can add to it more cycling (with more 10+ watts per week) and some of my training plan pre-accident.

This coming Saturday forecast calls for 11c and sun. So we are getting our Crux ready to ride near home. Our area is flat (beside overpass) so it should not be asking my knees too much. And if I tire or feel some "stretch" in the knee, simply need to turn around and head home. Even if the ride is 30 minutes, it will be very good mentally to get some fresh air. Been stuck on sofa for way too long.

So that is excellent news. Just need to be patient and careful in getting back into shape, careful while walking, etc. Doc said fracture is healed, but still fragile at this stage.

[Pax]

So glad you're healed up and getting back to real life!

[Crankin]

That is wonderful news.

[ny biker]

Great news, Helene. Best wishes for your continuing rehab.

[OakLeaf]

That's great, Helene! Enjoy your ride and keep healing.

[Helene2013]

Thank you.

Today went to my aqua-therapy session. We had a blast. Did some spinning in water, and other water weight toys. Nice 45 minutes of pushing, jogging, etc in water. Hubby joined us in the pool and at some point I could not come back from deep end (doing some jogging/cycling moves with the hand weights). We laughed almost to tears trying to come back to the other end of the pool. It was a good challenge with a type of thing we had in our back (like a buoy) plus the foam weight bar in my hands to do some tricep/bicep work, in the water.

When I got home, I spent time in the yard with our dogs and shoveled snow from one part of the yard to where none was left - it's melting (makes it easier for my blind dog when there are less "bumps" for him to bump into.

No pain in the knee whatsoever. Wanted to go for a short outdoor bike ride tomorrow but winds will be gusting at 42km/h. That will be too much for my knees at this point (well too much for me normally period! hihi). So it will be on trainer I suppose. But that's ok. We're still mid-March and still winter here. So having some nice warmer weather right now is welcoming. Even if it won't last.

[Helene2013]

I am soooo happy. Today it was beautiful and sunny, but forecast called for winds gusting at 42km/h. I'm not good with winds and with this "healed" fracture I should not push my luck.

I did a few things in the house in the morning and was sitting on sofa planning my upcoming summer vacation (thinking Minnesota to meet friends or go back to Nasvhille as we have friends there too). I'm pushing for MN as we have not been there in ages and Nashville been there twice in 3 years already. So many nice places to cycle too in MN. We'll see...

But saw 6 road cyclists go by. That was it. Told hubby to stop the renos he was doing and we're going on the Crux. He was all smile. So we did a 17km ride. It is not much but a lot since I got the ok only last Tuesday from surgeon and only to do thing gradually. I'm an "extremist" and gradually is not a word I understand well. :( :) to me gradually is going from 13km/h to 22km/h in one ride. To surgeon I'm sure it has a different meaning. hihi

I did stay on the small cog between 3-5 gear (easiest). We did ride in residential areas but was able to get a speed of 21-22km/h and when facing winds I was between 15-19km/h. Good enough for me. It was not hard at all, no pulling or pain in the knees. Cardio was good. It got colder as the sun decided to hide mid-way through our ride and we're not that well equiped for such colder weather. So my feet started to get cold when we had about 10 minutes left. Out of 55 minutes, not bad. I'm very happy to realize I have not lost that much since I've been "off" gym for 9 weeks now. I did keep up with physio but it is not the same.

So I think I'll be able to push a notch harder on the trainer bike now. We'll see what my physio says.

Today made up for the past 9 weeks of mixed feeling with this fracture. I feel alive again knowing I can get back to my activities. Yeah.

[Catrin]

Congratulations on your progress! I'm SO glad you are able to get back to your favorite activities :cool:

[Aromig]

So that is excellent news. Just need to be patient and careful in getting back into shape, careful while walking, etc. Doc said fracture is healed, but still fragile at this stage.

So I find that is the HARDEST part of any recuperation -- being patient and not pushing everything immediately because I want to make it up ALL RIGHT NOW! Congrats on the good news!

[Helene2013]

Yesterday was 1st day back at work (progressive). Got beautiful flowers from the team. I had a nice day. Not too hard but I had tired legs after the day. Glad to be on a day off today. Working tomorrow and Thursday and off Friday. Should get better over time.

Did 2 bike rides this past weekend. 17km Saturday and a faster 20km on Sunday. Enjoyed temporary warmer weather as the cold is back. Afterall, it is mid-March and snow to be expected at some point.

Going on trainer now but it will only be 30 minutes max.

[OakLeaf]

So happy for you!

[Helene2013]

Update.
Back to work full-time for a few weeks now. Had synvisc One injected yesterday in both knees.

I can do most everything so far but walk good distances.

I did ask yesterday the surgeon how long it will take to get back to my normal walking without feeling a pull/pain on the right side of the knee since the fracture happened just over 3 months ago. He said to be very honest and serious that some people will never walk normally after such fracture. blah! But it is still "fresh" and we'll see.

I could not do much anyway until I got the Synvisc One since my cartilage is worn out and squatting, etc was sort of painful. So I should see some improvements in the next few weeks on that side. Seeing my PT Monday night so she will be able now to build my gym program now that the fracture has healed (at least functional) and injections are done.

TBC...

[OakLeaf]

Good luck going forward. It's really pretty early, though I know it must seem like forever. You still have a lot of recovering to do - try not to worry.

[Helene2013]

True it seems so long ago but it is not. And now with the Synvisc One injected yesterday that knee is swollen some. Nothing major, but enough to keep me from walking properly. So icing and Aleve again. But at least not painful. Just uncomfy. The other knee has no swelling, nothing. It feels just great. grrr

[Helene2013]

Well since I wrote this many things happened again. Nothing major but important at same time.

After injection, my right knee stayed swollen for about a month. The ortho had wanted to wait a month after I returned to work to get those Synvisc-One so I could get the knees in a "working" mode and see how they reacted once back at work. Well it did not go well. Not like the last time I had injections. The knee did not like being stressed again after the fracture. I had waited 6 weeks instead of the 4 for those synviscone. Should have waited more I think. Anyway, my weight was shifted to the left knee...which started to act up about a month ago. I slowed down my activities, did the my RICE technic, but still went on to do my 60km bike ride challenge (it was 110km but due to high winds and rain and cold I decided to cut it short to avoid more injuries.

Forward to now. I had was lucky enough to call Monday to see my ortho surgeon and get an appointment for 2-3 weeks to check my swelilng and the return of a baker's cyst. I did not want it to rupture like 2 years ago. Anyway, his secretary told me that he was going on vacation soon and appointments would only go end of July so I should not fool around and have the cyst checked out. So I went yesterday (Friday). Talk about good service. So I saw him. He told me that I did all the right things and it was good that I still kept active, all the while listening to my legs. He did not remove the fluids (is not a lot) as he said it would return and it was not hurting me. I do everything but it is just annoying and pain in the b**t. He did a shot of cortisone and told me to apply some Voltaren twice a day instead of taking Naproxen pills that get hard on stomach. If the cyst does not resorb in 3 weeks, he gave me a reference to go to an xray lab and they will remove the liquid in the cyst through ultrasound. But he is confident it should improve by then. He told me to see my PT and she can do me a back knee taping to help the cyst resorb. I was able to get that done at 3pm. So overall... I find myself pretty lucky to get all those specialists in a few hours and it was not an emergency.

He said no cycling for 48 hours. Limit my activities until Monday. Then I can resume...but gently to start of. I can wear an elastic bandage around the knee, but only to walk on longer distances and not to wear while sitting down since I have the taping in the back and it would make it too tight.

The fluid has reduced by half. I was able to walk without any discomfort today. Tonight is a little bit more sensitive but not much.

I go back on Monday night to see PT. She will see if this taping worked and if not, she will do the spider one type.

TBC...

[Pax]

Glad your doc is being so responsive to your needs. Knees are such funny things, you don't notice them... until you do, and then they remain front and center in your thoughts for as long as the healing process takes.

[Helene2013]

Yep. He is very good and I like him a lot. He's very sympathetic and efficient and always with a smile and tender words for you. Not like some mean ones you get to meet once in a while. He's a keeper for sure. He did not want to remove the fluids (not enough to limit my movements because removing it means a surgery. And surgery is always a risk (even if it is only sucking liquid out) of bacterias going in. So the less tempering the better.

It's better for the front knee fluid. Almost gone. I can pratically bend my knee normally. The back of knee (going down the upper leg is much better but at the end of the day, it gets "tired". But I can't complaint. There are so many more people much worst then me on this planet.

But true, any body part...you take for granted until it starts acting out. But I find knees/feet are worst as they limit you much more than an arm.

Oh well.... It's ok. I have a super long weekend coming up next week and I sure hope I'll be able to cycle some. Mostly on flats not to overdo anything.

My taping is holding on very well so I may push my PT of tomorrow night to change the tape to Wed night. I should be able to keep the new one for longer that way.

But lesson learned. If one of my knee freaks out...never bear too much weight on the other one to compensate. Use cane or crutches. Because of my worn out cartilage in both knees, the extra weight on the "better" one during an episode will affect later on the other one.

[Crankin]

Glad you are healing, Helene. It seems like a long road for you!
I woke up this morning with my right knee aching and stiff, after a hilly ride on my "other" bike. Five minutes of icing helped eliminate the pain, but it's a reminder that I need to use easier gears more than I already do.

[Helene2013]

It has been a long road indeed but it could be much worst.

Hoping your knee is better. But still a sign that you'll have to watch out for it. :)

As for me, it is much better today. I guess the combo of cortisone, Voltaren, remaining quiet this weekend, etc paid off. I have no more pain. But I still will stay calm for the next week to give it a chance to heal better. And yes, I will have to be careful on hills as well. Baby steps...again.

[OakLeaf]

Hang in there, Helene.

[azfiddle]

Hang in there Helene. It is so hard to be patient and feel like you're missing out on the things you want to do, and deal with doctors and meds and physical therapy and everything. But it sounds like you're on the right track.

[Helene2013]

I am back to normal. No more swelling, nor pain. I guess SynviscOne also kicked in since I can climb stairs without feeling anything at all.

I know all is very fragile, and will remain for life since the knees are already damaged a lot. So I have to be careful in doing my activities and not overdo on anything.

I tried going for a bike ride last Sunday. It was soooo hot and sticky that after 8km I was back in car and heading to campground while hubby decided to do his route as he is used to that one. After an hour he came back and said he had more than enough. Too hot and hills killed all the fun do to heat. hihi

But I am happy to walk normally for now. It is when something goes "wrong" that you notice how badly you miss the "old" times.

[Pax]

... But I am happy to walk normally for now. It is when something goes "wrong" that you notice how badly you miss the "old" times.

So, so true!!

[Thise1936]

Sorry for you. Get well soon.

[Helene2013]

Yesterday I had my other round of Synvisc-One in both knees.

So far so good. It's been over a year from my tibial plateau fracture and it was time for those injections again.

Swelling is minimal and I can walk normally vs last year. I can resume gym lightly on Monday. Just light spinning to start with.

Surgeon and his assistant were impressed by the "milleage" I put in and training I do to get to my 110km ride in June. He said we should have more people like me that have had injuries and "body part" issues and still going on strong. hihi His assistant said everytime she sees me, I'm her inspiration. haha

He also rarely sees a trainer like mine that will ask the client/patient to tone down on the training a few days prior to injections. It makes a difference when getting to the hospital with a knee relaxed vs from asking too much the night before.

So for now, it is good and it feels so nice to go up the stairs and feel no pain from the knee joints. He says I can go back in 6 months if I feel the need it there, if not, whenever I'm ready I will be able to grab the injection boxes at the drugstore and take an appointment and he'll do them again. He already gave me the prescription paper so I don't waste time going back to the hospital ortho clinic to pick it up.

[Catrin]

So glad to hear that things went better this time, and you're feeling better!

[ny biker]

Yes, glad it went well!

[Crankin]

That's great, Helene.

[Helene2013]

It's been going on 5 days post-injections. Left knee is ok, right is still a little swollen on the outside but I can walk normally. I shoveled snow (it was very light) a good 4 hours yesterday and no knee pain. Fun to climb stairs and not feel that "sharp" pain in the knees. I resume cycling on trainer 2 days ago for a good 25 minutes (no hard gearing) but still a a cadence between 80-88. Going tonight for some more. So this time, injections are not bad compared to last time a year ago. Physio said I should be able to resume muscle training next Monday. Until then, just light but steady and increase in duration cycling. Yeah.

[Catrin]

Glad to hear positive results!

[Helene2013]

It's been 2 weeks since the injections of both knees.

Of course all cannot always go well, or as we'd wish. So the knees did swell some, but never like last year's injections post fracture.

But what a pain it is not to be able to resume your life and wonder how long it would take. One knee (the one that was fractured last year) felt unstable and the other I felt like their was a baker's cyst behind. I could not do much but RICE but still needed to work. argh. I can't afford (not for money but too much work) to miss work.

Finally all is good and it feels so good to be able to climb stairs properly. I was able to get back on trainer yesterday and cycle my life away. hihi

We'll see how long those injections will last in the knee. I'm not looking forward for another round of SynviscOne but they are working well so it may be worth the "little" problems it can create if only for 10 days.