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obie

Physical Therapy

I'm interested to know about recovery exercises/programs used by people who have successfully recovered from a broken leg.

Went down on 9/5 in Lone Pine on my MTB.  The surgery went well and my orthopedist said things look good for a full recovery in 8-12 months.  He said I'll need the boot and crutches for another 6 weeks.  Until then I'm  limited to leg lifts, stretching and moderate walks outside.  Water exercise was also recommended.

I can't afford a physical therapist.  My recovery will be built around any research I can do online and from what others have experienced themselves.

Any specific exercises or recommendations would certainly be welcome.

Thanks.
Bill

Re: Physical Therapy

obie wrote:
I'm interested to know about recovery exercises/programs used by people who have successfully recovered from a broken leg.

Went down on 9/5 in Lone Pine on my MTB. The surgery went well and my orthopedist said things look good for a full recovery in 8-12 months. He said I'll need the boot and crutches for another 6 weeks. Until then I'm limited to leg lifts, stretching and moderate walks outside. Water exercise was also recommended.

I can't afford a physical therapist. My recovery will be built around any research I can do online and from what others have experienced themselves.

Any specific exercises or recommendations would certainly be welcome.

Thanks.
I had a Tibial Osteotomy a few years ago, and I highly recommend the pool/water exercise as the best.  There are resistence exercise, and cardio which can be performed fairly early on which are low impact, and excellent for that purpose.  I also recommend push-ups, sit-ups and pull-ups, all of which increase metabolism and promote healing.  Make sure you maintain good nutrition including calcium (drink your milk)  I did all that stuff and healed pretty quickly.  Good luck! Cool
obie

Re: Physical Therapy

Quote:
I had a Tibial Osteotomy a few years ago, and I highly recommend the pool/water exercise as the best. There are resistence exercise, and cardio which can be performed fairly early on which are low impact, and excellent for that purpose. I also recommend push-ups, sit-ups and pull-ups, all of which increase metabolism and promote healing. Make sure you maintain good nutrition including calcium (drink your milk) I did all that stuff and healed pretty quickly. Good luck! Cool


thanks. I have a small a lat-pulldown set-up on my weight bench and have been working that daily. Good thought on the pushups, tho, I'm still a ways off on putting pressure on the bad leg.

Free weights, some yoga and light spinning on the trainer are in the mix too.
RichardK

Re: Physical Therapy

obie wrote:

I can't afford a physical therapist.


Check your health insurance.  It may pay for some visits to a physical therapist.  I had knee issues several years ago when I had Cigna PPO through my then employer.  They paid for 60 PT sessions per year.
obie

This simple little gadget is great. Respiratory therapists had me working this everyday in hospital. 75-100 reps per day. Builds lung power back up.


Incentive Spirometer:

http://www.amazon.com/dp/B002NHKE...95105&creativeASIN=B002NHKE54
obie

It has been 10 weeks since surgery (10" s.s. plate and 13 screws for a major spiral fracture of the tibia.) Xrays last week showed good healing, plate correctly aligned and so forth.

I've started "50% weight-bearing walking", which is basically putting more weight down on the foot while still using the boot and crutches.

The doc said I could increase the duration and intensity of the cycling. I'm now doing between 2-3 hrs. daily on the bike. Gearing starts at 30/28 and moves to 53/18, 53/14. Good progress here - my leg shape is improving - finally. The calf is still very underdeveloped but I can feel/see some toning in the overall lower leg area. Ankle swelling has decreased some but the discoloration is still there and flexibility in the joint is poor.

Adding a book holder to the bike handlebars was a good move. It's nice to be able to get lost in a book while spinning long duration...and a live stream of music off the web. Spinning beyond an hour is quite boring no matter what distractions I have.

I could not find a pool that was convenient & affordable. So, when I asked for an opinion on my self-researched recovery program, my doctor (Dr. Scott Forman/California Orthopaedic Specialists in Newport Beach)said my current program of spinning, yoga and upper body weight training seems to be working well and commended me on making very good progress on my own. (I can't tell you how relieved I was to hear that!)

The doctor feels though that the pool work would accelerate the skin regeneration. As an alternative to that he recommended a massage tool, to not only help with skin regeneration but to aid in muscle regenertion. I use a soft spike rubber ball on a stick that works fine. I also scrub the leg in the shower each nite with a good, stiff, natural bristle brush. This is great - the skin appearance is improving markedly in the past two weeks. (I looked into EMS therapy for muscle stimulation but found the cost of the machine ($400.00) a bit much for me as well as clinic sessions. It appears that this is a popular tool in muscle stimulation for athletes.)

Current projections: walking with the boot but w/o crutches: early December (three months out from surgery)

Riding the bike: January.

Reserved a camp site in JTree (Indian Cove) for mid-January. Bringing two MTB's. We're planning on 2-3 days of camping, hiking and riding. Totally focused - making this reservation/commitment really boosted my spirits. Having something fun and exciting to look forward to in the not too distant future is great therapy in and of itself!

T/R to follow. Smile
Bill

Cool
obie

11 weeks after surgery:

Started walking w/o the crutches today. Wearing the boot.

First few forays across the room were awkward - holding back on full pressure on repaired leg makes for slow going. Doc's assistant tells me that 'big plate in there will keep everything together - go for it"...uh, ok.

Ankle still swollen/ locked up. Cindy Abbott said ankle flexibility was still a problem for her 6 months out from surgery. Hiking a problem probably till then but right now pedaling the bike is no problem despite 'lock-up'.

Calf muscles starting to show some life: veins popping out after long session on bike. Three hours on bike yesterday with approx. 90 mins. of that in 53-11 gearing. The rollers are maxed out - need to put a towel under back set to give more resistance. Daily workouts of yoga, lifting, bike = 5hrs.daily.

Will start long walks along the beach, possibly w/o the boot to give the foot more flex work. Problem is that I have a flat arch on foot and generally can't do much walking without two arch supports in my shoe, so this will be interesting.

Next appt.with doc and new xrays in two weeks and, hopefully, back to work and road cycling then.
Rick Kent

Sounds like progress Obie!

6 weeks for me tommorow.  Next appointment is Tues.  Guess I need to start figuring out how to get some exercise.  I've done absolutely nothing.  I hope they take this damn cast off and give me something else.  Ankle feels good.  Feels like I could start putting some weight on it.  I can tell I've lost quite a bit of muscle mass.
Rick Kent

Hey Obie, are you using an exercise bike or one of the trainers for an existing bike?  I'm thinking I should probably get one or the other.
obie

Rick Kent wrote:
Hey Obie, are you using an exercise bike or one of the trainers for an existing bike? I'm thinking I should probably get one or the other.


Hi Rick.

I have rollers.

http://www.youtube.com/watch?v=MiCdm5FsJpg

For this rehab I cut the legs down on a sawhorse and attached the front fork to same.  Exercise bikes and/or a trainer would probably give you more resistance and, more noise.  Try one at a bike shop first - the inexpensive ones can be quite noisy.  Rollers are a better workout but, with a major injury, not exactly what you want to be using for the first couple of months. Very Happy

I work outside so I had to get moving with the rehab quickly.  After walking around for a few hours today I know I have to get on with more yoga to loosen the ankle.  It's awkward with the boot but, I haven't been able to get a shoe on yet.  Can ride my MTB though.  Felt great to be outside and mobile again.

Good luck!
Rick Kent

Thanks Obie!

I found a friend who has a trainer so I'll give that a try and see how it works.
obie

Beats riding indoors.  

Working on getting the ankle to fit in a riding shoe...still swollen a bit.  The boot's gotta go.

obie

Took a bit of a setback yesterday but, I think it's not too serious.   My ankle is pretty sore and I've been icing it 5-6x/day.  C.Abbott said she had to push through this stage with walking and icing, so I'm not too worried yet.  The swelling is still there and it throbs a bit at nite - tho I'm glad to be sleeping w/o the boot these past few weeks.

I've been doing more walking w/o the boot in the house and, also longer walks outside with the boot.  A couple rides on the MTB up/down the street and 2-3 hrs. a day on the rollers. I think I overdid it yesterday by adding in a trip to the new REI in Tustin to see Cindy's slide lecture.  I was hobbling through that one -  I did too much walking.

Big lift to your spirits when you see/hear Cindy's story.  I'll never complain.  

Thanks to Cindy & Larry - there was some great energy in that room! Very Happy
obie



Everythings holding up. Met with the doc today and he gave me the go ahead to return to work next week.

Wants me to wear a compression sock all the time. I have one already that I've been using after long rides/hikes. It's the proper strength he prescribed (15-20mmHG). I use the 2XU compression products - they're pretty good quality and popular with endurance cyclists.


www.2xu.com

He's pushing me to do some pool work. I'll bring my 4/3 wetsuit with me during the week and jump in the ocean or a customer's pool. He said I need to work different muscles than I'm currently doing with the bike rollers.

The soft tissue/venous flow issue in the ankle he said could continue for another year. My ankle feels like it's always sprained. Not much to be done outside of elevation and wearing the compression sock. It doesn't bother me at all on the bike, when I put pressure on the foot then things get sketchy.

Psyched.


(There's 13 screws there...you need to see both front/sideviews to get the full capture. From what I've seen lately, my 10" of s.s and the 13 roofing screws still have me comfortably out front in the 'Screw Brothers' competition on WPSMB) Smile[/url]
Z

cool pic Smile
obie

Swimming:   Three Things I Wish I Knew Sooner


1.  The doctor said it's good for you.   More so than I could imagine.

2.  Meet other old busted up surfers, sailers, bikers and hikers - collect and compare war stories for further 'Legend Enhancement'.

3.  Meet many glorious, athletic, outgoing WOMEN who thrive in the water and the sun.  HOW DID I MISS THIS PART for the last three months?



Get thee to a heated, communitypool and jump in...you will be surprised how inspired one feels to step up the rehab as you enjoy the scenery. Very Happy
Rick Kent

8 weeks for me today.  I still have some swelling in the foot which makes it painful to try and walk but I assume that's pretty typical.  Although I'm probably supposed to be keeping the boot on I haven't been using it much lately.

I got on my mountain bike yesterday and rode it around the block a couple of times.  Just like Obie mentioned I had no trouble with this at all and for the first time in 8 weeks I felt totally normal at least while riding the bike.  

Feeling cocky I decided to go to the grocery store today.  I figured I could just grab hold of a cart and then use it to walk around with.  Sounded like that would be easy.  Yeah I know they have motorized thingys availble but real men would rather walk on bloody stumps than use those (heh).  Ok so I thought walking behind a cart would be easy.  Holy hell!  That turned out to be quite an experience.  I survived but it was the most painful thing I've done so far.  Oh and yeah I wasn't using the boot.  Anyway I forced my way up and down every single aisle.  This resulted in more strain and stretching than any of the PT exercises I've been doing.  I forced myself to relax and it kinda felt good even though it was hard.  Unloading the groceries at home using one crutch was also challenging especially since by then the foot was stiff.

Gave it a cold soak and a few hours later I ventured over to Walmart (an adventure even when healthy) to grab a new phone.  Used one crutch (again without the boot).  Slow going but again I made it.

Received my stationary bike yesterday too.  It's a cheap one and doesn't offer near the resistence of the one I used a couple times at the gym but it will be more convenient.

All in all it seemed to be a pretty good day.  Most of this week I felt like I was losing ground.  Despite (or perhaps because of) the PT my foot had been stiff and painful.  More frequent cold soaks seem to be helping.  I keep alternating between one crutch, two crutches, and the boot on and off.

My left knee is a bit tweaked right now which doesn't help.  This was in part due to pushing it on the exercise bike after not using the leg for so long.  Also, walking goofy with one crutch transfers stress to the knee.  I have to conciously force myself to walk as to normal as possible.  It's hard to do.

I've been back at work for 3 or 4 weeks.  I've been using a temporary downstairs office but might try to move back up to my regular office next week.  Actually kinda feels good to go up and down the stairs.

I have no idea how much longer I'll need the crutches but certainly it's going to be a while longer.  I tried my trekking poles out today but those didn't work as well as I hoped.  I still need to build up the ankle more.

Alright, I need to find these women that Obie talks about.

-Rick
obie

Good going Rick.  You're moving fast - I couldn't handle the grocery cart routine until two weeks ago.  

The ankle issues are tough but, it is great to be at least able to ride a bike.  I'm psyched about swimming now.  My legs were bombed after one hour of laps yesterday.  

I can see more definition in the ankle - whether that's all from the water exercise or not I don't know.  My doctor had been pushing me to get in the pool from day 1 after surgery.  It was dicey for a bit - worried that I might get tangled up with another swimmer and, might wreck havoc on my ankle.  The more I swim, though, the looser the ankle gets.  So, I put a fin on the good leg and use those small hand discs and can move pretty well now.  I found that without the fin on the good leg I was not floating/moving well enough.  The float pads work well too but, there's certainly a better workout if you can manage to free swim.

Heading back to work next week - it's been three months since surgery.
Rick Kent

I say we go 2 more weeks and then have a race up Iron Mountain!

ha!
obie

Rick Kent wrote:
I say we go 2 more weeks and then have a race up Iron Mountain!

ha!


OK...if we can make this a duathalon and, add a MTB sprint from Baldy Village to the top of Lift#4. Wink


I left the boot behind today and am making it a point now to heel/toe it all the time - no more limping and no more boot....finally.

Swimming is great - another hour of laps today and. also just hanging in deep end corner and kicking with the weak leg....feels great.

I need to get back to my normal weight - should help ankle problems. I gained 16 pds. in the last three months.
obie

Good workouts in the pool the past three days, plus some job work = I'm feeling better in the ankle and but my agility and overall leg strength is sketchy.  Can't pivot or move quickly on the bad leg yet so I have to be careful in close quarters work - plan each step and leave yourself some room to topple over so as to not overflex the bad ankle.  Work will get done but it's going to take longer.  

Dropping the fins and hand things and just swimming is a lot of work on the legs and glutes.  I can see more definition in the calf now and I'm a lot more encouraged that I can build my legs back up again.

The people who can crank 45-60 mins. of nonstop laps are in fine shape.  I haven't tried to swim in fresh water for 30+ years...and it shows.  Swimming's a great way to get/maintain fitness.  I'm a new convert.  There's a lot of technique to work on...I wish the city could afford some coaching and rehab help but, at this time and, in this economy, I'm just happy to have a nice heated pool to swim in.

Tried some 15-20% incline work afterwards.  That's a good way to mark progress.  I couldn't heel/toe down that ramp a week ago and now I can 'shuffle' down with a bit more flex.  Ski Hut trail is my Everest now.

Going camping at JTree next week.  Will give it a go on the bike and on foot for Xmas day.  Hell, kicking back near a fire, bustin' out a few Sierra Nevada's and a few smors will seem like Heaven on Earth after these past three months!
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