# question regarding my broken tibia plateau...



## sriracha (Jun 23, 2004)

thanks for all the replies on this thread:
http://forums.mtbr.com/showthread.php?t=238535

but now i have a specific question regarding tibia plateau recovery, which i completely underestimated.
i'm at 3 months from injury. i've been doing physical therapy for 6 weeks. one week into weight bearing. getting range of motion back is a total beeotch! i'm currently at 108 degrees of max bend.
my question is, approximately how long does it take to get max range of motion back?

right now i'm not even close to a full revolution on a normal bike. i can spin a recumbant stationary bike tho. when (if ever it seems) will i get my range back so that i can ride a mountain bike again??? and if i do ride again, will this injury bother and haunt me for the rest of my life?
thanks.


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## BoiseBoy (Mar 1, 2006)

*Patience little grasshopper*



sriracha said:


> thanks for all the replies on this thread:
> http://forums.mtbr.com/showthread.php?t=238535
> 
> but now i have a specific question regarding tibia plateau recovery, which i completely underestimated.
> ...


Impossible to give you an exact date. There are too many varialbes involved.
Degree of injury/Fx, hardware, surgical procedure, age, health, smoker, diet, inflammation, edema, ifection, pain tolerance, complience, skill of PT.......

Keep on stretching and mobilizing the heck out of it, ice it often if it gets sore/inflamed/swollen after your sessions/workouts. Use your meds before your visits if pain is a significant factor/limitation.

You need to take into consideration that you were likely imobilized for some period of time and probably NWB for a couple of months. What happens to your legs on a long road trip as you step out of the car for the first time. S-T-I-F-F! Now multiply that by weeks!

At 108 deg of flexion, you must be getting farily close to a full revolution! Just keep after it.
I had a pt recently who was in a similar situation, but a bit worse as she had about a chunk of cartilage the size of your thumb nail chip off of the femoral condyle as well.
We completely hit a plateau and I had her continue in our gym independantly and about a month later now she has full patellar mobility and full ROM. It just takes time.

Good luck and keep with it.


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## rob_s (Sep 18, 2006)

I have been weight bearing now for three months and still can not extend my knee completely straight. My doc has said that I shouldn't expect to be able to ever lock my knee again. He tried to do it in his office and couldn't get it straight. It still gets stiff on longer rides which for me now is over three hours. I have done a few 4+ hour road rides recently that have left me stiff for the remainder of the day. Keep at it and it will get better, but realize that you may find that you can't do some things anymore. It does cause a little bit of latteral instability once in a while but I never notice it while riding. 

Now for the positive stuff, you will get your strength back and surprisingly fast if you work out right. At two months of weight bearing I did a 58 mile road ride that had over 4,400 feet of climbing with a couple 17% grades and severarl 14-15% grades. It was hard but I made it and completed every climb. On the mountain bike I have done a couple rides that prior to the accident I would have had a difficult time with the drop offs and such. You will get healthy and strong, just give it time and keep working at it.


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## MartinS (Jan 31, 2004)

I found Physio was the biggest help in getting back range of motion, I shattered my plateau and it took about 9 months to get close to full motion back, but it is pretty good now.


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## sriracha (Jun 23, 2004)

MartinS said:


> I found Physio was the biggest help in getting back range of motion, I shattered my plateau and it took about 9 months to get close to full motion back, but it is pretty good now.


wow. i had no idea this injury took so long to recover from. gaining range of motion is a slooow and painfull process.


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## sriracha (Jun 23, 2004)

sriracha said:


> wow. i had no idea this injury took so long to recover from. gaining range of motion is a slooow and painfull process.


so, it's now feb 23rd, 4 1/2 months since i broke myself. 3 months into physical therapy, and i'm stuck at a range of motion plateau of 110-115 degrees of bend. i can straighten my leg pretty good (good enough), but i have been at this 110+/- range for 6 weeks.
i visited my ortho surgeon yesterday, and he said that i should have greater range of motion by now and something is wrong. upon inspection, he concluded that i have two golf ball sized lumps of scar tissue on either side of my knee/tibia.
these giant scar growths have been causing a lot of pain and restricting movement.
one is under my patela tendon, and every time i bend my knee, i feel the tendon moving over the scar tissue. this does not feel good, to say the least.

my ortho-surgeon wants to go in there, orthoscopically, and trim away at this scar tissue. his plan is to trim, bend, trim and bend my knee untill it bends to 125-130 degrees on the operating table.
i'm going in on march 2nd for the procedure. hopefully this is the solution, and i achieve greater movement in my knee. not looking forward to the soreness and pain from this.

is this a viable solution? i don't think it's uncommon to trim up scar tissue from knee injuries.
anyways, just an update.


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## washedup (Jan 2, 2006)

I had this exact procedure done 11 years ago after breaking my tibia plateau and had a total knee reconstuction. I went to PT and worked really hard and reached a point where I wasnt getting anymore motion. All I remember was waking up in my room after the procedure to remove the scar tissue, which I belive was about 3-4 months after my first procedure, with that machine that constantly bends your knee moving my knee at almost full flex. I felt so good I literally got up out of bed and walked w/o help of cane or crutches to the bathroom. (results may vary) It took me about 9 months to begin racing again and recover 90-95%, which is where I still am. Getting those muscles back into shape is probably the hardest part. I get quite a bit of grinding in there when I squat down these days, but I guess that is the price to play. I have put in some 40+ mile days and am still able to get on the bike the next day. I also work on my feet and it doesn't bother me there either, but the hip is another story. Try to stay motivated and positive. Dont get frustrated on the bad days.


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## MartinS (Jan 31, 2004)

Yeah, it will take a while, just keep at it and good luck with the surgery! My leg feels pretty good since getting my plate removed a month ago, the constant ache is reduced and in another 2 weeks I should be able to XC ski - if there is any snow left...
I don't know how bad your injury was, in my case I pushed 60% of the plateau down 2 cm and it looked like a jigsaw puzzle, got an ortho in North Vanc. that is a sports specialist and works with the Canuck ski team. He did a fantastic job and got the plateau totally level, and luckily I didn't damage the cartilage or muscles. With any injury like this in the long term prognosis you will have a very good chance of developing arthritis, start chugging the Glucosamine!!
At the end of it you will really appreciate any and every ride more than you used to though, I still remember my first slow ride afterwards as one of my best ever, although I have cut back on the high flying antics and have decided to stay off the skinnies as they are a great place to do plateau damage.


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## Pilot (Mar 1, 2004)

As you know, I am just starting on my recovery from the same kind of fracture. My ortho has been saying from the start that arthroscopic surgery is in my future. It is common for the scar tissue to impede knee motion, so they often need to remove some of it. Also, they can repair any damage to the meniscus or ligaments. 

Sorry to hear that you are still off the bike. But, I think the arthoscopy should help get you back in the game quickly.


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## Madmaxx (Oct 12, 2005)

*bummer*

going under the knife is the only way to fix big ligament damage, they don't self heal because blood no longer circulates through them after they tear. But cool things are being done with ortho so that you'll be back as fast as possible. The trick is to mobilize it as much and as often as you can, ice to stop inflammation, and avoid heat (b/c that causes inflammation...no hot tubs, no-matter what you hear. Your body heals in respect to the specific way you rehab it. If you are trying to rehab yourself back riding, stay on the recumbant bike and keep working that range of motion at low intensity. One of the best sports rehab physical therapists is Gary Grey/Gray. If you can get access to his Tweakeology vidoes (which are expensive unless you work around it), they can tell you a lot of really great things to do to speed up your recovery. I've interning at an athletic performance gym here in Austin and we watch and read everything by G.G. as soon as it comes out. Some of that stuff is really helpfull, even for after you recover to prevent furture injury.
-Max


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## sriracha (Jun 23, 2004)

thanks for the responses and input, everyone.

well, i went thru with the manipulation. dr. gainor went in, arthroscopically and removed "a lot of scar tissue". he was able to get full range of motion on the operating table, without much resistance.

i've spent the last 4 days since surgeury, in an oxycodone induced daze, aggressively doing physical therapy. i've made a huge jump in range of motion from 110 degrees (before) to 130+ (after). so far, most of my internal knee pain has dissapeared, and it seems to be smoother. now, my quad muscle is killing me, as it has been stretched greatly to accomodate the increase in range of motion. seems as if the manipulation was successfull and has given me new optimism in my recovery.
i'm back on the bike, now, gently cruizing around to loosen up the knee and quad. been doing a lot of stretching, bending and icing. i think i'm on the home stretch.

check the pic:


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## MartinS (Jan 31, 2004)

Good to hear!
I recently went to physio for the first time in 1 1/2 years and they said my range of motion was only 2 degrees less on my bad leg than my good leg, can't complain about that!
The snow up here is starting to melt, I'm looking forward to riding outside myself and testing out my tibia without the hardware! 
Sitting on a trainer inside sucks, hard to get motivated.
Good luck!


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