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Knee brace after Tibial plateau surgery

 Poster: A snowHead
Poster: A snowHead
In march i managed to break the top of my tibia, ACL and MCL are fine, had the surgery and now looking for best knee brace for the tibial support...any suggestions. Or do i not actually need a brace ?
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
yorkshirelad, what does your surgeon/physio say? Do you mean for skiing out generally? Were you in a brace post-surgery?
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Well, the person's real but it's just a made up name, see?
Surgen said nothing!! Wore knee brace for two days and did not need it. Start weight bearing next week, looking for brace for skiing ...all seem to be for acl damage etc.
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yorkshirelad, you are still a good way from having to consider your options. there is every chance you'll make a good recovery, many folk here.do (I'm hoping to be one of them). In your position I would be taking to my physio about the best programme to give you as much chance as possible of recovering strength and stability
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yorkshirelad, I'm not sure why you think you'll be needing a brace .
a brace can in most cases offer a little support and stability but only a bit.

you need to work with your physio to strengthen or stretch the relevant muscles to properly stabilize the knee.

assuming the break heals nicely and you've no other damage, there's no reason you shouldn't be back.

sadly I can't give you any timescale though, I'm sure Mr Bell will know more on that side of things
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yorkshirelad, wot he ^^^^ said.

I would wait and see what is advised by your physio. Getting dependent on a brace is a bad thing (and I'm speaking from personal experience), it becomes nothing more than a psychological crutch. Far better to work on intensive rehab to ensure top fitness and excellent muscle and proprioception.
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Then you can post your own questions or snow reports...
Physio was a waste of time to be honest, hoped for a lot more from private sector, anyway, wife is sports injury massage so she has got my leg moving nicely. I dont think i will need a brace for skiing but i dont want to fall and damage recovered joint on first day out. Hence a " comfort" brace. But i also dont want to pay 500 quid for a brace i may not need.
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
yorkshirelad, you say you are not even weight being yet, at that stage physio is limited to retaining some muscle tone and flexibility. The real work can start next week. I suggest you find a better physio, explain what you want to achieve and work hard on the programme. I had my op 3 weeks ago, physio can only be quad crunches, knee bends and leg lifts basically. Do you have full knee extension and can you bend your knee normally, i.e. can you touch your bum with your heel? If not you need to work on that otherwise you will compromise normal life (a limp) never mind skiing.

I am working with my physio to move to exercise bike, gym work and maybe hydro therapy in a few weeks time when I am partial weight bearing. I don't think there is any alternative (I broke mine quite badly), I will only get a result commensurate with the amount if effort I am prepared to put in, which us a bit of a PITA as I am a lazy cow really.
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been to see Sports injury therapist monday and tuesday, will be going again tonight, so far the knee is about 75 degrees bent , hoping for 90 degrees before weekend, going on the cycle machine only to help release the tight quads etc...can't get the pedal above '9 o'clock' yet but working on it. but as you say it can't be rushed. although no pain its so tight to move....then again my leg was imobalised for nearly 6 weeks, !!
I'm lucky that my ACL and MAL were not damaged. My weight bearing starts on Monday, hopefully the physio will have more information with him about my op and how far he thinks he can push it, but he seems to have ne experience in massage techniques to help release muscle !!
re Lazy cow...lol....it's difficult for me to motivate myself, but once in the treatment room i'm off !! then to the pub
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yorkshirelad, I've got to about 85 degrees this morning and aiming to move to 120 degrees at the end of next week,

I'm interested in why you say ' massage technique to release muscle', what are you feeling that makes you think muscle needs 'releasing'? I had little enough muscle before and even less now so I'm not really familiar with this feeling, and I've never had a masage any more taxing than at the spa after I've had a facial wink
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My muscles are pretty well in tact, when i try to bend my knee though it is stopped by the tight quad muscles, one technique been used on me is the press and release, .........
push leg as far as you can and you can find the tight area, then release,
then put pressure on tight spot and use muscle again, it should move further than before,
then release the pressure, voila!! More movement.

Sports injury massage is working far better that the physio.... Physio just stands and watches me !!! No physical contact
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And love to help out and answer questions and of course, read each other's snow reports.
Hi Yorkshirelad,
I am 14 days post operation for ACL replacement with patella tendon graft. My Surgeon and Physio tell me that expectation is to make a full recovery, and will be able to ski without a brace.

To your original question I skied this year 12 days on what (I now know) was a ruptured ACL. (got a wrong diagnosis even after an MRI) I wore a brace the Mueller Hg80 Hinged Knee Brace with Kevlar Medium, light weight, breathable, seemed to give great support, not bulky and didn't budge an inch during a full day skiing.
Having said all that, I am not sure how much support I was actually getting from it, but what it did do was give me great feedback from my knee which is somewhat missing without an ACL.

Wakkitt
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So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
sadly that is true of many physios now.
they no longer get taught the soft tissue techniques that they used too.

I've spoken to quite a few physios recently that are having to take extra training to get them to be able to actually treat people.
far too many of them assess you and send you away with stretches and exercises to do.
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 You know it makes sense.
You know it makes sense.
Neville...how true, fortunately i have a full time personal sports injury therapist to help me ( the wife!!) so im lucky.
Would always go to sports injury therapist rather than physio, but it was on my private health so i thought whats to lose ??

So .....Sounds like i dont need a brace...but wife thinks it will help support knee if i do fall again!!!
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
yorkshirelad, thanks. I don't think my quads are stopping any movement ( there is no tightness there), it feels more the tightness inside my knee which needs to gently stretch a little further and further (which it has from 40 degrees last week - too easy - to 70 degrees yesterday, also pretty easy, but getting from 70 to 90 is harder)

My private physio is sports injury and does hands-on work so I'm happy with that. NHS physio basically just gave me the sheet of exercises.
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 Poster: A snowHead
Poster: A snowHead
holidayloverxx, my knee seems to be reaching same point now, this afternoon the knee was very tight in the whole joint. Could not get any improvement on yesterdays session. Knee a tad swollen as well so resting it tonight. No rush, not skiing again till 20th january wink
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
yorkshirelad,

Tibial plateau fractures vary in their severity, so the advice will depend on the fracture pattern, it's site and severity. It will also depend how well it has been fixed. In the absence of ligament injury I doubt there is any point budgeting for a brace.

Your surgeon should have prescribed the outline of the rehab programme or sent you to a physio who would know what to do without a lot of detail.

Physio.

I would not expect a sports masseuse to be able to adequately rehab a tibial plateau fracture through to full recovery. However soft tissue release techniques can be a useful adjunct if there is a lot of swelling early on. They can be also useful if there is a lot of spasm in the muscles and fear of getting the knee moving. I have seen many tibial plateau fractures rehabilitated without massage but it can be helpful.


There is a problem in physio.

They have historically been very poor at protecting their title so just about anyone in the world of sports injury has tried to pass themself off as a physio,the perception of physio has not been helped by this.

Lack of senior supervision for juniors in the NHS.

Too many physios trained during last government ( remember widening participation where everyone should go to university) without any hope of a training job in the NHS.

As a result many have ended up in the private sector which now has an oversupply of inexperienced physios. Insurers have used this oversupply to drive down prices by directing patients to whoever will do the work for the cheapest. Not surprisingly quality is suffering.

A competent physio will be able to deal with the swelling, muscle spasm, restricted movement and may well use soft tissue release, stretches and exercise prescription but you will need to seek them out. You may also find they aren't the ones recommended by the insurer because if they are busy they will not have reduced their prices to rock bottom.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Jonathan Bell, nail on the head there ...

wife has now done as much soft tissue work that she feels can be done, the range of movement has improved but knee still swollen, so lettng it reduce a bit more, before any 'severe' treatment.

re the surgeon.....went private intially until the private hospital realised that the knee surgery required was beyond their scope, so the consultant refered me to another chap, who then said it would be best to treat me via the NHS but under him, as there he had a better tool kit and a bone bank to call upon, but Once out of plaster though i have had no input from the surgeon, no referel to a Physio either, i had to arrange that. so flying a bit blind at the moment on how far we can push the knee etc... not in a rush but don't want to leave it too long and lose movement in the futrue due to lack of early treatment.

re the Brace, I was hoping that i did not need one, as the ones i was looking at were nealry £500....nealry pays for a weeks skiing in bulgaria !! lol
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yorkshirelad,

It amazing how many surgeon don't realise that they can get much better results if only they accepted that rehab can make a huge difference.

Shame on him/her. You really need at least some red lines on what you can and can't do so that at least you can pass them onto a physio. Unless some exceptional reasons, you need to see physio straight away. I would go back to him with a list of when you can weight bear, start moving, swim, cycle etc


Last edited by You need to Login to know who's really who. on Sun 28-04-13 6:58; edited 1 time in total
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Saw the physio on monday....said there was not a lot he could do apart from instructions on what i should do until this coming monday when i start weight bearing !!! So if he us not any good i will be seeing chap who treated the cricketer darren gough !!
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wakkitt wrote:


To your original question I skied this year 12 days on what (I now know) was a ruptured ACL. (got a wrong diagnosis even after an MRI)


If doctors rely on MRI as an "electronic doctor" they will frequently under diagnose ACL injury, they will also grade MCL injuries as less severe. For this reason do not use MRI to diagnose ACL rupture.
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Well, so far its 12 weeks post op today, and it's been 4 weeks full weight bearing, but knee still only 75 degrees, although i do walk ok now.

apparently the knee tendons had gone fiborous !!
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
13 weeks post op and knee at 90 degrees if given slight encourgement, now able to do full revolutions on static bike, hopefully put some resistance on next week.
Physio delighted at my progress so i'm happy there, he see's no reason in me not to be able to ski in january, although i may need a letter from surgeon to clear me, and at the moment he is being very very cautious !! seeing him wednesday for check up...don't see why as not booked me in for x-ray !!
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