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Pilon Fracture? return to ski?

 Poster: A snowHead
Poster: A snowHead
Hi All

I am 8 months down the line after a Pilon fracture of the ankle suffered skiing Dec 23rd 13 (yes the last run of the day I Know ha ha) - a long and at times a dark road -more depressing that fact I missed the best snow on record at Madesimo last season. I'm full weight bearing doing pool and bike exercise's in the gym, but walking still painful and a lot of stiffness in the ankle joint - any feedback appreciated on when and how anyone returned back to ski - as my consultant has left me unsure of if? when? that's going to be possible. Any advice most welcome - the thought of not being able to ski - is just crazy -so got to keep positive and wait for that unforgettable feeling of clipping in my skis and off we go - its my passion -my job -its not going to rob me of that!!!
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
bella ski Italia,

Difficult to be precise without " knowing" your fracture but pilon fractures are, as you know, serious.

It will depend in a number of factors besides the pattern and severity if injury but ultimately comes to how hard you can push your rehab.

If fixed well the worst pain will tend to settle by a year . It may however still swell after activity.

At present I would prioritise range of movement so that as the leg takes more load you have the range and suppleness already sorted out.

Getting a ski boot on is diff. With a stiff ankle.

As a rough guide if you can tolerate a gentle jog you should be almost certainly fine to ski , but may be able to tolerate some skiing earlier.

If you are not getting any guidance from the surgeon you could just try and build activity listening to what the ankle tells you but only do that if surgeon says fracture has united.
Start swim then bike or cross trainer then add in walking ,then stepper, skipping, hopping and then jogging.
Jonathan Bell
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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?
Dear Jonathan

Thank you very much for your response and obviously very knowledgeable on this subject and your advice much appreciated.
As quoted from my consultant - it was a bad fracture in 4 places but not displaced - so after much deliberation he took the non operative route ie plaster cast's -air boot etc. In May told to FWB as tolerated - I started pool running and exercise bike -which I continued to do - through good and bad days never pain free - walked a mile or so with increased limp but not that much increased swelling.
I had my final visit to the hospital clinic and signed off by a different consultant just reading my notes? at the beginning of August and told -not to do too much and not push it to much?? totally confused all he could tell me was to avoid high impact activities though the bones have healed ok and there was nothing else they could do.
I am a distance off jogging just yet - but I will heed your advice as a barometer on that and make that my new target to get back skiing.

many thanks again
regards
Phil
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bella ski Italia, are you going to physio? I find it invaluable (after tibial plateau fracture) for knowing when to push harder and when its sensible to ease off. I wouldn't have got back to skiing as soon as I did without it.
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
Hi Holidaylover
thanks for the response
Yes I am having physio once a week at the moment - I know exactly what you mean -push to hard and you pay for it, its a very difficult balance, I am at the stage (to little equals stiffness and pain - too much pushing equals just pain.)

How long did it take before you were back skiing? and any tips on how you achieved it - would be appreciated

regards
Phil
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bella ski Italia, very different injury so you can't compare but I had my injury in 1st april last year and skied in November. I was lucky that I never really had pain or stiffness...it was all about muscle loss. As soon as I was FWB in July I went to physio 3 times a week plus 1 or 2 sessions at the gym for a couple if months . After that I went to physio twice a week along with 2 sessions at the gym till about September (the insurance money ran out) Since then...a year later... I still go once a week and do gym once or twice a week (I really should go twice).

EDIT: I go to a private sports physio, NHS signed me off as soon as I had ROM and could walk

I did 5 weeks skiing last year starting with Jonathan Bells highly recommended Return to Skiing After Injury day at Hemel. ..which meant for a couple of months I was also going to his physio for assessment and a fiendish exercise programme.

So in my case hard work and commitment. But if I had pain it would have been a different outcome.

Good luck with your rehab

p.s. if you want the full story, it's here
http://snowheads.com/ski-forum/viewtopic.php?p=2273161&highlight=snowhead#2273161 Toofy Grin


Last edited by You'll need to Register first of course. on Fri 15-08-14 11:23; edited 1 time in total
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
bella ski Italia, best of luck with what sounds like tough rehab. Can only echo the recommendations for lots of physio.
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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!
Many thanks for the responses -plenty of physio and being positive about the out come in order -I think.
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 You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
Just an update to hopefully give encouragement to others in a similar situation - 13 months after the Pilon fracture - everyday gets slightly better - after Johnathans advice -plenty of swim & gym work and hours on a Boso Ball to try and gain balance which is still difficult but improving, the light at the end of a dark tunnel is nearly there. I was out in Italy at Xmas and New Year and managed to do plenty of walking on snow with a few nervous moments going downhill ha ha.
After a few nervous days and avoiding the reality I finally decided to try and get my ski boots on - first real disappointment no chance - but still extremely positive and out to find a pair out boots that I can get the ankle in, just to keep positive for this Feb.
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Ski the Net with snowHeads
bella ski Italia wrote:
Just an update to hopefully give encouragement to others in a similar situation - 13 months after the Pilon fracture - everyday gets slightly better - after Johnathans advice -plenty of swim & gym work and hours on a Boso Ball to try and gain balance which is still difficult but improving, the light at the end of a dark tunnel is nearly there. I was out in Italy at Xmas and New Year and managed to do plenty of walking on snow with a few nervous moments going downhill ha ha.
After a few nervous days and avoiding the reality I finally decided to try and get my ski boots on - first real disappointment no chance - but still extremely positive and out to find a pair out boots that I can get the ankle in, just to keep positive for this Feb.


It's really good to hear you are making progress.

A good boot fitter will be able to help you.

there are numerous threads here on boots and stiff ankles so have a look at those.

Good luck

Jonathan Bell
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 snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
Words of encouragement to everyone in a similar position at last after 14 long months after the fracture - I have managed to get my foot in a ski boot thanks to the "Slippin bag"(its an incredible product) then the big test - clipping into the two planks again and standing nervously at the top of the first run, freedom again -I felt like my wings had been unclipped as I made my first nervous turn,second third and away we go I could fly again , I had worried for months that I may never experience that feeling again and worried how I would react to actual movement - very difficult to explain when it takes weeks to learn to walk again never mind ski,but I'm here now and though a long way from prior level before the accident,more than happy to enjoy being able to do a few runs around the resort and hopefully as the say in Italy piano piano - slowly slowly improve over time.
Also a big thanks to Jonathon Bell whose words provided encouragement and were absolutely spot on with everything he advised.
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
bella ski Italia wrote:
Words of encouragement to everyone in a similar position at last after 14 long months after the fracture - I have managed to get my foot in a ski boot thanks to the "Slippin bag"(its an incredible product) then the big test - clipping into the two planks again and standing nervously at the top of the first run, freedom again -I felt like my wings had been unclipped as I made my first nervous turn,second third and away we go I could fly again , I had worried for months that I may never experience that feeling again and worried how I would react to actual movement - very difficult to explain when it takes weeks to learn to walk again never mind ski,but I'm here now and though a long way from prior level before the accident,more than happy to enjoy being able to do a few runs around the resort and hopefully as the say in Italy piano piano - slowly slowly improve over time.
Also a big thanks to Jonathon Bell whose words provided encouragement and were absolutely spot on with everything he advised.


Very pleased to hear you got there, I, sure it felt like a long journey. Very Happy

Jonathan Bell
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