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TBF TYPE II - advice needed for PT

 Poster: A snowHead
Poster: A snowHead
Hi, suffered a TBF knee injury in Switzerland recently and was fitted with a plate and pins. Now back in the UK, I am experiencing conflicting advice from the NHS.

Advice from OS in Switzerland was to keep doing daily PT exercises up to 90 deg flexion and this matches some research I did online. NHS Dr tried to put me in a knee brace and restrict to 30 deg flexion. Have ditched the brace as my knee immediately started to feel stiff/sore. Feel as though I'm not getting the right advice from the NHS as they are not experienced enough with sport injuries, particularly skiing ones.

I'm happy to dip into my pocket for some private consultation and PT. Can anyone recommend a specialist in the south east Essex/north east London area?

Many thanks
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
@nobubblesdave,Jon at Chelmsford physio. I had a similar injury 2 years ago...blog and journey back to skiing is in the Apres Zone. I'll try and find it when I'm on a pc.
can't remember when I got good flexion but it was pretty quick. Nhs consultant said I could ditch the brace at about 5 weeks if I felt comfortable and didn't feel vulnerable to tripping/falling over. I was certainly more than 30 degrees. Physio till weight bearing is minimal really...scissors to try and keep glutes and hip flexors going, quad contractions and knee bends. Once you are weight bearing you can start the hard work. I went to jon 2 to 3 times a week plus gym twice a week for months. I had £500 for physio on my travel insurance. I am still going to physio every week now and gym twice a week as I easily lose the strength, flexibility and stability after skiing and Jon gets me back on track.

Let us know how you get on


Last edited by Obviously A snowHead isn't a real person on Fri 6-03-15 13:42; edited 2 times in total
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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?
@nobubblesdave, a SH- Jonathan Bell - is a knee specialist at http://www.wimbledonclinics.co.uk/consultants/mr-jonathan-bell/
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@nobubblesdave, link to my experience http://snowheads.com/ski-forum/viewtopic.php?p=2273161&highlight=snowhead#2273161

oh, and it's customary to post the injury porn...x-ray, scars etc wink
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
under a new name wrote:
@nobubblesdave, a SH- Jonathan Bell - is a knee specialist at http://www.wimbledonclinics.co.uk/consultants/mr-jonathan-bell/


I presume by TBF you mean tibial plateau fracture.

The best person to determine the immediate post op care is the surgeon who carried out the surgery.
Having surgery in one country and rehab in another is a disadvantage and is why i strongly recommend not having semi urgent surgery like ACL reconstruction carried out in or near the resort unless you live there.

You will, i'm afraid, find that no two surgeons will fully agree on the exact post op advice as their suggestions will be based on experience/culture and scientific literature.

On reason to fix fractures around joints is to get them moving.

If you don't follow the surgeon's advice you may have problems so i cant advise you to ignore their advice but i think a further discussion with the surgeon may be of some help.

I presume you'll have no further input from the treating surgeon as that has been my extensive experience of treatment overseas. It is disappointing as where i have treated people from overseas i have tried to liase with the local physio but it requires effort to do so.


Jonathan Bell
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Thanks for the advice Jonathan, yes it is a tibial plateau fracture.

The surgeon in Switzerland has been brilliant. Has provided all the medical notes plus his contact details. Alas the NHS surgeon has had no interest in looking at the notes or contacting the Swiss team!
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
nobubblesdave wrote:
Thanks for the advice Jonathan, yes it is a tibial plateau fracture.

The surgeon in Switzerland has been brilliant. Has provided all the medical notes plus his contact details. Alas the NHS surgeon has had no interest in looking at the notes or contacting the Swiss team!


Have you thought about going to Switzerland to see you?
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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!
While you're not weight bearing do leg lifts as much as you can as its amazing how quickly the muscle goes..and with this type of injury its difficult to get it back as quickly as some other injuries. Also get an excersize bike at home...really helps getting the knee moving once you're weight bearing...i found trying to pedal backwards helped get the knee to bend... plus seeing a good physio
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You'll get to see more forums and be part of the best ski club on the net.
I had a type 2 TPF. I was allowed to start flexing the knee (limited mainly by pain) as soon as the wound from the operation had healed. I think it was after about 3 weeks.I was partially weight bearing after 8 weeks and full weight bearing at 3 months, at which point I had also reach full ramge of motion.
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I had a type 2 TPF. I was allowed to start flexing the knee (limited mainly by pain) as soon as the wound from the operation had healed. I think it was after about 3 weeks.I was partially weight bearing after 8 weeks and full weight bearing at 3 months, at which point I had also reach full ramge of motion.
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I was full weight bearing two months after op... physio took crutches off me on second visit.. to get full movement i did my own physio sessions every morning. . Bending the knee as far as possible. .surgeon said it will hurt but it needs to be done..used a yoga strap over my shoulder. .. the bike to help force it as well but found i got better results pedalling backwards !! Lots of lower leg swinging as well..still do that. .
but wish i had done more straight leg raises when i had pot on...
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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.
@yorkshirelad, +1 for more leg raises. You think what's the point at the time..then you realise....
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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
Exactly. .. i actually thought i was hurting my knee and restricting the recovery ..oh silly me 😄
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