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Skiing after a tibial plateau fracture

 Poster: A snowHead
Poster: A snowHead
I had a tibial plateau fracture last month. Surgery with 6 screws and one plate. Last run of the day in Norway before a 23 days trip to the Alps. I am wondering if any other here have sustained this injury and come back to skiing at the same level? What is your experience with skiing after such an injury? My physio thinks I will be on skis the next winter with good training and that there is a good chance of skiing fully (offpiste and on all conditions) in 2018..
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 Obviously A snowHead isn't a real person
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@Woosh, yes. 1st April 2013 accident back on skis at the end of November . I did physio and gym 5 times a week at soon as I was fully weight bearing and gradually reduced to 3 times a week. Do as much a you can with glutes and quad exercises whole you are not weight bearing. You will be shocked when you see your leg looking like a saggy pillow I did a blog in the apres section if you are interested.
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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?
Oh...and i Ski better now than before partly because of better fitness. ..I still go to physio and gym every week as I also stretched the MCL ..quite common but you won't know till you start walking ...it is now a life goal to keep mobile.
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.. and check your travel insurance for physio cover. Mine has £500 which made a huge difference.
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Anyway, snowHeads is much more fun if you do.
And ask your physio about sports massage to aid recovery
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@holidayloverxx,

Thanks for your reply and tips. Luckily we have free physio in Norway after such an accident (half a year) and you can choose whoever you like. Really encouraging to hear how quickly you were back on the mountain. Inspirational and also good to hear that you are better than before. My life goal is also to be as active as I was before the accident:)
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@Woosh, good luck. Let us know how you get on
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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!
Sorry to hear about your injury. I had a TPF in November 2014, from a non-skiing injury. I started skiing again last October (in a fridge). I have just returned from a skiing week and I also think I have actually improved, also because of more fitness training.
Keep a check on the mobility and extension in your leg as you recover. I think everybody and every injury is different, so go at your own pace. You will know when you are ready to ski again. Do all your physio exercises, regularly! It really is key. As soon as I could walk unaided I started going on long walks, building up the distance gradually. I also found spin classes really useful for cardio and strength building.
Good luck - there is light at the end of the tunnel!
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Sustained a TPF in a super-G March 2011. Internal fixing with plate and 7 screws. Was back on snow late November, but couldn't race that season. Things got a lot better after I had all the metal removed the following spring.

Since then I have done the Swedish Alpine Trainer levels 2 and 3 and I've just won the Swedish Cup in Speedski at age 49 Happy

You can get there, but you need to be realistic about goals for the coming season. Work hard, but don't set yourself back by rushing things. It does depend a bit on your age as well. I put huge effort into my rehab, but even at the age I was when I had the injury (44) things just take longer to heal than when I was young.
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@sara, thanks for your reply and tips. Really encouraging to hear stories from others who have gone through the same thing and that there is good possibilities on the end of the recovery path.

@hyperkub, WOW, I am impressed. Really good work and also motivational to hear your story. Congrats on your victory. Do you feel 100 % recovered in your knee today?
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Did mine in march 2013 and was skiing at Manchester by november 2013, then went to italy in january 2014, had to take it easy, getting boot into ski meant leaning backwards etc. but did notice a lot of swelling by day four... Had a day off then was ok. ..
I now ski better than i did before due to having some lessons on how to ski with a tender knee. Took me a while to get all the muscles working as i was limited by how much and the type of excersize i could do, as running and jogging were out,
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And love to help out and answer questions and of course, read each other's snow reports.
Did a week skiing last week in the Alps. Superslushy conditions but could ski all day for 5 days straight. Yes, it does hurt sometimes and yes, need much more muscles , but what a great feeling to back on ski properly again. Hope to be able to ski offpiste properly again next year. Fingers crossed
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@Woosh, fab....Thanks for letting us know
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 You know it makes sense.
You know it makes sense.
Broke mine and also had surgery (rod and 4 screws) in andorra this season, and now im wondering about getting back next season and how to avoid similar injury in the future.

I got my left ski stuck in a pile of snow skiing a highly 'pipe'd' (not sure what the word is, but a run that has high sides, almost like a natural downward sloping half pipe i guess?) piste when going up the side slightly to make a turn.

I feel it was 50/50 my fault after not ever having been taught to ski in such deep snow (good snow day!) and that I really felt my ski should have released (when i landed and tried to assess the damage i realised my boot was 180 degree turned round to my knee with my skis side by side.. one pointing backwards still not released)

Is just lowering the DIN to below what the shop set it to (they're my own skis, new this season and set by a shop in the resort when i arrived) and then taking some lessons to reaffirm my technique (not had lessons since i learnt 10+ years ago but had a 4 year gap no lessons after returning) the way to go?
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@calro, I reduced my din and I never get a pre release. I went onto Jonathan Bells Return to Ski day at Hemel 7 months after the break and I also had 3 mornings of private lessons with Steve Angus for confidence and technique.
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 Poster: A snowHead
Poster: A snowHead
I fractured my tibial plateau after my ski clipped a hard bank of snow on a narrow ‘blue’ path in Meribel. The edge of the bank was solid like a half pipe - I flipped over and my ski didn’t release - my leg did a full 180 turn and twisted my knee so violently I felt the injury happening. I have my own skis and boots so feel that it’s probably my fault that I didn’t check my bindings were on the right settings before skiing. The fall resulted in a displaced, compressed fractured plateau with 3 breaks. I was repatriated to the UK for surgery, involving plate, screws and bone graft from my iliac crest ( pelvis). I am week 2 Post- op and am doing exercises recommended by my private physio as I have not yet been sent an NHS physio appointment.
I am female, 58 and very keen skier ( skied for 30 years). I am so gutted and upset this has happened. Skiing is my passion and I start looking forward to my next ski trip as soon as I am leaving the mountains.
I am now in a brace - set to 90% and working hard at my exercises. I can already see the muscle wastage and my thigh muscle is like jelly. I had good, firm muscles from skiing and cycling so am hoping I will regain some noticeable tone soon. I also have some damage to my deep perineal nerve - medial branch - my big toe and 2nd toe are numb. This can happen with compression in ski boots but I have had the same boots for 3 years and they are very comfortable. I supposed the nerve could have got damaged in the fall or during surgery.
It’s so good to read your stories and I am encouraged to read that most are skiing again fairly soon after surgery. I have booked to go again in December (booked before fall) so fingers crossed I may be able to do a bit of ‘ gentle’ skiing. Thanks for reading
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
I fractured my tibial plateau after my ski clipped a hard bank of snow on a narrow ‘blue’ path in Meribel. The edge of the bank was solid like a half pipe - I flipped over and my ski didn’t release - my leg did a full 180 turn and twisted my knee so violently I felt the injury happening. I have my own skis and boots so feel that it’s probably my fault that I didn’t check my bindings were on the right settings before skiing. The fall resulted in a displaced, compressed fractured plateau with 3 breaks. I was repatriated to the UK for surgery, involving plate, screws and bone graft from my iliac crest ( pelvis). I am week 2 Post- op and am doing exercises recommended by my private physio as I have not yet been sent an NHS physio appointment.
I am female, 58 and very keen skier ( skied for 30 years). I am so gutted and upset this has happened. Skiing is my passion and I start looking forward to my next ski trip as soon as I am leaving the mountains.
I am now in a brace - set to 90% and working hard at my exercises. I can already see the muscle wastage and my thigh muscle is like jelly. I had good, firm muscles from skiing and cycling so am hoping I will regain some noticeable tone soon. I also have some damage to my deep perineal nerve - medial branch - my big toe and 2nd toe are numb. This can happen with compression in ski boots but I have had the same boots for 3 years and they are very comfortable. I supposed the nerve could have got damaged in the fall or during surgery.
It’s so good to read your stories and I am encouraged to read that most are skiing again fairly soon after surgery. I have booked to go again in December (booked before fall) so fingers crossed I may be able to do a bit of ‘ gentle’ skiing. Thanks for reading
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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?
@Linzijane18, keep at it and stay positive. If the healing goes well and you work hard in rehab I'm sure you'll be back on them soon; so sorry for you accident. I'm sure you had plenty falls and twists in the 30 years you stood up from and you're attitude to it sounds great. You'll likely face a mental battle when back on the planks; I found this is harder then the physical after I got back in the mountains 14 months after Tib and Fib break in Jan but second trip in April was night and day. I also ski every weekend on a dry ski slope which has helped. Your health experts will guide you I'm sure; I was amazed when 11 months after my break my physio said 'go have a gentle ski' and I was like 'really'!!
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@Linzijane18, You'll be fine - do the work and it will pay off (I was 53).
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Sounds pretty serious.. I would only get back skiing if your 100% reocovered if your unlucky to get injured again next year its going to be a huge set back even further.
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Quote:

I would only get back skiing if your 100% reocovered

It's rare you get 100% recovery within a couple years. Some never got back to 100% at all. So forget about that!

I'd focus more specific on strength and flexibility. If those are back, you're as good to go as any other time.
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@abc, correct..from someone who has the tshirt
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After all it is free Go on u know u want to!
@Linzijane18, not had that injury - but you'll get lots of encouragement here from those who have. And welcome to SHs. Can imagine how upsetting it is, facing that long uphill struggle to regain strength and flexibility.
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Thank you for all your encouraging comments. I am working hard at the PT and my flexion is now 95. 6 week check with surgeon next week so hope the x Ray shows that it is healing well. I am still wearing a hinged leg brace which is very uncomfortable and I can’t sleep on my back so not sleeping well. This is so upsetting as skiing is my big passion and the thought of never doing it again or at the same level is soul destroying. Some say I could get better as I will have a regular exercise programme but others say I will never regain the same ROM. I guess it depends on how invasive the surgery is, age, bone density, fitness etc. The bone graft taken from my pelvis has left a six inch scar and bending my torso aches too! I think I did a pretty good job at smashing my knee up!
Anyone got any advice on how long you are likely to wear a leg brace after NWB and when you can expect to walk unaided without crutches. Can you sleep without a leg brace at 6 week’s post op? I guess it depends on the individual....... thank you for reading and responding - fellow skiers.
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@Linzijane18, the detail is in my thread in apres...will find a link. My surgeon said i could ditch tbe brace at 5 or 6 weeks i think...as long as i did not run any risk of falling over.


I got full ROM back quite quickly

Crutches...PWB at around 8 weeks ditched the crutches at 13 weeks. Would probably have been 12 weeks but couldn't get an appointment at 12.

I ski better now than before

Link to blog

http://snowheads.com/ski-forum/viewtopic.php?t=99642
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Quote:
This is so upsetting as skiing is my big passion and the thought of never doing it again or at the same level is soul destroying.

I haven’t had the same injury so can’t offer any specific help.

But it sounds like this is your major injury?

I’ve been through that same doubt/anxious cycle the first time I experienced my major injury. After decades of injury-free high risk sports (mtn biking, white water kayaking, skiing), I took it for granted. Then all of a sudden, that life style seemed to be at risk.

My physio kept me positive. She’s seen many patients gone through her. Many don’t recover fully because they didn’t do their work diligently!

Also, be patient. It’ll take a while, probably longer than you like. Cool But most do recover fully eventually, just about the time you think you won’t Toofy Grin
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@Woosh,
I’ve seen many people over the years get back from this injury.

There are some factors that are relevant.
The subtype of tibial plateau fracture, the severity and then how well it has been fixed. On top of that any pre- existing problems such as arthritis.
The rehab program is then vitally important.
There are plenty SH who have got back from your injury.

Jonathan Bell
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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
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Not checked into this thread for a long while, but I saw Linzijane's update. How are you doing now, Linzijane?
It's now been three and a half years since my accident, and it all seems like a very distant memory now. I ski once a year, so I've been three times since, with no problems at all.
I have never completely recovered the full range of motion with my knee. I will never be able to sit back on my heels when kneeling again, but it's as near as. I don't run anymore. My knee feels fine, but I kind of feel the plate during the motion and it's very uncomfortable (sorry if TMI!). I have found other things to do instead.
The surgeon's team told me that my injury would be as good as healed after a year, but I found that it carried on improving into the second. My knee feels like it used to now, like nothing happened.
Everybody is different, but I hope you have a successful recovery. All the best!
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 You know it makes sense.
You know it makes sense.
from my experience....best advice at this stage is to do as many leg raises that you can !! the knee needs the muscles to suport it.. and if you do get to go skiing you may find its hard to push your heel into your bindings, aslo don't be surprised if the knee swells up a lot during skiing or any excersize...take time, there are some great ways to bring down the swelling that do not involve tablets.
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 Otherwise you'll just go on seeing the one name:
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Thank you for all your replies, advice and encouragement. I am now 4 months post-op and am doing very well. I have excellent ROM and have been walking FWB unaided by crutches for 6 weeks. I was FWB for 6 weeks and PWB for a month, building up to FWB gradually. I can walk really well but feel a slight ‘lag’ and discomfort after walking all day or driving my manual geared car. I can’t kneel without discomfort tho. I have been doing hydrotherapy for 10 weeks, PT every day at hone Nd have just started spinning classes, which seem to be helping a lot. I am still intending to ski in December, as I booked before my accident, so I am working hard to build up my muscle strength in order to make this happen. I feel quite anxious about skiing again ( plate, 9 screws and bone graft) but I guess if I had fallen off a horse or had a car accident ( depending on severity) I would do both those things again. The main thing is keeping positive and having hope. The physio is essential for any form of normal movement to return. It can be boring and painful, but I know it has made a huge difference to my recovery. Thanks for reading.
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 Poster: A snowHead
Poster: A snowHead
I've just picked up on this thread as I was searching "Tibial plateau fracture" as my wife picked up this problem at St Gervais last friday.
She has been a very timid skier for many years now and I feel that at the age of 68 she is going to give it up Sad

I enjoy our ski holidays together, but I fear that she won't want to ski again.

Looking at the x-rays, I can't see any displacement.
We spent 12 hours in Addenbrooks on Sunday waiting around for scans and opinions.
The service at the Medical Centre was just top notch, she had already been X-rayed, diagnosed by the time I took the rental skis back about 100 metres and got down the gondola.

They were waiting for me to get the script filled from the pharmacy for
Brace, Crutches, injections to stop blood clots, and big dollops of paracetamol.

The only problem I have is I purchased the carte neige type insurance from the list station at the start of the holiday ... and I can't find the paper ticket that went with it.
I thought I'd purchase it to make life easier than using our own ski insurance. Puzzled
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 Obviously A snowHead isn't a real person
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Thank you for responding to my post and sorry to hear of your wife’s injury.
If it’s any consolation, I have been on two skiing holidays since my accident in April 2018 and have just booked my third.
I worked hard on my physio and also went to the gym to build up my muscle strength. I was very nervous when I went for the first time (8 months after surgery) and felt quite nauseous. However, I started on the beginners slopes just doing some slow, controlled turns to see if I felt any pain, and as it was not painful I gradually progressed to gentle green and blue runs. I skied for an hour or so a day to start and rested my knee in the afternoons. I have just been away again and progressed further to red runs at a slow and controlled pace compared to my previous level of competent skiing. I am looking forward to continuing to progress when I go again in March.
I would hope that this post will encourage your wife to ski again. I am pain free, but am being sensible about my rehabilitation and building up my confidence gradually. I have accepted that I probably won’t ski to the level I did before, but I am just happy that I can ski again. I am 60 this year. I wish your wife a very speedy recovery.
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 Well, the person's real but it's just a made up name, see?
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Janet's approaching the third anniversary of her TPF and is skiing better than before. Agewise, she is between Linzijane18 and your wife. Janet opted to have the metalwork removed after six months, delaying her return to the slopes until a year post break. The surprise for me was the extent of the mental element of the recovery. Best of luck for Mrs Lawn.
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Cheers @Linzijane18 & @Val Desire for your good wishes and encouragement.

We've been back to the hospital today and the good news is that it's only a fracture and nothing is displaced.
No surgery or manipulation required.
So her leg is in two tone plaster of Purple for the Tibia End and Pink for the top end with a hinge in between.

We have an appointment again in 6 weeks tie and they will probably take it all off.

She says she wont bother skiing anymore, but next time I take her I'll drive down and take her little 123cm skis and boots along.
We may get her out on a nice sunny day so she can explore the restaurants above Megeve.
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Just a bit of encouragement, particularly for any senior readers. I had TPF in 2008 which did not require surgery as it was non-displaced. I was non-weight bearing for a few weeks and totally recovered. I had already had an ACL repair and other ligaments are partially torn so I have been wearing a CTi brace for nearly 20 years now. Arthroscopy last summer for a cartilage tear. I have done 2 separate weeks in Europe already and soon heading to Colorado for a couple of weeks. Skiing as well as ever including moguls - and I am now 70. Keep fit, do all the physio and keep skiing. The only thing is I've been told not to run outside as there is too much impact on the knee. I can run on a trampette indoors and do lots of walking - off to Nepal trekking later in the year.
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I'll add another experience to the case load. More of a long term prognosis example.
My OH fractured his TP in January 1998. He was skiing again the following Winter, and has skiied once or twice a year ever since. He had metal screws and plates which they weren't going to remove, but about 5 years on the knee was giving him a bit of grief, so the metal work came out. Improvement for a while, but he has since had 2 arthroscopies on it to try and improve things. Twenty years on, for every day stuff the knee is fine, but it no longer bends nearly as much as it did (used frequently as an excuse as to why he can't get his foot onto a crucial climbing hold...). When we go skiing he takes Naproxen, and it copes with 6 days, but more than that isn't much fun, and then it usually takes about 3 weeks to properly calm down afterwards. Piste skiing isn't too bad, but it's when we go off piste that it's worse,probably not helped by the fact that we're not very good at it.When he stands for long periods of time it stiffens up, but walking and cycling are fine. Can't say about running, he's never been a runner!
One thing that a physio friend recently suggested is sleeping with the knee in a good old fashioned tubigrip to help keep the inflammation down overnight, and apparently it's quite effective.
I think once you've broken something it's sadly never going to be totally the same again.
Hopefully those of you suffering from the same injury will be rather more diligent about physio etc than I think he was, and have better long term prognosis.
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karin wrote:
One thing that a physio friend recently suggested is sleeping with the knee in a good old fashioned tubigrip to help keep the inflammation down overnight, and apparently it's quite effective.


Interesting. I've always felt like I wanted to do this (not for tpf, mind) but have always read great warnings about never sleeping with tubigrip on. Presumably some worry about over compression and doing damage whilst snoring your head off in the land of zzzs and thus not realising it. Or just because you're lying down and may be reasonably immobile for several hours?
What level of fit have they recommended? Presumably to be effective it needs to be pretty tight?
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@Grizzler, Not particularly tight. I'm also doing it for an ankle injury, and you wouldn't think it was tight enough to achieve anything. But it does. When you get up in the morning there is just less puffiness and congested feeling than there used to be. I actually look like I have a normal shape ankle for a change!
I understand it's because when you are sleeping there is no movement going on, so fluid can collect in the joint, and the light compression just helps prevent some of that.
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Interesting, when I broke my ankle and moved from a cast to a moonboot+tubigrip, I was warned by the doctors/nurses not to sleep with it on. Actually I didn't hear them tell me not to, and they were shocked when I said that I didn't remove it to sleep the next time I went in, so after that I stopped wearing it to sleep. It didn't affect me one way or another, my ankle looked pretty bad no matter what I did to it at the time! (much better now though!)

Maybe it's to do with the tightness of whatever tubigrip they give you? Something slightly looser than what I was given might be safer overnight while still effective over 8 hours Smile
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My misses, is walking now after her TPF skiing in February, but not as well as she wants to.
She has started playing "bowls" again.
But she is finding even a short walk of about 800 meters gives her gyp.
Her passion is "rambling" and she's worried she won't be able to do it again in September.
4 months now, and healing seems a very slow process.
But she is almost 70.
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