Fractured fibula- how long till I can ski?

A snowHead

Fractured my fibula on 22nd December. It's a clean break and not required surgery/plates/screws. In non weight bearing plaster at the moment. Hopefully out of plaster early Feb. I had two trips booked but the second was mid Feb so have cancelled both.
HOw long would it be until I can ski gently? I was hoping to take my daughter (blue slopes only) for a long weekend mid march snow permitting

Thoughts?

A snowHead

Just glue the binding bit of an old set of ski boots to your plastercast. jobs a good un

Well, the person's real but it's just a made up name, see?

You will need to talk to your doctor/fracture clinic. As without their say so you wouldn't be insured for any further problems.

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I broke my fibula 24th December 2010. I could have done physio better than I did, and I went back to work last week of March (doctors told me to do 10 weeks off - I do a physical job so couldn't be desk-bound)

All I can say is, I should have waited longer and done physio properly. It did long term damage rushing back to work, which I'm still trying to fix, 6 years later.

I don't want to be a killjoy but my honest thoughts would be to knock skiing on the head for this year. It sucks, but it'll be much better to go back next year fully recovered, then rush back this year, do yourself an injury which to a normal person would hurt but not be serious - and do serious harm that takes twice as long to put right.

Skiing gently is all very well, but low-speed injuries, especially where your binding doesn't function because of the low energy, can be some of the worst injuries.

Anyway, snowHeads is much more fun if you do.

@OMF Mark,

6 weeks for the fracture to heal. If the boot is removable start physio as soon as you can, even first few weeks. ( you may want to double check that with fracture clinic)

The fracture will be tender for months so may be difficult to wear boots. Also if stiff the boot will be sore or difficult to get into.

The ankle will tend to swell for many months after sports. You may feel the ankle is weak and likley to turn over of you don't do any rehab so ironically the boot will support it.

I've known some ski at six weeks - but pretty sore. By three months hopefully should be fine if you've worked hard at rehab.

Jonathan Bell

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Excellent advice as usual from Johnathan.

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I bust mine 4 years ago when I hit a car on the bike. Surgical debridement but it went back together well so just in a boot. I was back on the bike after 6 weeks. No real ill effects other than a bit sore on uneven ground for a bit. I don't know if I'd fancy skiing after 6 weeks but cycling was fine.

No problems with it now.

After all it is free

Around new year, having just booked the SOPiB on 21 Feb, I managed to give myself a stress fracture of the fibula. I was determined I'd get better quickly and didn't rest, sensibly convincing myself that using it would be the best approach.

Of course I went skiing. The line of the fracture was about the level of the top of my ski boot. First day was ok. Second and subsequent days it got progressively more uncomfortable, not helped by icy crud and bumps off piste.

I carried on skiing but with less and less commitment to the turns... A few days later I fell in deep snow and tweaked it. Managed to get back down under my own steam somehow - too proud to call the blood wagon - but boy was it sore. Drove back to the airport and went to A&E when I was back home, where they confirmed it was now a proper break. I then recalled the popping sensation in my calf as I fell...

I know, I was very stupid.

Anyway, they didn't give me a cast. I can't remember how long it took me to get better, but walking was initially excruciating and I was conscious of a dull ache for months. My muscles were surprisingly wasted too. I do recall being very nervous of it for the rest of the year, and being apprehensive when I went skiing the following season. It ended up being fine though.

If I was to do it again, I wouldn't even consider skiing unless my leg no longer felt remotely sensitive and I'd given it a fairly good testing-out before I went away. dp's point about low-energy falls is a good one - my binding didn't release when I fell.

But @Highland Lad, you were very useful for doing runs to see the other broken people in hospital!

I (accidentally) skied on a low spiral fracture at 2 days and again at 4 weeks. Ironically felt great in the ski boot, but walking on a slightly unlevel surface, and doing stairs, was agony! Had no treatment, and at 8 months it's still painful if I run and twist the foot slightly…

My insurance company were happy to cover the leg for a trip in europe at 3 months, but would not cover me to ski in argentina 5 months later because they felt the risk of re injury, combined with the difficulty in getting easy access to medical care, was too great. I did also have a tibial plateau as well.

ps random question@OMF Mark, Do you work in OMFS?

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I have a similar experience to others here- got a boot top fracture of the fibula in late Dec a few years ago. Like you was clean just a single line.

It was actually missed at first as had an MCL sprain at the same time which I got physio for. Thought it was just some muscle soreness..

Tried to ski in late Jan, as soon as I put my boot on was in agony. I'd be having some aches at the end of the day but hadn't had any hard pressure at the spot of the fracture so just hadnt realised

Got an aircast after, and was told I'd be good for March. Mid March I could pootle about but as soon as I did any skiing at speed or bumps quickly stayed hurting too much to ski. That said maybe my recovery was delayed by the fact that I'd been potteriing about as normal for the first month and worse had been getting some physio massage around that point as we thought it was a sore muscle..

snowHeads are a friendly bunch.

If clean, complete fracture and recovery uncomplicated - I usually advise return to weight bearing gentle exercise at 3 months - strenuous activity with risk of fall ( similar to skiing ) at 6 months. I'm a consultant in occupational medicine.

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I often give different opinions to orthopaedic surgeons

You know it makes sense.

Otherwise you'll just go on seeing the one name:

A snowHead

12th November: I fell into an open sewer in Ghana (walking in pitch darkness, sober). Twisted my ankle. Passed out with pain and shock. Nothing seemed broken though. 5 sessions of traditional voodoo healing in Togo, and I continued my solo motorbike tour.

8th-20th December: skiing in Mayrhofen and Kitzbühel. Uncomfortable to turn and stop. Couldn’t keep up with the 50ish “youngsters”.

10th January: began 8 week stay in Kitzbühel. Skiing hard with younger friends, but the pain kept increasing.

24th January: Doctor friend examined it in the pub and sent me for an Xray. Fibula cracked and splintered at the bottom with multiple stress fractures - the original fracture had not healed. But all well-aligned. Plaster cast until 14th Feb. Off games for 6 weeks.

6th February: still in Kitz going mad with boredom. Only so much beer I can drink. 2 daughters and 4 grandchildren coming out next week for half-term, hoping to ski with me.

There is no point asking what the orthopaedics guy advises, the answer is pretty predictable. But I need to
find a balance between my physical and mental health. Planning to start skiing gently again when the cast comes off (3 months after original injury, 3 weeks in plaster). Will report back.

BTW: a local friend once had the same issue. He took the inner out of his ski boot and carried on skiing in his plaster cast. That injury healed well. He’s 73 now, lots of titanium elsewhere, but still active.

A snowHead

I hope you got a refund on the voodoo.

Well, the person's real but it's just a made up name, see?

She wouldn’t accept my GHIC card. Worth every penny though (£30 for 5 hours total) in entertainment value alone.

“If I could live the rest of my days playing in/on water (including snow) I would be a very happy boy.”
I admire your philosophy and that’s pretty much what I have been doing since I retired 12 years ago.
Plus a bit of horse riding and motorcycling.

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If you continue to “aggravate “ even a stable fracture it will fail to unite(heal). That is poss my what happened here. Had the voodoo doctor have known that fact they would have presumably advised you of this.
Your friend seems to have confined that the fracture has failed to unite.
United fractures may go in to heal if immobilised but it often requires a longer period than it would have taken for the fresh injury to heal.
Just waiting a week till it feels better isn’t a sign it’s United. Can I suggest that you see an orthopaedic surgeon as a patient and not a friend and then ask what has to be done to get it to heal. It may now require surgery to get it to heal.
Jonathan Bell

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You need to see an orthopaedic surgeon. Probably shouldn’t ski till next season.

Then you can post your own questions or snow reports...

Here’s the promised update:
(NB. my circumstances probably differ from yours, so please get suitably-experienced advice).

Another medic turned up in Kitzbühel. A regular visitor I have skied with on and off for several years. He is a limb surgeon who works, researches and lectures internationally in biomechanics and nerve function. Early in his long career he specialised in sports medicine (team doctor for his national ski team).

When he arrived I had been in plaster for 3 weeks. He said that because I was not his patient he could not advise me, BUT that he could tell me what he would do if he were me.

He checked all my X rays, said some interesting stuff about the negative side-effects of immobilisation. Then: “in your circumstances, I would remove the plaster and start moving again now.” He talked at length about the reasons for that opinion.

The hospital doctor had told me not to ski for 6 weeks. “Standard orthopaedic advice, they have to say that”. But apparently there are wider holistic considerations.

He stayed on in Kitzbühel for nearly three weeks and we skied together most days as my ankle steadily strengthened and normal function almost completely returned under his supervision.

If anyone has a similar issue, I hope you have access to the same level of relevant expertise, and the same good fortune.

After all it is free

I listened with interest to his explanations, although I don’t remember (or probably fully understand) everything he said.

Two things stood out however. At the risk of oversimplifying:

1. Regarding the Voodoo treatment:
- he dismissed my scepticism and spoke of his respect for the wisdom and long experience of our forebears. He said it’s unlikely traditional therapies would have survived if they were ineffective and in many areas orthodox medicine is only beginning to catch up. He gave some impressive-sounding scientific explanations. Apparently there is strong evidence that the kind of deep massage, manipulation and compresses I received soon after the injury can contribute to faster healing and better outcomes. He believes that stimulating the flow of blood (and other healing substances produced by the body) in those early stages is valuable. He couldn’t comment on the efficacy of the various herbs, but says he keeps an open mind. Two subsequent weeks in tight-laced motorbike boots may also have helped. So it seems that by chance I may have done a lot of the right things.

2. He said bone can heal relatively quickly and predictably. Soft tissue is a different matter, and unnecessary immobilisation could delay healing and risk permanent loss of nerve function, mobility and flexibility as well as causing stiffness muscle-weakness and poor balance. Movement is important: he said that with physiotherapy it could take a year for soft tissue damage to heal fully and muscle strength to recover; without it the loss of functionality could become permanent. He also showed me some helpful exercises.

A lot of his explanations went over my head. To me the important thing was that after only three weeks in plaster I was able to ski again, more comfortably and confidently each day. That may have contributed to my rapid and (to date) almost full recovery. What’s more, we were able to ski with four of my grandchildren.

Now back in London for a couple of months, I have started physiotherapy.

Again, please bear in mind that my injury may not be typical and that I was fortunate to have the advice and constant attention of a leading scientist with directly-relevant expertise.

Interestingly if you break the Tibia and fibula (breaking the first usually breaks the weaker second) they nail the Tibia (ie rod down the cavity of bone) and just leave the fibula to come together on its own. No other immobilisation but crutches to take most of the weight for a while, of course (they taught me how to go up and down stairs the next day).

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That seems to accord with at least one of the things my surgeon friend said. If I understood him correctly, he expected my fibula to continue taking care of itself, and warned that there were more serious long-term issues at play. He suggested those may not be being adequately addressed by the hospital, which seemed just to be going through its standard short-term orthopaedic routine. From his fascinating accounts of some of his groundbreaking work (his signature operation takes 30 hours and six support staff), and of the subsequent rehabilitation, I feel pretty confident he knows what he is talking about

Help!!

Fractured fibula- how long till I can ski?

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