Recovering from a broken leg

Our resident Chiropractor and ironically a renowned ski injury expert, turned the focus on himself recently when he fractured his leg while skiing in Canada late in the 2012 ski season. Below is an outline of what was involved in the recovery process taking him from a shattered leg and shattered dream of working at the London 2012 Olympics, to a recovery that has amazed leading surgeons and physiotherapists.

Update April 2013
Ski trip Easter 2013 – putting the mental demons to bed. Twelve months nearly to the day of the leg break I headed off to Val d’Isere, France to test the knee and to take the family for our first family ski week. I started conservatively with a few nervous moments and flashbacks to the previous year’s injury – initially I stayed on piste and enjoyed a different type of skiing which involved skiing on piste and stopping at some of the great mountain restaurants Val d’Isere had to offer. My confidence in the knee grew as the week went on and ended the week off piste and shredding some great pow!(see the pic below) Thanks to Phin my long suffering wife for helping me through this horrible injury, my kids for keeping me smiling, my surgeon Mr Bell, Wimbledon Clinics , James my physio, who I still see every week has helped transform me to the fittest and strongest I’ve been in 20 years and the Putney Chiro team for stepping up and running things while I was gone. Thanks everyone!

Update 17th October 2012
I’m just back from my 6 month check up since surgery and all is going well. See the x-rays below taken on the day and you’ll notice there is still a crack in the tibial shelf and this means no running, jumping or plyometrics just yet (or skiing before Christmas). Healing takes time huh, especially when there is a 3mm chasm to fill in. So what can I do? I can do a few laps at 17mins per lap in Richmond park with the Dynamo group 1 lads before being dropped and be in the winning team of a relay triathlon. I can deep squat/split squat 80kg and leg press 200kg. I’ve taken my amazing chin up ability from 3 sets of 2 reps to 3 sets of 10 reps and did a 2km rowing ergo under 8 mins (that was a bad idea – ouch! Heart not legs). Oh, and I’ve booked a ski week at the end of March 2013 to jump straight back on that pony!

The Story

Below are images of my knee break (tibial plateau fracture), the shot of my puffy swollen leg 24 hours after the injury and the money shot – after surgery with a plate and 7 screws. Click on any image to enlarge.

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April 15, 2012 – Heliskiing in Canada.
I was on the trip of a lifetime celebrating my 40th birthday and indulging my passion for skiing the back country. All was going well with a great road trip from Calgary-Banff-Jasper. A late season storm provided in resort 50cm of fresh snow to play with before I started the Canadian Mountain Heliski week. The video shows a four minute summary of what I was doing at the time of injury. Read on below to discover how I made my recovery.

 

 

 

The surgery and recovery.
I finally made it back from Canada after a few delays in dealing with insurance companies and airlines and went straight to Parkside hospital for MRI and CT scans it was then the the true extent of the damage was discovered. What looked like a fairly clean break on the X-ray at Banff hospital, turned out to be a fairly messy break. The only good news from the scans was the knee ligaments were intact. So I had a couple of days to get the swelling down from the flight for surgery in a few days.

Lying in a hospital bed with a puffy bruised leg picturing what was coming was not a place I’d like to be everyday. Terrifying stuff, but I had complete faith in Mr Jonathan Bell, and the team from Parkside. It was a long week from the time of injury to finally getting the operation underway. The operation went smoothly and after a bizarre night on morphine and coming to terms with general anesthetic, the physio team were keen to get me moving my knee from day one. I was sent to the hydrotherapy pool 36 hours after the op and the aim was to get me moving ASAP.

Movement
Immediately after the op I had 90 degrees movement of the knee which by week three was 120 degrees and week 7 was only a few degrees of normal. I was amazed at how quickly the movement had returned, especially as to how it felt from the beginning. The hydro therapy pool was great a increasing slowly the movement I’d lost, with the sensation of floating helping big time with the pain.

Swimming
I luckily had no plaster and so swimming became a vital ingredient to my rehab. The first 4 weeks I pretty much did daily hydrotherapy and by week four I began swimming in the pool with a buoy between my legs. Aside from entering the pool via the disabled steps, swimming was the only thing that made me feel ‘normal’ as it was the only thing I could do which made me appear able bodied. Between week 4-8 I started ramping up the distances and one of the challenges I set was how far could I swim non-stop for an hour. My record to date was 3800m. Swimming, although mainly working my upper body, really helped keep the physiology ticking over helping circulation, weight management and sanity.

Pain 
Bizarrely at the time of injury, I was not rolling around the snow screaming in agony, it actually hurt less that I would have imagined. As the time went by the pain was more from having a massively swollen leg than bone pain. Obviously initially, the first two weeks did feel like I’d had a drill taken to my tibia, but that thankfully this decreased as time went by. The other main issue was from being unable to weight-bear for 12 weeks, having your leg bent with crutches and for weeks, gives you a permanent hamstring cramp! Not fun.

Cycling
At week 8, I had a good chat with Mr Bell, the knee surgeon, and we decided stationary bike work was a good idea, I promised to stay seated and not push too hard through the left leg and this had a fantastic affect on the circulation of my leg. Within a week, I lost the purple leg that would appear whenever I stood for longer than 5 minutes. It didn’t take me long to build up to an hour of turbo trainer/ watt bike work and was able to build up a much needed sweat! At the 12 week review, I convinced my surgeon that road cycling would be OK. Although I wasn’t able to walk without crutches, I promised to behave myself and headed off to do laps of Richmond park. Possibly getting carried away by the cycling at the Olympics and did a lap of the men’s road race one day totaling a 120k on that day.

Muscle wasting
I’ve lost 5cm in thigh circumference and have a long road back to get the muscle that has disappeared from dis-use. There is no shortage of help and expertise from my own training and a big thanks to James Vickers, ex-GB ski team physio. We are using a technique called occlusion therapy which is essentially doing weights with a tourniquet. The aim of this is a muscle that has reduced bloodflow during activity can increase in size at a faster rate.

Walking
At the time of initial injury I knew that weight bearing was not an option. After the diagnosis was made and the surgery planned the prognosis was non weight bearing for 12 weeks. (gulp!) Looking back, this is how it went, 12 weeks of non weight bearing using two crutches, week 13 one crutch and week 14 onwards no crutches around home and for short walks but still one needed for longer outings.

Back to work
So 15 weeks after surgery I’m heading back to the practice. Thank you for all you patience and thank you to the great PCC team who have run the clinic smoothly while I was away. You’ll notice I have a slight limp from the muscle weakness, but all is feeling good. Can’t wait to see you all soon.

Craig McLean