I have searched but other topics aren’t quite specific to my situation.
After a ski accident and avulsion fracture and resulting knee surgery, I am in a brace with the leg extended for 6 weeks. Doctors advice for activity during this time is to put weight on the leg as comfortable and do anything I like, just do not bend the knee. Now I am four weeks post surgery and things are feeling less fragile, but still a little sore. My activity has been low, and the muscle is shedding fast. Also, the HRV has dropped noticeably. PT will start in April.
I am trying to do a little more walking but taking it slow. I might remove the pedal from my trainer bike and do some one legged riding. But primarily, I think to ease back into some activity before the PT starts, yoga may be a first step.
I started doing one of my favorite yoga videos, with the intention to just skip anything that I can’t do in the brace. The problem is, I will need to skip most of the workout.
Does anyone have suggestions for one of the Wahoo yoga videos that is mostly on the floor and maybe has a number of poses that I can do without bending the bad leg? I could start going through them, but hope to save myself some time.
It’s not yoga and still involves a lot of standing, but many of the Mobility workouts (in the Strength & Mobility section) don’t involve too much knee bending.
Best of luck with the rehab and I hope you’re back on the bike soon.
Gosh that sounds horrific and reminds me how lucky I am after my ski injury at Christmas.
Have they given you straight leg quad activations? Sit with leg out straight, pop a towel under the hamstring and activate the quad to straiggten the leg without any support under the lower leg. Can work towards lifting it a bit. Key is to activate the quad first then the straigten and lift. Also lifting off toes, like heel raises.
Are you getting any physio? I would push for some if you can.
Welcome to the avulsion fracture suffering club. I went 6+ weeks before I did anything physical on the injured leg. Looking back at my history in SYSTM, I see some yoga and some strength work but nothing stands out. Crutching around is pretty good cardio, though and doing slow walks with weight bearing will help with the healing. When I was able to navigate a gym safely, I started doing upper body work just to do something physical.
At 8 weeks I did start riding indoors with a flat pedal replacing my clip less on the injured side and a change on the crank arm length (I have a Kickr Bike so that was just changing the pedal hole). I thought about the 1 legged riding BUT there is a bio-mechanical issue with the hips when you start doing that. I decided that I would rather deal with both legs losing muscle and building them up together than dealing with an imbalance that may cause even more issues.
Getting the range of motion back took another 8-9 weeks of consistent PT (starting about 6 weeks post injury) and working on my own (a stretching strap helps with flexion). I added in a knee rehab program from The (P)Rehab Guys app (8 weeks) then followed on with their 12 week Prehab program.
The good news is that you will improve over time. I’m 46 weeks post injury, did the Tour this year and logged 200 miles that week. I’ve also been able to do some weight training and some rucking to build up strength in the legs. The bad news is you may still have pain (I do) and it may limit some of your riding and other physical activities (my knee gets sore every day and feels ‘tight’).
One thing that I wish I would have done early on was to watch my nutrition a little more closely. It is easy to put on the pounds when you aren’t getting the amount of physical exercise you are used to doing AND are bored from sitting around.
Thanks for the response, Dame Lisa. I have been doing quad sets. They feel very weird, but I’ve been going at it to the extent that it is comfortable. PT, or physio depending on your part of the world start in April. I’m crawling the walls right now though and really feeling like I have been sitting around more than is healthy.
Thanks Chris. That is super helpful information, particularly some of the the detail about your timeline.
I am hoping to start some upper body strength work at the gym soon.
I have the Kickr bike as well. I didn’t consider the bio-mechanical issue you mention and that seems logical. I’m glad you mentioned that.
The surgeon did suggest I could try swimming as long as I keep the leg straight. Sounds like a great way to keep the upper body moving, but I have no idea how to do that without risking an unintentional knee bend. The local Y has leg floats for this purpose, but getting in and out of a pool without the immobilizer is going to be a trick. You don’t mention swimming, so I suspect that is not something that you tried.
I hear you on the weight gain. I eliminated most processed foods and shifted my diet to fresh veggies and lean protein. I am pretty sure I cut calories and have certainly reduced the fat and sugars, but the weight is still increasing. Given that I am losing muscle and bone right now, the weight gain can only be from fat. Frustrating.
IDK, but after an ACL reconstruction in '94 (MX mishap), I got a Nordic Trac because I could swish forward and backward on the skis with my leg straight in a brace. I continued using it throughout recovery, then it gathered dust.
My doc never had me totally locked in the hinged brace. I adjusted the flexion and extension stops to my level of comfort. At my 6 week followup, he took those out to allow the knee to go as full of a range of motion as possible. That is also when he prescribed 2-3x a week PT.
I was told by my PT not to swim. Part of it was kicking could aggravate the injury and part was just the logistics of getting into and out of the pool. PT didn’t say anything about biking and had me using a stationary bike as part of the warmup for our sessions, so I tried to do a short 15-30 minute ride indoors in level mode a couple of times a week.
Two weeks after starting PT and 8 weeks post injury I did an outdoor ride on my mountain bike. The upright position coupled with a dropper post and flat pedals let me adjust for comfort but the first 100 feet I was second guessing myself on if it was a good idea! It was and it pulled me out of a deep depression that 4th of July weekend.
Ultimately I rode El Tour De Tucson’s metric route 6 1/2 months post injury. I’ve jumped on the 80/20 training bandwagon after seeing some very positive results from it versus the more HIIT style training of the SYSTM plans.
When I started riding Zone 2 consistently I dropped about 5-6 lbs between Thanksgiving and Christmas, then plateaued at my weight prior to the injury. Based on a post on this forum, I found the Lose It app, started a 1 lbs/week weight loss program and was able to drop 15lbs and 5% body fat in about 8 weeks while maintaining muscle mass (between nutrition and lifting). So don’t get overly concerned about any weight gain (donuts are a comfort food…) as it will come back off. It just takes time.
I put myself at 90-95% of where I was a year ago and probably as good as I’m going to get in regards to the injury pain and stress tolerance. The ortho and PT both think I’ll probably need a knee replacement at some point in the future (my fracture progressed to avascular necrosis). My hope is to push that off as long as possible to get in my bucket list rides and hikes…
I was told in no uncertain terms I needed a full 6 months of rehab just to be able to be pain free with day to day movement, not sport. I was pretty upset and understand the crawling up the walls feeling. Afrer a couple of incidents of overdoing things, I buckled down and focussed on rehab perfection like a pro. Helps my physio is excellent and gave me a very clear set of boundaries.
Result is knee Doc signed me off 3 months early because I’ve taken 3 months to progress 6 months worth of typical recovery. I was dying mentally but being “good” and not pushing too hard and just maximising the rehab to the absolute max allowed. I still have heaps of work to do but I’m back to full cycling return to play now (a game changer) and will be fine to puah on the skis come snow in July.
The first exercise I was given was quad activations and I was told no limit on how much I did them. The exercises that followed had pain thresholds. There were a lot of set backs and very little progress and then suddenly there was this massive improvement. Trick then is to keep up with the rehab.
Oh the other thing that helped was letting my physio know about every new little niggle. I had a wierd one where the bone bruising and resulting inflammation caused inflammation in a big nerve which then got “stuck” and felt like my ITB was in agony. So she added in some ridiculous neural flossing exercises and it sorted it. Every new niggle she tweaked things and my knee feels so strong now.
I will need a knee replacement down the track but for now, its mostly, back to full play on the bike.
I got lucky. Whole knee went sideways, and popped the MCL. Big time bone and cartilege damage which was the bigger issue. Doc has no idea how I didnt snap the ACL as well. Short term prognosis is just fine, especially because MCLs typically heal really well. So no surgery needed now. The other ligaments just got big spraining.
But he says long term the joint will likely fail because of the other damage. Very wierd injury. Not too bad in the grander scheme of things.
The plan is to be on top of all my strength and mobility work to try avoid surgery for as long as possible, but my perfectly tracking knees are no more which is gutting, but physio is doing heaps to get it back to as close as perfect as possible. He says not to do it again…
Sorry to hear about the injury. May you heal fast.
As someone who has had a full leg brace on for 6w (maximum weight allowed was occasional toe touches and crutches, I had a chat with the consultant after a few weeks and while I was allowed to bend the knee (to an angle restricted by the clever brace thing) I was broadly told to just stay off it and use both crutches to get around ‘or else’.
In short, I did absolutely zero for the full 6w and just let me body do its thing.
Then I just followed the physio and strength work like I was told and happy days.
Like @DameLisa … my knee will likely require surgery one day, but I look after it and feel lucky I got looked after during my 6w layoff and subsequent physio sessions twice a week
No actual activity I found that was relevant in my 6w.
Can’t really think of much (thinking back to my brace) that I could do that was of any real practical use - though I did get told to bend my knee but that because it was a weird separation of tibial plateau from tibia that while fully separated and effectively a disconnected leg, it was ok to bend the knee a wee bit. Scary as F.
So - your fixed leg sounds a bit different but still can’t think of much from that time that would make a mass of difference ahead of the big day when you get asked to walk normally again (and I hope that goes really well )
