Coming back from a broken leg... What expect?

[Prime_Time_Rider]

I recently broke my leg just above my ankle in three bones (tibia, fiblia and one other bone) and will have surgery next week. Orthopedic surgeon plans on putting in a plate on my tibia which has a spiral fracture and some screws. He said he will prescribe physical therapy and estimates I won’t be able to ride until January, maybe December.

I have no idea what to expect as far as rehab and prognosis for riding. The orthopedic surgeon says his fairly confident I will be able to ride after I am healed but can’t say if I will be completely unimpaired.

Anyone out there who can share their experiences with rehabbing and riding after a triple leg fracture?

I realize everyone’s experience is different.

[PetraRiedel]

I had almost the same injury ten years ago. Spiral fracture of tib/fib and ankle. I had three plates and thirteen screws. I was non-weight bearing for 11 weeks - longest and most boring 11 weeks of my life. I had a removable cast (moonboot type thingy) so after 5 weeks I started swimming 3 times per week. This really helped! I had something to do, didn’t feel handicapped in the water and it was great for recovery.
When I was finally off the crutches - I started riding again. Tendons and ligaments in my right leg were somewhat shortened and it felt like my left leg was longer than the right…I usually warmed up and after a while it started feeling more even. But be prepared for weird feelings of asymmetry, not being able to get the heel down in the affected leg and generally feeling awkward in the beginning.
I also had to deal with fear. I am not a timid rider but after the broken leg I had unpleasant fantasies about falling off and re-breaking the leg or the horse falling on me and crushing my leg…those feelings of fear were new to me and hard to deal with. And I didn’t break the leg from anything horse related.
I also did a couple of weeks of physiotherapy - the exercises helped - especially if you do them at home as well.
I limped slightly for years after getting out of bed (tendons were tight and shortened) but that would resolve by walking around for a bit. I have ran 2 half-marathons since the break and I feel that I am 100% recovered.
All the best for a good recovery!!!

[hank]

Mine was 18 yrs ago. Petra described my experience perfectly. I still deal with being more timid a rider than I would like. But I did start my last colt a couple of years ago. We did fine.

[dreamswept]

I didn’t have a triple leg fracture, but I did have a very traumatic fracture of my femur, right where it connects into the knee joint, last year. I required pins in my right lateral condyle and bone grafts where I crumbled up the bottom of the femur. Still amazes me how I could have been in a seated position 32 inches off the ground and land in soft sand and still have that happen, but I was in my driving cart - the pony went left, I went right and kersplat, 3 months of wheelchair time earned right there.

I was non-weight bearing for 12 weeks, started walking again right around this time a year ago and had months and months (and months) of physical therapy. I didn’t start riding until early March and then it was only a few minutes of walking. Serious riding didn’t start till June, and I’m back to walk/trot/canter, and able to do hills and some pretty serious trails 16 months after the accident.

I have somewhat limited bend in my right knee. I have great extension, but would probably fail a flexion PPE. I still can’t bend it as far as it used to go, but I can run, ride my bike and my pony, and recently managed to be able to kneel down on both knees (and crawl on my hands and knees so if I ever have to escape a burning building by staying low, I’ve got a fighting chance). My orthopedic surgeon says there’s a possibility I might need another surgery to go in and try to clean up the scar tissue whatever from when my leg was stuck straight out in a brace for 3 months, but we’re holding off on that to see if I can work it out myself, as little by very little, I am getting some more flex in the knee as time goes on.

It’s been a long uphill slog, but I no longer limp when I walk, have no pain (moderate stiffness in the mornings) and I can ride. That’s part of my healing process.

[Cowgirl]

I had a bimalleolar fracture (tib/fib) exactly one year ago. I had surgery on October 1, 2015: a plate and six screws on one side; two very long screws on the other side. I was NWB from the time of the injury (Sept. 21, 2015) until about mid-November, when I was allowed to start a little bit of weight bearing with a CAM boot. I was released to return to work for half days on December 1, and fully back to my office job on January 1, 2016. On May 5, I had the metal removed in an easy day surgery and was riding my horse (at walk) about two to three weeks after that. Throughout, I had physical therapy. I started PT when I was NWB (driven to my appointments and I had a knee walker). I terminated PT before my second surgery and restarted with another therapist about a month after the second surgery. I had weekly PT June/July/August and just terminated PT about two weeks ago. I have another three months of home exercises.

I had a lot of pain and stiffness issues, and swelling, that PT helped with enormously. Re-strengthening all of the little bits of soft tissue in my foot, ankle and calf has been difficult, painful and time consuming. I had to go through a lot of overuse injury while I was coming back, until I could finally get beyond my foot and ankle and start loading on my calf. I still have issues and have gimpy days now and then and I am not fully weight bearing yet in my left stirrup and have to be really conscious that I am balancing on my horse. I have no idea how long it is going to take to get back to the level of riding I was doing at the time of my accident. I walked for a month; trotted for a month, then started cantering. I am now doing some lateral work (conditioning my horse back up as well) and am now feeling like I am back to training my horse.

The imbalance is really difficult and frustrating. Although I am not ready to go back into serious training, I have hired a coach to help me with evening out in the saddle. I need coaching so that I don’t mindlessly compensate for my weaker leg.

I have my year anniversary appointment with my orthopedic surgeon in a few weeks. I haven’t regained my full range of motion yet, and still have pain and stiffness and swelling. I was told that it could take several years, if ever, to feel normal again. But I am able to get around easily, I can ride; I just don’t have the balance I used to have and I have to spend 45 minutes most morning on exercises for my rehab… I can say, though, I still see improvement from week to week.

I broke my ankle about 17 years ago (different horse) and sort of remember that is was 4 or 5 years to become normal again.

[Prime_Time_Rider]

Wow, Cowgirl, that is really sobering. I had my surgery two weeks ago (plate, screws in three different places) and orthopedic doctor told me it would be four weeks after my one week check up before I would be sent to PT and would be able to bear any weight on my leg.

He did tell my to start ankle flexion excerises 3x daily which I have been doing diligently. I was totally freaked out when I couldn’t flex my ankle at all one week after my surgery, but I have experienced a lot of progress in just on week.

I am totally bummed at my situation and had expected to be able to walk in December or January. I am wondering if that is realistic.

[drawstraws]

I had a major tib/fib fracture at the end of April 2013 although mine wasn’t a spiral - I basically just blasted the heck out of it - it was open with the bone sticking out. I had two surgeries within the first 6 days, went home for 10 days with an external fixator and then went back for a third surgery and was completely non-weight-bearing with plates and screws until the end of August when I finally got a walking boot and I could start weaning off the crutches. It took me until probably mid-October to get rid of them completely and feel balanced walking on my own two feet again.

Because it was so late in the year, I didn’t start trying to ride again until spring 2014. I sent the horse to a trainer and the first few months were rough. Mentally it was hard for me to get back on that particular horse (thank goodness I also had a gelding at home that I trusted implicitly, so he helped me a lot) but I also had some pain in my knee, which was weird because my break was just above my ankle. It mostly hurt while posting, so I would do a bit of sitting trot, and then post a little, and then sit again. After a while it did go away as I got stronger on that leg again.

PT was actually a breeze for me and even though my ankle was a little stiff from being in a splint and a cast for so long, I pretty much had full range of motion back right away. I’ve had the hardest part with lymphedema in that leg causing a cankle and do wear a compression sock when I know I’ll be walking a lot or sitting for long periods of time. I still haven’t found a hunt boot that I can get over that ankle. And three years later, I still get muscle cramps in that leg frequently - in my calf, the outside of the leg where one plate is, the top of my foot, my toes, etc.

Jingles that you’ll have a speedy recovery with few issues!

[egrubbs]

I broke my tib/fib and had a plate and 6 screws placed back in 2004. I broke it on a Friday night, 7/9 in Raleigh, NC and was flown to Northern Virginia that Sunday because UNC Medical Center refused to operate. My aunt and grandparents had me in with a ortho surgeon on Monday and I was in surgery Tuesday morning , 7/13. I was never placed in a hard cast, only a soft air one that was removable. I was then placed in a walking boot after a month or so. I started PT around 10-14 days post op. I was back on a horse 9/13 and continued PT through the beginning of October. I had to switch to Herm Sprenger jointed stirrups to help provide some flexibility to my ankle. I hear horror stories, but being proactive and keeping up with PT is what made my recovery so successful. We also kept up with massaging the scar to help hinder the adhesions around the plate, ligaments and ankle joint. I developed a cyst 4-5 years later that required a drain and injection of the human version of a joint injection. Knock on wood…haven’t had an issue since! I’m also in a high demanding career as a firefighter and paramedic. I also crossfit and run 10k’s. I also still have all my hardware! It wasn’t worth the possibility of being down a month or more when it rarely gives me any problems.

[Man_in_Black]

My step-mom’s horse flipped over on her in July 2014 breaking her leg in three places that required plates and screws and the whole nine yards. Her recovery was lengthened due to uterine cancer that was cleared with a hysterectomy. She is, for lack of a better description, an ants in her pants, always moving, never sits down kinda girl and did some PT but just kind of went back to work where she’s on her feet the entire time. It took a long time for her to get her strength back. Exactly one year after her fall she showed up at the farm and said she was ready and climbed right up on my 16.3hh, built like a house, saint of a Thoroughbred and was 100% fine. Said she felt uneven and less flexible in that ankle and it was a little sore after, but other than that she was fine. She hasn’t ridden since, not for any other reason than lack of time. Last night at dinner she claimed she was ready to sit on my unbroke, warmblood pony…Bless her heart!

No time in the saddle is time wasted. Praying for your speedy recovery!

[Prime_Time_Rider]

Egrubbs, I hope my recovery is as rapid as your’s. My doctor saw me a week after surgery and put me in a soft cast/walking boot and told me to do ankle flexion exercises 3x daily. I go back to the orthopedic surgeon next week and hopefully will be released to go to PT, which will be 5 weeks post surgery. Massaging the scar sounds like a great idea.

[amastrike]

First off, I’m so sorry! It really sucks. I hope you didn’t do it riding, simply because the psychological damage lasts a lot longer than the physical.

In May 2010 I fell off my horse and broke my left leg in 5 places. Tibia and fibula both had multiple breaks. There was also a break in the ankle (bottom of the tibia). They put a rod in the tibia with a total of 4 screws holding it in place, plus 2 more screws in the broken ankle. As it was an open fracture, it was emergency surgery.

I was able to start bearing weight 5 weeks after the accident… so obviously I immediately got on my horse (not the same one I fell off), lol.

It was probably a few weeks after that, so about 2 months post surgery, before I was able to walk easily and confidently without the walker. I also had surgery on my other leg just over 2 months post broken leg, so it’s hard to tell exactly how the broken leg recovery went for riding as I was laid up with a different injury. I never had physical therapy for the broken leg.

So broken leg May 20, surgery on torn ACL July 29(ish), and I was back to riding mostly normally by October or November. I had to dismount onto a mounting block for a while, so there were a few times I just wandered around on my horse waiting to find someone who could hold him at the mounting block for me to get off :lol:.

For the most part, the only lasting issues from the broken leg are with my ankle. I lost probably 10-15 degrees of flexion and have lingering ankle pain which is pretty much taken care of by steroid injections. Fingers crossed that keeps working; there aren’t many options for ankle problems.

I hope your recovery goes quickly! Just don’t rush it, getting back on the horse a couple weeks sooner isn’t worth a lifetime of pain. One thing that probably works in your favor is the fact that you had time between the accident and the surgery, so you’ve been able to think and figure out what your specific concerns are and address them with the ortho.

It’s a ways to go before it’s even an option, but ask your ortho about hardware removal. You may be fine with it in, but it’s good to know getting it out is an option if it causes problems in the future.

[Prime_Time_Rider]

Amastrike, yes, I broke it as the result of a very unspectacular fall off my horse when she stopped at a jump. Normally, it would have been a “nothing” fall, just tumbled over her shoulder, but unfortunately I twisted my ankle when I landed on it, breaking three bones!

I am hoping the fall doesn’t result in any psychological damage, although I am rethinking the wisdom of jumping her again as she has developed a nasty stop.

[lorilu]

Trainer broke her ankle 18 months ago. Surgury and a plate. She had lots of stiffness which she solved by riding with that stirrup one hole longer until her ankle flexed back to normal. That took about a year…

I broke my femur 15 years or so ago. That leg still works differently than the other. One thing that really helped was yoga especially one legged asanas like tree and one leg forward fold… helped me to balance securely on that leg again. I still have to watch that I don’t do most of the exercising work with the “sound” leg- a habit developed during recovery.

[IFG]

Yoga. Not my ankle, but I had a tibial plateau fracture Jan 2015. Two plates, 14 screws. Lots of PT, started riding after 7 months. My horse is semi-retired, so no jumping, bu WTC. I do flow yoga twice a week, and that has been terirfic for rehab. My range of motion is nearly back to normal. I am hoping to get the hardware out this Feb. I had pain when my MCL rubs over a screw. Do PT, do yoga or something similar, and you will be good. This was the third in a string of injuries. I broke my left foot, then my right foot. Neither was surgical, but getting range of motion and strength back is always 1-2 years when you have been non-weight-bearing in my experience.

[egrubbs]

[QUOTE=Prime Time Rider;8876440]
Egrubbs, I hope my recovery is as rapid as your’s. My doctor saw me a week after surgery and put me in a soft cast/walking boot and told me to do ankle flexion exercises 3x daily. I go back to the orthopedic surgeon next week and hopefully will be released to go to PT, which will be 5 weeks post surgery. Massaging the scar sounds like a great idea.[/QUOTE]

Sounds like he’s being proactive by not putting you in a hard cast! You need to find a good PT to work with, they make a real difference! They should have you doing ankle rolls, lateral and medial rolls and massage to loosen the joint capsule. Where are you located if you don’t mind me asking? I crossfit/functional fitness stuff and have myofasical and deep tissue work done by one of the top guys in the industry who specializes in rehab…him and my former guy, moved to FL have connections and can provide a stellar recommendation of who to see!

[Prime_Time_Rider]

I am in the Dallas Fort Worth area and have made an appointment with a physical therapist near me who works with a lot of equestrians. She has also come recommended by several friends.
I am currently doing ankle rolls per my doctor’s advice. I’m not sure what you mean by lateral and medial rolls.
I am anxious to get started with the PT. I still have some drainage from one of the incisions in my ankle so it’s probably a bit early for deep tissue work, but we will see.
It’s been 8 weeks since I broke my leg, which seems like an eternity!

[Cowgirl]

[QUOTE=Prime Time Rider;8860046]
Wow, Cowgirl, that is really sobering. I had my surgery two weeks ago (plate, screws in three different places) and orthopedic doctor told me it would be four weeks after my one week check up before I would be sent to PT and would be able to bear any weight on my leg.

He did tell my to start ankle flexion excerises 3x daily which I have been doing diligently. I was totally freaked out when I couldn’t flex my ankle at all one week after my surgery, but I have experienced a lot of progress in just on week.

I am totally bummed at my situation and had expected to be able to walk in December or January. I am wondering if that is realistic.[/QUOTE]

Well here it is, a month after my last post and I have had tons of progress! I had my last visit with the Orthopedic surgeon one year after my first surgery. She was very happy with the outcome (I have regained nearly all of my range of motion). I told her I was having problems with balance and she said that it was because of the NWB and using my right side more that my core was over developed on the right and weak on the left. I am now 22 days into a plank challenge that has really tremendously helped my strength and balance. (and despite working on a reformer over the summer, there is nothing better for getting your core back than planks!) I can sit trot without stirrups now for 7 minutes (I used to do half of my hour long rides without stirrups and couldn’t even do a minute a month ago). The second PT I had was great and gave me 3 months of homework at my last visit and I have been diligently doing it for six weeks now. My ankle stopped tiring before my calf muscle was engaged and so I could really build my leg strength. I am now pretty even in the stirrups. My riding coach says I am making huge strides from week to week. One thing that helped to even up, btw, was to drop the other stirrup and just use the stirrup on the recovering leg.

I can say that I do still have to take care of it (ice and cold laser) and I do still wear compression socks, but mostly I don’t think much about my ankle and I am so much more balanced in the saddle month later. I think I might be completely normal in another 3-6 months if I continue to work this hard at it and I might be back to the level of riding I was at when I was injured (GP dressage).

As far as just walking…well I was back to work full time three months after my surgery…and I think I had mostly ditched the CAM boot by then. Walking well took a lot longer and, in fact, I had my metal taken out in May, seven months post surgery, because I was having lots of problems with it (it had shifted). I also had walking problems with muscles and ligaments in my feet and toes as I was regaining mobility and PT really took care of that. I was riding 7.5 months after surgery. I probably could have ridden earlier, but my horse was also out of work (although getting treadmill) and I didn’t want to take any big risks.

I was injured while hand walking my horse at a show; and it did translate to some fear problems early on when my horse was a bit spooky, but I quickly got beyond that. I was extra special cautious handling her on the ground for a bit though. Don’t take any big risks and it should work out ok.

[Prime_Time_Rider]

Progress! A week ago (5 weeks post surgery) my orthopedic surgeon gave me the go ahead to start walking in my soft cast boot. I am walking fairly well in it, and have experienced no balance issues. I am able to walk down our road and around the cul de sac (about 1/4 mile) without any assistance or problems.

The bad news is that one of my surgical incisions hasn’t healed well, sp the surgeon referred me to a wound care specialist. Wound is healing, but until it is completely healed the surgeon doesn’t want me to start PT.

[Cowgirl]

[QUOTE=Prime Time Rider;8902511]
Progress! A week ago (5 weeks post surgery) my orthopedic surgeon gave me the go ahead to start walking in my soft cast boot. I am walking fairly well in it, and have experienced no balance issues. I am able to walk down our road and around the cul de sac (about 1/4 mile) without any assistance or problems.

The bad news is that one of my surgical incisions hasn’t healed well, sp the surgeon referred me to a wound care specialist. Wound is healing, but until it is completely healed the surgeon doesn’t want me to start PT.[/QUOTE]

I had to have an amniotic allograft don on one of my wounds. They did I it during surgery. I had the most trouble with it. I use scaraway silicon patches and my horse’s cold laser on it.

[amastrike]

Prime Time, how’re you doing?