Experiences / outcomes for tibia plateau and proximal humerus fractures?

[slp2]

Hi all!! Hoping to get some perspective from other riders on healing / rehab and getting back o to the saddle from others who might’ve had similar injuries. Managed to break my left tibia plateau and my left proximal humerus (pulled the rotator cuff off with the bone break). Surgery on my shoulder went well and the doctor opted to leave my tibia fracture alone since there was very little displacement. I am getting around in a wheelchair because I can’t use crutches or walker with my left shoulder being injured too! It was a weird accident, basically, my horse fell and landed on my left side. He either stepped in a hole, or got tripped up in a clump of tall grass —he tried hard not to go down, but ultimately wiped out and fell on his shoulder.

Anyone have any experiences with healing time, rehab and getting back to walking and eventually riding? I have my post op appointment later today and am hoping that I get some information on starting physical therapy asap! I am going stir crazy as a person who was working full time and actively riding my 2 horses, walking and doing other workouts to help my riding fitness. My pain is minimal and I am doing leg lifts, ankle pumps with the leg and pendulums with my shoulder.

[LCDR]

What is your current range of motion? Same injury managed 30 years ago with bone grafting and took six months to walk wirhout crutches or cane and several years to finally get back to riding. ROM at best point in recovery only 90 degree bend. Being scheduled for joint replacement due to ongoing bone resorption. Since you did not have surgery on the knee you should do much better. Keep up the PT and really work on range of motion no matter how much it hurts.

[slp2]

Thanks for your reply, but ugh— it sounds like you had a long and painful recovery! I can bend a little more than 90 degrees and straighten my knee (doctor said that is okay — just no weight bearing). There’s a lot of swelling from my knee down, so I feel like my ROM is restricted partially due to the swelling around my knee. I am 3 weeks post accident. I am in a leg brace (Donjoy x-rom). I wear it the majority of the time, but take it off overnight as I am sleeping in a recliner for my shoulder so I won’t accidentally roll onto either side. I have adapted to sleeping in one position since this happened.

[Simkie]

I think a helpful rule of thumb for rehab is to expect coming back to take as long as you were out. For example, if you’re non weight bearing for 6 weeks and partial weight bearing for another two…expect at least 8 weeks of rehab from that. So 16 weeks post injury, you can expect to be roughly back at the level you were pre injury.

Being non weight bearing is a lot to recover from. Be kind to yourself & give yourself not only time to heal but recover from that period of not using those muscles. Strength is lost so quickly. That ALONE needs it’s own rehab period, beyond allowing your broken bones to mend.

[SBrentnall]

I fractured my tibial plateau in March 2023, along with tearing my MCL and ACL and getting a patella bone bruise. Like you, I didn’t need surgery because the fracture wasn’t displaced or depressed.

I was on crutches for 4 weeks, I think, but I started riding before that, just at the walk. I used the same type of brace you mention, with the side angles set to 30 degrees to start with. The doctor said pain is a yes/no question with this type of injury, not an issue of level. If it doesn’t hurt, you can do it.

I found it helped to do a lot of pilates reformer work with hands in straps, core work, etc. The key was not to sit around just because I couldn’t work out normally.

I started PT as soon as I was allowed. Stick with it - it hurt, but was so essential to me getting full range of motion back.

By May I was riding normally and in June I went on a 3-mile hike through the mountains with no crutches or cane.

[SBrentnall]

This little gadget was a godsend: I started just with ice, but moved to the heat/ice program as soon as the initial swelling was down.

Amazon.com: Hyperice X Knee Device - Advanced Heat and Cold Contrast Therapy -...

[mikeyscott]

@slp2

Hi all!! Hoping to get some perspective from other riders on healing / rehab and getting back o to the saddle from others who might’ve had similar injuries. Managed to break my left tibia plateau and my left proximal humerus (pulled the rotator cuff off with the bone break). Surgery on my shoulder went well and the doctor opted to leave my tibia fracture alone since there was very little displacement. I am getting around in a wheelchair because I can’t use crutches or walker with my left shoulder being injured too! It was a weird accident, basically, my horse fell and landed on my left side. He either stepped in a hole, or got tripped up in a clump of tall grass —he tried hard not to go down, but ultimately wiped out and fell on his shoulder.

Anyone have any experiences with healing time, rehab and getting back to walking and eventually riding? I have my post op appointment later today and am hoping that I get some information on starting physical therapy asap! I am going stir crazy as a person who was working full time and actively riding my 2 horses, walking and doing other workouts to help my riding fitness. My pain is minimal and I am doing leg lifts, ankle pumps with the leg and pendulums with my shoulder.

Oh this is bad guys, I guess this is why they call it the, nasty accident. It is good to know that you surgery was successful and that you are now doing physio exercises. Good luck to get a good rehab plan from your doctor today. Keep it up with the right attitude and focus on the process of healing ahead of you.

[slp2]

Thanks all— very helpful relies and advice. My follow up appointment went well yesterday. They were happy with how my shoulder was doing post surgery and tibia fracture is healing as expected for 3 weeks in.

They said I can start therapy for my shoulder in 2 weeks. In 3 weeks I have a follow up appointment and they said I can probably start putting weight on my left leg. They might change me to a different type of brace for my leg (one that helps transfer weight). I feel like once I can start walking again (even if limited) it will be major progress.

The ortho surgeon did tell me that my shoulder is going to be my longer heal. Similar to rotator cuff surgery— there is a lot of rehab to get full ROM and strength back. He estimates that I’ll be pretty far along after 4 months, and complete healing at 6 months. So of course, he wants me to wait to ride for 6 months. I’m a bad patient and am hoping to get back on my horses sooner than that, but we will see how it goes. Right now trying to stay positive while I continue to sit on my arse for another 3 weeks!!

[LCDR]

If you want to get back around horses before you can ride, consider this from my experience. Riders, and particularly youngsters at shows, have no appreciation about how limited you are in making quick avoidance maneuvers and will put you in harm’s way of being bumped, pushed down, or otherwise injured. Even having a cane or being on crutches doesn’t seem to help. And if you are in a wheelchair, just stay at home.

[slp2]

Thank you LCDR. Good advice as well.

[SpicyPRE]

Or have a helper.

[Jackie_Cochran]

@slp2, if you cannot resist getting back into the saddle before your healing is complete you NEED someone on the ground helping you every ride for a while for safety reasons for you and to reduce the confusion of your horse. You aids WILL feel different.

With my MS it is not safe for me to ride without help. At least your problems will heal and then you can ride as you wish.

Too much pride can really mess up healing. Your horses might be in the groove of “of course she knows how to ride” and not adapting to your injuries at first, at least that is what happened with my own horses when I started riding them again after serious MS exacerbations. It is hard to have exciting rides when your body cannot cope with those exciting rides.

[slp2]

Thanks— more to think about. I am early on with my injuries and expect that when I start physical therapy, my loss of fitness and strength will be sobering. And, my check up appointments will inform my decisions about what I can or can’t start doing. In the meantime, I am looking forward to the PT as a way that I can get on a path back to normal living and eventually, riding.

For the last few weeks, barn friends and husband have been driving me out to the barn occasionally so I can watch others ride my horses. It’s a quiet boarding barn and I stay safely outside the arena or in the aisle. Of course, my horses are both happy to take treats from me and it’s therapeutic just to pet and see them.

Realistically, the earliest I’ll likely be getting back in the saddle will be about 4 months (depending on how healing is going) or up to 6 months. I posted here because fellow riders have a better understanding of the physical capabilities needed for riding vs other sports like swimming or running for example. Thought it would be good to hear some success stories from riders who have recovered from similar injuries.