Recovery time for liver laceration and displaced rib fracture?

[trakehners]

Curious more for the former injury rather than the latter - I searched past topics but didn’t see a ton on that particular subject. My horse kicked me two weeks ago (I don’t blame him at all, he’s been on stall rest for over a month aside from tack walking and I should’ve upped the sedatives sooner) and I wound up in the ER trauma unit after being diagnosed with a grade 3 liver laceration and a displaced fracture of my tenth rib in the back on the right side.

For some added info, I drove myself (oops) to Urgent Care for x-rays (which don’t show the rib fracture) before they sent me to the ER across the street, and I was transferred from that ER to the main hospital after the CT scan they did revealed all of this (no one thought anything was seriously wrong until then as I was walking around and my vitals remained stable). They thought they may have to do surgery but decided against it due to the aforementioned vitals stability. I was admitted for observation for two nights and requested no pain meds the entire time. It (unsurprisingly) hurt a lot when it happened, but aside from sneezing and the fact that I’m tiring out a lot quicker than usual, it’s been pretty much fine otherwise. I’ve taken some ibuprofen here and there since I’ve been home but that’s been more for headaches than physical discomfort (I don’t have a TBI - just stay up too late sometimes).

I was initially advised a recovery time of 4-6 weeks for both, but I’m curious as to how long one or both of those injuries have actually taken in terms of back in the saddle recovery for fellow equestrians. My trainer has offered me the quietest of her horses when I’m able to get back in the saddle so that I can get my body used to everything again before I get back on my own horse (who is usually a saint, but. stall rest). I don’t want to rush myself but I’m itching to get back to the barn and back to riding and I want to have a more realistic timeline for getting back to normal in the saddle than what the trauma unit recommends for the average person getting back to day-to-day life. My horse has his own recheck this weekend and will hopefully be allowed to start trotting then so I also want to have a better idea of how long I’ll be out of commission before I can get back to doing his rehab myself.

(I do have follow-up appointments with my PCP and the trauma clinic this week and will be asking them all of these questions, but I’d greatly appreciate the horse person perspective too.)

[Willesdon]

I was due to have a liver biopsy to check a mysterious blob on my liver that showed up on a CT scan during post-cancer surveillance. When sitting on my bed awaiting awaiting the procedure, the doctor actually doing the guided biopsy came for me to sign the consent form. “So, you understand there is a 1 in 200 chance of your death doing this? We’re really good so we’re better than the national average.” No one had told it was that risky!! I’ve won money at the races with those odds. And then I didn’t actually have the biopsy because he found the blob was so close to my heart it was just too risky. Even so, I was not allowed out of my bed for hours afterwards and had constant observation for hours afterwards, and was not permitted to drive and had to have someone with me overnight. With that story, I suggest you do not go back to the stables or play with horses until the medics say you may. If your liver bleeds, I doubt you will notice until too late.

[trakehners]

Oh I have absolutely no intention of getting back on before I hit the minimum recovery time that they’ve given me—more wondering how long it’ll be until I feel normal in the saddle again. I’m fully anticipating that it’s going to be longer than 4-6 weeks, just trying to figure out by how many times

They told me from the beginning that I could drive and work as I feel comfortable but I’ve put off going anywhere on my own for the last couple of weeks as I don’t want to do it til I have confirmation this week that my recovery is proceeding as it should. If it was just a broken rib it would be one thing but I know even that can be complicated (my dad was hit by a car while cycling a few years ago and broke three ribs in two places, plus punctured a lung and a few other things, so while he’s fine now I’m fully aware of how seriously to take these things).

Even once I’m able to get to the barn without my parents my trainer won’t let me do anything that could jeopardize my recovery—I’ve known her almost 20 years and she’s always been that way. Mostly I just want to be there to see her work with my horse because I went from being at the barn daily to only being out once in the last two weeks and my brain doesn’t like it.

[Willesdon]

Self control. Just stop yourself from just… Because we all automatically just do around horses: I’ll just pick up this rope, just move that bucket, etc.

[Miss-O]

Almost exactly a year ago I broke my 3rd rib. Right behind my shoulder blade. It felt like a sore muscle at first until I sneezed, it displaced, and I passed out. It took about a week for it to displace after being injured in the first place. It displaced so baldly I almost had to have surgery to repair it. I was told by my GP, the surgeon, and my Chiro to give it 12 weeks after it settled down into its forever home before getting back in the saddle. It took about 4 weeks after the fall that injured it before it seemed to stop moving around. I waited 12 weeks after that. All in 16 weeks of no riding. I was probably being overly cautious but I like my ribs and didn’t want to risk losing one again.

The horse that did it was being restarted. We used the no riding time to give him some more much needed ground work, which really helped in the end. I’m sorry you are hurting. I hope you feel better quickly. I understand the tiring out thing too. That happened to me as well.

[OTTB-Hunter]

I fractured 4 ribs a little over 2 years ago, 2 of them were displaced fractures, with 1 having a floating piece. Same circumstances as you, was hand walking my young mare on stall rest and she got surprised, jump, spun, and kicked and got me right in the back. The rib breaks were severe enough that I did have surgery to have them fixed with plates. My understanding at the time from the trauma doctors was that displaced rib fractures that are not surgically fixed have a higher incidence of not healing properly so rest is key so they don’t keep moving. About a month after the injury, I started going to the barn to spend time with her but didn’t get back in the saddle for another month after that and only at the walk. Then I slowly progressed from there. Probably 6 months until I started feeling even remotely normal again. Listen to your body, if it hurts, don’t do it would be my best advice.

[trakehners]

Thanks for the feedback, all - fortunately the timing is working out pretty well on this at the moment. I had my follow-ups with my PCP and the trauma clinic this week and was told to wait til six weeks out to try to do more than walk (on foot, not on a horse lol), so I’ve got another three and a half weeks til I reach that point (and will still be listening to my body afterward). All the medical staff did say that they normally don’t see people this chipper or comfortable when they have these injuries though The fracture may be displaced but it’s so slight that it wasn’t visible on the x-rays, only the CT, so it’s not like I’m dealing with a significant displacement and my dad and I are both betting that the periosteum didn’t even tear (he’s got a PhD in physical anthropology and I have a BA in it so we talk about those things).

I am allowed to hang around the barn as long as I’m not handling the horses or doing the heavy lifting myself so I’ll probably be out there once or twice a week to assemble pony’s supplement cups and get in my social hour. He had his recheck this past weekend and we decided to tweak his rehab in favor of turning him out in a small flat paddock with no riding for the next six weeks (he was cleared to trot) and doing his scans at the end of September rather than scanning now and having him doing specific work under saddle with my trainer. Our vet said it would lengthen his rehab timeline by a couple of months and isn’t her normal strategy with sport horses, but obviously I’m not riding now and it’s going to be winter when we’re cleared to go back to full work either way, so what’s a couple of months between friends.

It’s only day three of turnout for him but my trainer reported he’s been extremely well-behaved for both going in/out and actually being outside (and that’s with him on fewer drugs) so I think this is going to work out better for everyone (and makes me feel less inclined to rush back since I know he’s happy and getting plenty of opportunities to move around). There was no way he was getting through another 6+ weeks of stall rest without something else unfortunate happening (be it to him or one of us). My trainer has also already told me that she’ll do the first few rides back on him after this rehab period because he’ll be trotting and she doesn’t want me getting back on until she knows he’s going to behave himself, but once I’m cleared to get back on in general she’s got multiple dead quiet options for me to walk around on until I feel comfortable doing more, so all should be good.