[DaKahuna]

Hoping to get some advice on exercises to help my recovery from a severe compound fracture to my femur. I am getting close to getting the green light to start some rehab exercises and at 34 years old, I need all the help I can get to try to recover as best as possible. I have no guarantees yet as to my final level of recovery, due to losing a lot of bone. It all depends on how well the bone grafts take. Here's the basic story....

I made a step-down road-gap out near where I live. About a 15 foot drop and a 30 foot gap. I did several practice runs to gauge my speed, and thought I had it figured. When I made my attempt, I hesitated and tapped the brake.... I didn't clear the road.... I tried to ditch the bike at the last minute, hoping I could at least make my body clear the road - no dice. My knee was the first thing to hit and I drove my femur out through the skin and into the ground. As I continued rotating forward, I ripped a 3" x 1.5" chunk of bone off of the front of my femur. Thankfully I also knocked myslef out for several minutes! The bone chunk was actually recovered by friends, only about a 1/2" was exposed, the rest of the 3" had been embedded in the ground! Strangest memento I have from riding for sure.... Below is an x-ray from early in the process.

 

[DaKahuna]

Below is an x-ray from surgery #3, when they put all kinds of titanium hardware in.

Again, any suggestions for rehab exercises or stretching exercises would be GREATLY appreciated!

I have looked for a way to get in contact with Wade Simmons, he broke his femur a while back. No luck on finding a way to contact him though....

 

[Toshi]

what does your orthopod and physical therapist say? they'd be a better rehab resource than us, given that the extent and history of your injury and surgery are not clear.

 

[DaKahuna]

Of course I will be looking to my docs for primary guidance.
But I was hoping that maybe somebody here might have some personal experience that might include something that isn't part of the traditional rehab regimen.

I had partially torn my quadriceps tendon in the process, but they reattached that and it is doing well. I have flexibility of up to about 120 degrees and can get full extension, but not the bit of hyperextension that I can get with my other leg. I have spent the last 3 months with no weight bearing on my leg, and a brace on it pretty much 24/7, so muscle atrophy is bad.

The first x-ray shows the massive bone loss. They needed more bone for grafts than they could take from my hip, so I got a mixture of my own fresh bone and some cadaver bone. Much of my future bone strength depends on the grafts growing and filling in well.

I have never tried acupuncture or yoga, and those are subjects I might be interested in, if they would help. Also any non-traditional exercises that might help, would also be appreciated.

Thanks!!!

 

[Special K]

I broke my femur on October 9, 2004. It was a nasty spiral fracture to the upper third of my femur. A titanium rod and three screws were inserted. It has been fourth months and I am still on a crutch, but can walk very short distances, such as going around my house. (I actually am a long term PE sub and that has really helped me. I.E., being active with the kids as much as possible.) I also suffered a DVT (severe blood clot) going in to week three which set me back.
My injury is a lot less severe than yours, but maybe I can offer you some advice that helped me.
First, here are the links to my story if you want some more details.
http://www.ridemonkey.com/forums/showthread.php?t=99574&highlight=femur
and
http://www.ridemonkey.com/forums/showthread.php?t=101009&highlight=femur
I began physical therapy a month or so after my surgery. It was awful at first. You have probably developed a tremendous amount of scar tissue in addition to the atrophy problem. Initially, I was told to: squeeze my quad and release about 10 times a day, lay on my stomach and try to bring my leg to my butt, sit on my bed and work on extending my leg out - holding it for 10 seconds and bringing it back. This was all done at home with a visiting nurse PT. Then I went to PT outside my house.
I found a PT who is a cyclist and let me tell you -- that makes a big difference. I have worked on leg raises. Theraband extensions to strengthen my hip joint and hamstring. These have really helped me progress from 2 to 1 crutch and to walking. Then hamstring curls, adduction and abduction machine. It is also important to stretch.
Baron Baptiste has beginning yoga videos that I have just started (last week, literally). I would not recommend yoga until you can put some weight on your injured leg, because there are a lot of lunges etc. Make sure your PT stretches you and you stretch as much as you can -- ask your doctor for stretches. PM me if you want some more ideas.
Also -- get on your bike if you have a trainer and your doc approves it. It will really help with your range of motion and breaking up the scar tissue.
Ok, well that is all for now, I guess. I hope this helps. PM me if you want more info. Also -- listen to your doc -- your injury is similar, yet very different from mine.
Kate

 

[Repack]

I would try x-posting this to the DH forum. More people will see it.

I'm Special K's bf and was there when she did her's. Not fun. I agree that you were lucky to be knocked out! I had ACL surgery last year and the PT's and docs said that extension was much more important than hyperflexion. Extension (if I remember correctly) can be limited be scar tissue, and if it doesn't come back soon, may not come back. Hyperflexion comes with time. Everything has tightened up and needs to be stretched back out. I was horrified at how much my thigh atrophied, but the muscle came back quickly. I had a patella tendon graft so it was painful to flex my quad for some time.

From what I know of leg injurries/surgeries in general, I would try to get into a pool. I lived with a torn ACL for 5 years. Then I tore more cartiledge. Thats when things started to suck. It was 6 months between the cart tearing and the surgery. During that time, swimming made a big difference.

A good friend of our broke his femur 3 years ago and said that once he was able to walk a little, hiking made a big difference. In PT, all of the excercises strengthen your leg front to back. Our friend said that walking on uneven ground strengthened the muscle in every direction.

Good luck with everything!

 

[DaKahuna]

WooHoo!
I'm glad to finally get some feedback!
Thanks very much for all the ideas. I will try cross-posting at least a reference to this thread in the lounge and maybe the DH section to get better exposure. I wanted to wait a while and see what I got before doing that, but it looks like I might need to do it.

I was very, very pleasantly surprised when I went to the doctor on 1/31 and got the green light to pursue exercise and even walking "as tolerated"!!!
The doc is both a moto and MTB rider and after talking with me a lot, he said he felt confident in letting me use my judgement as to how and how quickly to pursue a rehab regimen. I am at the one crutch stage, and can even hobble without them at all, after only a couple days of exercise. I did 4 miles on the trainer today! I had to have the seat up pretty high due to limited flex capability, but I am so stoked to spin the pedals again. I also like to go freediving/spearfishing, so I am hoping to be able to start swimming in the ocean soon. I will probably have to start without fins, but I can't wait to start getting active again. The doc warned me to take it easy, and with things healing almost a month ahead of schedule right now, I really don't want to do anyhting to compromise that. I feel like a big enough dummy already.... But it will be hard to resist the temptation to try and have some fun after 12 weeks on crutches!

Unfortunately, this has all happened at a time when I was without insurance, so I won't have access to a professional PT person. So please keep the advice coming!!

 

[Repack]

Thats good that you have an athlete for a doc. My ortho is a marathon runner. I refuse to be treated by ortho's who aren't. The non-athlete's just don't get it.