Rehabilitation Guide for Tibial Plateau Fracture Recovery - Rehabilitation

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Rehabilitation after a tibial plateau fracture can be a challenging journey, especially considering the complexities involved with your specific injury and the history of polio affecting your right leg. Your concerns about pain, swelling, and the ability to bear weight are valid and common among patients recovering from such injuries.
First, it’s important to understand that the tibial plateau is a critical area of the knee joint that bears weight and provides stability. A fracture in this area can lead to complications if not managed properly. The fact that your doctor has cleared you to begin walking and weight-bearing activities is a positive sign, indicating that the initial healing phase has progressed sufficiently.


Rehabilitation Timeline and Goals
1. Initial Phase (Weeks 1-2 Post-Weight Bearing):
- Focus on gentle range of motion exercises. Since you mentioned you can bend your knee to about 100 degrees, continue to work on increasing that range gradually.
- Perform exercises like heel slides, where you slide your heel towards your buttocks while lying down, and straight leg raises to strengthen the quadriceps without putting too much strain on the knee.

- Use ice therapy to manage swelling after exercises, and elevate your leg when resting.

2. Intermediate Phase (Weeks 3-6):
- As you gain confidence and strength, begin incorporating more weight-bearing activities. Start with partial weight-bearing using crutches or a walker, gradually transitioning to full weight-bearing as tolerated.

- Introduce low-impact activities such as stationary cycling or swimming, which can help improve strength and flexibility without excessive stress on the knee.

- Continue with strength training for the quadriceps, hamstrings, and calf muscles to support the knee joint.

3. Advanced Phase (Weeks 6-12):
- As your strength improves and swelling decreases, you can start more dynamic exercises, including balance training and proprioceptive exercises (e.g., standing on one leg).

- Begin functional activities like walking on uneven surfaces or gentle stair climbing.

- If cleared by your physician, consider working with a physical therapist who can provide a tailored rehabilitation program and monitor your progress.


Addressing Your Concerns
- Swelling and Pain: It’s normal to experience some swelling and discomfort, especially after an injury like a tibial plateau fracture. However, if the swelling persists or worsens, it’s crucial to consult your physician. They may recommend additional imaging or adjustments to your rehabilitation plan.


- Numbness or Tingling: The sensation of your foot being "a bit numb" when you bear weight could be due to nerve irritation or compression, which can occur after such injuries. If this sensation continues or worsens, it’s essential to discuss it with your doctor.

- Fear of Weight Bearing: It’s common to feel apprehensive about putting weight on a previously injured limb. Gradual exposure to weight-bearing activities, combined with supportive devices like crutches or a walker, can help build your confidence.

- Long-term Recovery and Potential for Residual Effects: While many patients recover well from tibial plateau fractures, some may experience lingering issues such as stiffness or weakness. Engaging in a consistent rehabilitation program is key to minimizing these risks.

Conclusion
In summary, your rehabilitation journey will likely take several months, with the potential for significant improvement if you adhere to a structured program. Regular follow-ups with your orthopedic surgeon and possibly a physical therapist will be crucial in monitoring your recovery and adjusting your rehabilitation plan as needed. Remember to listen to your body and avoid pushing through severe pain, as this can lead to setbacks. With dedication and the right support, you can work towards regaining strength and function in your leg.