Me and My Intramedullary Nail (2mths since the op)

Me and my IM Nail Part 2 (3mths since the op)>>>

Me and my IM Nail Part 3 (4mths since the op)>>>

Just over 2 months ago I had a fall and broke my left Tibia (at the shin) and Fibula bones (the lower leg bones) and had to have an operation so they could put a big metal rod (known technically as an intramedullary nail or rod) down the bone to help the healing process. There is not much information available on the internet about this procedure, particularly the healing process, so I thought I would share my experiences in case it is of help or comfort to others going through the same thing.

Tibia Break

Fibula Break

My fall did not seem like a major one and so it was a shock that I had broken a bone, let alone 2 bones and a massive unwelcome surprise that the breaks were so severe I would need an operation?! I was told that they would likely do one of three options: 1) put in a metal rod inside the length of the tibia bone; 2) put a metal plate across the shin area or 3) put in some sort of metal screw/nail horizontally through the shin.

I asked what the risks were and they said the intramedullary nail does have some risks and if I was having circulation issues before or during the surgery then it could lead to them having to amputate. I thought this was just a normal disclaimer but when I pressed the issue the doctor said there was a significant risk, although small in percentage terms of about 5%. The alternative would be not to have the surgery and have a cast, which would not guarantee the bones would heal okay and would also double the recovery time from 6mths to 12mths. I gave written consent that I was alright with them going ahead with the surgery.

It was only as I was being wheeled down to theatre that I was told they were going to do the more risky option 1. I told myself that 19 times out of 20 it would be fine, but couldn’t help but wonder if I would be the unlucky 1 in 20 and looked down at my left foot (well toes, as I had a cast pre-operation) and thought it might be the last time I would see it. When I stirred in recovery afterwards, my first action was to see if I still had my leg and was very relieved to still see it there.

My leg after the operation

Looking back on it, the hospital (St.George’s Hospital in Tooting, South London, UK) did not give me much information about what would happen to me and I was pleased to discover that I didn’t have a cast. Apparently, the point of intramedullary (IM) nails are that they help the bone heal a lot quicker by keeping it in position and also partly carry the strain the bone normally endures. As the ankle and knee joints are not restricted by a cast with this approach, it means partial weight can be applied and then increased when the bone and leg have sufficiently healed.

The technique was developed by German surgeon Gerhard Küntscher and first performed in 1939 to treat soldiers and helped get them back to health (and to fight again) much quicker. Having a cast and therefore a totally inactive leg for a minimum of 4 months or so requires a great deal of time and physio work to get back to normality. Whereas the IM nail approach would sometimes have soldiers back fighting within 6 months.

I found this You Tube video clip of an operation showing the insertion of the IM nail which would have been very similar, but not identical to the one I had. Note: It’s not particularly graphic but if you are a little squeamish, then probably best not to watch it.

I was told the metal used was a stainless steel alloy. People keep asking me if that means I will set off metal detectors at the airport and to be honest I still don’t know as I keep forgetting to ask. This article here suggests I probably will, but it won’t be a big deal and that airport security staff are quite used to it.

For the first day or so after operation, with a very swollen lower leg, I was on a morphine drip in the hospital and then was given Tramadol as a painkiller along with Paracetamol.  I was taking two Tramadol at a time, every 4 hours, and they made very drowsy as well as making me feel quick sick in the stomach. I let the doctors know and they reduced my intake to one every 4 hours, but I still hated the way they made me feel so decided after about day 3 to stop taking them, but kept them just in case I needed them.

I hate being in hospitals and could not wait to get out. I am in my early thirties and was in a 6-bed ward full of much older men with various issues more significant and serious than my own. Alfred, who was in the bed opposite me, was the undisputed wet fart champion of the ward. One evening there seemed to be an unconscious competition between the others as to who could fart and snore the loudest. Alfred was again the winner. One of the men was quite friendly and chatty but kept wanting to show me his stomach, which I was not so keen to do.

My view in hospital and wearing hospital slippers

I was admitted to the hospital late Saturday night and had the operation the following evening. I was told that some people, particularly the elderly, need to stay in hospital for a couple of weeks to recover but by the Thursday the doctors said they were happy for me to go home as long as the physio gave me the all clear that I was safe and competent on crutches.

I was desperate to get out of the hospital and could not stand to be there any longer than I had to so I needed to pass this crutches test with the physio. I’d been given the crutches late on Wednesday by a physio but unfortunately my first attempt was not a great success and only managed a few feet before having to lie down again. This was partly due to being very woozy from the painkillers, it also was my first attempt at being vertical since the operation and most likely due to me accidentally ripping out a poorly inserted cannular with the crutch and then started bleeding down my arm.

My swollen leg - taken when they were changing the bandages

The following day I stopped taking the painkillers and felt more awake and alert. The stomach guy on my ward had done the crutches test before and in return for finally showing me his stomach he told me what I needed to do to pass. You needed to go up and down the ward with confidence and then go up and down some stairs after they showed you the safe method of doing it.

The truth was it was an effort to get out of bed and even using the crutches to visit the toilet was a major ordeal. Having to wee into a container for several days was degrading enough, but I had refused to do a ‘number 2’ and so when I got the crutches I was able to go in a proper toilet for the first time in 4 days and boy did that feel good! Anyway, I had done a couple of practice runs on the crutches down the ward corridor and was not quick but felt I was competent.

The doctors had said I was allowed to put partial weight onto my left leg which meant when I walked with crutches I could put my left foot on the floor but not put any real weight on it. This is rather tricky at first as every instinct you have says not to put your painful foot (or rather leg) onto the floor. Keeping your leg raised in the air is a lot easier on crutches and you are assured that you are not doing any damage.  When putting the foot on the floor you have to time pushing down on the crutch handles ensuring your weight is carried by your shoulders and not your damaged leg.

My crutches

The physios wander the hospital visiting different patients and so you never know what time they will come round. Whenever I went to the loo on the Thursday I would do so as quickly as I could in case I missed the physio and would have to wait another day. He finally arrived in the afternoon and was a different person to the day before. He looked at my file and wasn’t sure if I was allowed to put partial weight on the foot or not. I told him the doctors had said it was okay and he asked a nurse who said she didn’t know. He then disappeared for ages and came back and confirmed I was allowed to. We went up and down the ward and he seemed okay with that and said that was enough for today. I told him that I wanted to go up and down the stairs and he said he wasn’t sure and went off to check something. I never saw him again that day and had to stay another night.

Poor old Alfred shat himself during the night. As in he properly shat himself and stank out the entire ward. Elsewhere along the corridor I heard a woman screaming in pain needing attention. I had to get out! I decided that whatever happened the next day, whether the physio showed up or not, I was going to leave in the evening.

A close up of just below the knee

I waited patiently for him to arrive and he did so just after lunch. Being off the painkillers (I only took them at night to help me sleep) made me feel a lot better and alert and when the physio arrived I felt confident I would pass the test. I asked him if we would be doing the stairs today and he said we will see how it goes. I then made it very clear to him that he was the only person preventing me from going home and that my bed could be used by someone more deserving than me. I gave him a look that made it clear we would definitely be doing the stairs.

We got to the stairs and he asked me if there were any stairs at my home and if so, were there any hand rails? I live in a flat so the kitchen, toilet and bedroom are all on the same level so that was fine, but I live on the top floor which means going up 7 flights of steps, plus a stoop at the bottom. I could not remember if it had handrails or not but needed to get out of the hospital so told him I had 3 flights of stairs and there were handrails on both sides!

I got my wish and passed the crutches test and could go home. My parents kindly gave me a lift from the hospital back to my flat which also turned out to be a bit of an ordeal. The U.K. had been hit by snow whilst I was I was recovering from the operation and so it meant the pavements and roads were very slippy. Not ideal for someone uneasy on crutches and a broken leg.

My ward seemed to be miles away from the exit of the hospital where I could get picked up by my parents’ car, but I was determined. My parents were stressing and fretting, getting annoyed with each other and I with them. When parking outside my building, my Dad preferred to use the side street from the main road but that was far too slippy and so he had to reverse onto the main road. Walking from the car onto the pavement was really quite tricky and very cold! I wasn’t able to put shoes on (my left foot and ankle in particular was very swollen) and so was wearing these pathetic and most unsexy hospital slippers.

Hospital Slipper

My parents were either side of me looking very anxious and every unsteady movement I made they over-reacted putting their arms out to catch me and making ‘aargh’ noises. They were just worried and wanted to help and make sure I was okay. However, it wasn’t helping me and I was in pain and quite cold so I got rather impatient with them and was quite rude to my poor Dad at one point. I got through the gate and to the stoop when I first had to start going up steps. I had forgotten the exact order of the method the physio had told me, but after step 3 or 4 I remembered and was able to get up stairs a lot easier and quicker than I thought I would, albeit one step at a time.

The safe method of going upstairs (or down) with crutches is to hold the hand rail with one hand and then both of the crutches in the other hand. One of which is used as a crutch and the other is horizontal as you are just carrying it, effectively. This is a safe method, but it is slow. It is also cumbersome when going up flights of stairs as when you have got to the top of one flight, you revert back to 2 crutches as you go round the corner and then have to change back to one crutch as you go up again. The alternative is to hop round, with the 2 crutches still in the one hand, which is what I ended up doing. After a few weeks you may feel confident to abandon this safe method altogether and use both crutches going up and down the stairs. I have been doing this for the last month, although I am sure physios would disapprove.

I got into my flat and lay on my bed, in my own clothes (not the horrible hospital gown) surrounded by my stuff in my bedroom that would not be disturbed by some nurse in the middle of the night asking if they could take a swab of my nose and groin. To which my response was initially okay and then as I realised what she had asked, “Hang on, you want to do what? Why do you need to do that? You do realise it’s my leg that has the problem?”

Being at home felt great and I was so relieved to be out of the hospital. My parents tried hard to persuade me to go and be with them in Somerset (2-3hrs drive from London) whilst I was convalescing. As the bedrooms are upstairs in their home it would mean them converting the living room into a bedroom for me. It would not be ideal and also, more importantly, it wouldn’t be my home. It wouldn’t be my bed and I wouldn’t have my stuff or my independence. It was better, although harder work for me, that I was in my flat. I don’t regret that decision in any way.

I’m still single at the moment and quite an independent, self-reliant sort so it was quite hard to be in my position where I did actually need a bit of help. My parents had been to the supermarket so I was stocked up with food and would not need to go to the supermarket for a while. A lot of the supermarkets do internet ordering and home deliveries and my flatmate offered to get stuff for me too so I knew I would be okay on that regard.

My first day at home alone was interesting. It’s the day the full realisation of your situation hits you as you figure out all the stuff that you are no longer able to do. So much of what you do in life depends on you having two able arms and legs.

Showering suddenly is a very precarious activity as you are balancing really on one leg and cannot move around. You can only wash yourself with one hand as the other is needed to hold on to the wall. It was only a few weeks ago someone suggested that you don’t actually have to stand up and you could sit on the floor in the shower/bath, I wished I’d known that at the beginning! As you have bandages, you need to have something to protect them from getting wet and my mum sent me the below which worked quite well.

Lower-leg guard

I am pleased my kitchen is quite small and so I can hop from one side to the other and rest on the counter without having to use the crutches. I was very pleased when I made my first meal for myself … some toast and a cup of tea. However, to get this from the kitchen to my room necessitates only using one crutch and carefully holding said plate or cup of tea and hopping gently without dropping or spilling anything. So transporting a simple plate of toast and a cup of tea turns into a palaver of two trips and even a third one to get the other crutch if you did not think of this when you first left your bed.

Going to the toilet is a bit tricky too and you have to be quite careful initially at lowering yourself down and standing up. It helps my loo is nearby and very narrow so there is always something to lean on or hang on to. I’ve also had to go from being a scruncher-stander to a scruncher-sitter.

As important as the physical side of things, is your mental attitude. After my operation in early January I was told it would be a minimum of 3 months until I was better and actually more like 6 months before I could “do the things you want to do”. Basically, all the plans and expectations I had for 2010 had just been thrown out of the window. I was hoping to get back into my jogging routine (having abandoned it for 3mths) and now I was being told that it would likely be July before I could think about doing something like that.

I feel I have approached the whole scenario quite well and in good humour. In fact, I have been quietly proud of myself in this area. I haven’t been angry about the situation or thought about ‘why me?’ or that is really unfair. It has happened and so you just have to get on with it.

I have focused on short-term goals rather than the end goal finish line. These goals were getting though the operation okay, then getting out of the hospital and then my first hospital check up about 2 and half weeks later. The next milestone was the following check up about 5 weeks later (a couple of days ago as I write this). More of this a bit later on.

The first week at home was the toughest week by far. The leg was still very swollen and very painful when not in a well-cushioned elevated position. Whenever I stood up, it felt as if blood was rushing in to the lower leg all and would be extremely painful for about 5-10mins. The kind of pain that leaves you out of breath and so I had to psyche myself up for every trip to the toilet or to the kitchen. It would be such a relief to get back to my bed and get my leg back on the pillows.

The swelling of the lower leg, ankle and foot meant that the leg seemed distorted and when I put the foot on the floor and tried to straighten it, I could only get my foot flat by standing at an odd angle with my other leg slightly bent. I was quite concerned that maybe something was wrong and that the metal rod was misaligned. However, when the swelling went down, all was fine.

After the first week at home, the swelling in the leg went down and it started to look quite normal and the pain gradually subsided. The 5-10mins of tremendous pain every time I stood up got less and less in time and intensity and I felt a lot better and was motivated to be more mobile.

I had been house-bound for over week and felt it was now time to venture outdoors. I planned a trip to my local shop to get a few sundry items, something that previously would be a nothing task that would take only 10mins to do. Now I had to plan this carefully as I felt sure I could get down the 7 flights of stairs and then the 50 yards to the shop without any problems. However, I was concerned about the actual shopping part as I would not have a free hand to carry the items I wanted to buy.

My solution to this was to use a rucksack which when in the shop would come off my back and, using the small top handle, would rest on one of the crutch handles. That way I could walk around and simply put in the items as if it were a basket. When full of items it does become a little difficult to walk about with, but overall has been more satisfactory than the hassle of putting the rucksack on and off again throughout the shop.

When I ventured outside onto the street I felt very vulnerable on my crutches and was really wary that someone would accidentally bump into me and I would fall over and damage my leg more. That feeling of vulnerability reduces the more you heal and the more confidence you gain on the crutches.

I was more than a little chuffed at having got to the shop and back with my shopping. I felt independent and quite knackered! Two days later I went with a housemate to meet a mutual friend at a nearby pub for a drink. The pub is a 7mins walk, but on crutches it seemed to take forever and was quite uncomfortable. I had got some padded bike gloves to use with the crutches but still managed to develop blisters. Some people wrap bandages or padding around the handles and I think this may be a better approach.

In the pub we sat on stools and had a drink and it felt good to be doing something normal again. It was my first social engagement since having the operation 3 weeks previously. It was not a comfortable experience as at that point whenever the leg was not elevated it became sore quite quickly and so I was always readjusting my position to try and make it more comfortable.

The elbow crutches I have are really quite good, but the one issue I have with them is that it is very difficult to keep them standing upright when resting against something. It only takes a slight nudge and they will fall over, something that happened many times when at the pub. However, it did act as a good ice-breaker to talk to people (women) who would ask what I had done.

Not having a cast was really good but sometimes it would have been useful to have one. People would notice the crutches and then look at the leg and because there is no cast they are less sympathetic, like I’ve just sprained my ankle or something.  Once the swelling went down it was easy to put on shoes and socks so apart from the crutches I look quite normal and able-bodied. So out an about on buses and trains people don’t give you as much space and are less wary about bumping you as they would if you had a cast.

My first hospital check up appointment was an important milestone I was working towards and I would need to get a bus for the first time whilst on crutches. Buses in London have a big step up to get on and I was worried about finding a seat in time before the bus started moving, not getting hit by other people and then getting off as you cannot stand up until the bus has stopped.

The bus experience was not as bad as I thought on the way there, early afternoon, and I was able to get on the bus without a major jump up or anything and found a seat relatively easily. However, the journey back was at rush hour and I had to fight a swarm of people to get on and then find a seat. It was okay, but I wasn’t comfortable.

The hospital check up went well, apart from the ridiculous waiting time and had an X-ray done and then spoke to a consultant who confirmed the IM nail was aligned exactly as it should be and that I should come back again in 5 weeks time. He said if I started to feel better that I could start putting a little more weight on the leg.  Rather than stitches, I had metal clips and these were removed at the visit. They have a little device a bit like a fancy staple remover that takes them out and is mostly painless.

Metal clips below the knee, just before they were removed

Bottom left is the bruise and mark on the shin from where the bone almost came through the skin

It was the first time I got to actually see the metal in my leg and was a little shocked as I saw more metal than I expected! When I was told that I would have a metal rod in my leg I had pictured in my head a thin rod and some small screws at each end to hold it in place. As you can see the IM nail is quite substantial and the screws holding it in place are the width of the leg, seeming like they may pop through the skin at any moment! The doctor let me take a photo of the X-rays.

X-Ray of IM Nail in my leg - top left is my knee and the whitest parts are the nail and screws holding it in place

Another angle - showing the IM nail just below the knee

Passing that first big milestone was a real motivator and confidence boost as all the worries I’d had were now gone and I was feeling more comfortable and less in pain as each day went by. Thankfully I work for myself and so it meant I could now start to get back to work and earn some money. Unfortunately, I am self-employed and so I had no income at all for January and I was not cash-rich when the accident happened and so it has left me in a difficult financial position, one that I have not yet resolved.

The next few weeks I ventured out a bit more, went to a few work meetings, to a friend’s birthday celebrations and even travelled by train on my own to Birmingham (2hrs from London) for another friend’s 30th birthday. Actually that latter trip was a tough day as it was a Saturday but I was doing some work for a client in West London and the plan was to finish up there and then head straight to Marylebone to catch my pre-booked train. I realised as I left my client that I had left my train tickets and wallet in my flat so had to go all the way back to South London to pick up my wallet and then travel across London again and buy a new much more expensive ticket to get to Birmingham. I was so annoyed with myself.

Using the London Underground is not the easiest thing in the world as most stations are not geared up for people with disabilities. To get through the turnstile you have to swipe your oyster card and quickly get through the gate before it shuts on you. You feel a bit vulnerable on the escalators and it is a bit hairy if the person in front of you decides to get off at the very last moment. So far people on crowded buses and trains have been really good and someone has offered up their seat when it has been busy.

My next milestone was a couple of days ago with my second hospital check up. I have been getting really bored and tired of being on crutches and the pain has pretty much gone, just a little soreness. In the week leading up to the appointment I had felt a lot better and had been putting a bit more weight on my leg, but not too much as I still have a bruise and swelling where the tibia break was (the shin). I was eager to start physio and start the process of being able to walk again and did not want another 5 weeks of being on crutches.

The appointment went well and was told I was healing fine and that I can start putting more weight on the leg. I showed the consultant that I could stand on tip-toes unaided and could walk without crutches, well, I can do this rather slow pathetic hobble walk. The consultant made a ‘lame’ joke about is that how people walk in Clapham (where I live) and said I needed to start physio and putting weight on the leg would aid the healing process. The nurse told me that when I started putting more weight on the leg and doing the physio my leg and foot would swell up, but this was normal.

I left feeling very happy. I had passed the milestone and was onto the next phase. I now only use one crutch when moving about the flat and although it is not a fluid movement and still a bit of a hobble, it is a lot better than before. I can now put the used tea bag straight into the bin from the cup (as you need two hands to do this) rather than putting it on a plate and emptying it later.

When I was waiting at the hospital I saw another guy who had crutches. He could walk without them and had a very slight limp and walked into his appointment carrying the crutches and then came out without them. That is my next goal, to be like that guy at my next appointment in 6 weeks or so.

My ultimate goal is to be able to do a 10mins jog. Once I can do that I will feel like I have recovered, but that is a long way away and I am just focusing on the next goal.

If you have your own experiences to share or know of useful information or resources online please add them in the comments below.

Me and my IM Nail Part 2 (3mths since the op)>>>

Me and my IM Nail Part 3 (4mths since the op)>>>

Jake McMillan

242 responses to “Me and My Intramedullary Nail (2mths since the op)

  • Mark Thomas

    I have recently had excatly the same operation as you. Mine was on 13th March 2010.

    Im amazed as to how much i can relate to your story, im interested as to how things are now?
    So i can get a estimate on my recovery

    Do you have a email address i can contact you ?
    email me

    Thank You

  • MiamiMilt

    Hi Jake,
    I’ve had a similar “Nail” procedure, only mine was an ankle fusion and the Biomet Nail went in through the bottom of my heel, up into my tibia and it was only about 8″ long. I can’t emphasize enough that you don’t rush it. I had a couple of screws that started backing out in the second month, tenting the skin up. Wow, did that hurt. Skin has the most pain sensors of any body part. Because of infection risk, I had to go back into the O.R. to have them removed. At some point they’ll probably tell you to start trying to bear weight on it because the body’s natural reaction helps speed the healing. I was given an Exogen bone growth stimulator device (sonic I think) to use for 15 min each day with the leg elevated. It’s a small battery powered box with leads to two pucks that you sqeeze some conductive gel onto and hold in place with a velcro strap. I’d like to think it worked, probably did more to improve my attitude than anything else. I came up with a pretty good way to carry groceries or whatever, up stairs and around the house while on crutches. I kept a bag of Bungee Cords in the trunk, the kind that are a variety of lengths with a hook on each end. I picked out one that was long enough to hang around my neck with at least six inches to spare on each end. Then I’d just hook on an ordinary plastic grocery bag filled with whatever I needed to carry. Works like a charm, both hands stay on the crutches and the bungee stretches but is comfortable on your neck. Since you’re leaning forward on the crutches the bag just kinda hangs steady. Let me know if that works for you. I also used a lot of freeze packs to ease the pain and bring down swelling, but you’d better check with your Doc first on that one.
    Hang in there !

  • Terry

    Hi Jake,
    I had a skiing accident in Ramsau, Austria on the 6th. March. I went through a lot of pain being moved from the top of a mountain to the hospital. Took nearly 2 hours to get to hospital upon which the removal of the ski boot nearly killed me. Don’t think I’ll go skiing again.
    They operated on me straight away because of the onset of compartment syndrome. Also received a nail 315 mm long and made of Titanium. Woke a few hours later on my back with a tube coming from my knee to a small bottle strapped to the bed beneath me.
    My life afterward was nearly a carbon copy of yours, apart from the slippers.
    I was released after 5 days with a lightweight resin plaster, which was cut from top to bottom to accommodate swelling. It was removed after 2.5 weeks along with the stitches. Now I have the same problem, ‘no plaster no problem’.
    Since then I have had 2 physio visits at home to help with knee and ankle mobility. She also massages my scars, because if not they can apparently glue to the underlying tissue thus reducing mobility even more. I have also been given a scar ointment (Contractubex) to reduce scaring. Next week 20th April is my next appointment to see if I can full weight bare my leg. I hope so…
    Before my accident I was a runner, running approx. 200Km. a month. With you having a 2 month advantage it would be interesting to know how you get on.
    Get well soon.

  • Todd

    I broke my tibia in two places about three inches above my ankle and my fibula inches from my knee.lucky me! Now I can’t lift my foot or my toes. They say I did damage to a nerve around my fibula.and That it could take six months to a year before It heals. I think I can do better than that! It’s been around two months. I’m shooting for four months.then I can get back to walking without tripping on every thing my foot passes over. I like a good challenge. this should be about the biggest one I ever come across. It should be a lot of fun.ha.ha.

  • Jae

    I am so happy to have found your blog!!!!! I am female and I have been through almost the exact same experience as you have. It was , Monday, April 19th and I had just come back from the most wonderful cruise vacation ever!!! (Cozumel, Mexico, Roatan, Honduras and Belize). I was in my bathroom getting ready to go to work , first night back, on my midnight shift, when I failed to turn on the bathroom light, was wearing socks and somehow slipped and fell over my travel case. I remember grabbing ahold of the towel bar on the wall and it broke loose, and I went down, hard! The pain was unbelieveable!
    I was not able to get up to walk , and that is when I realized that I had a broken leg! I am a nurse and I was annoyed that this had happened, because, “I didn’t have time for this, I have to go to work!” By then I was in shock, because I had never broken anything, and I couldn’t believe this was happening to me! I had to scoot on my back to my bedroom holding my leg straight up, because the pain was making me want to pass out.
    I managed to make it to the phone and called my job, told them I would not be coming in to work(an hour before my shift)and one of the nurses offered to call 911 for me. I did not know how I could open the door for the ambulance drivers, because I didn’t know how I was going to get to it.
    I did manage to scoot on my back, holding my leg straight up and get to the door, unlock it, and scream for help!! They were all so wonderful, the ambulance drivers, the fire department AND the police!
    When I got to the local hospital ER, I was totally in shock, my blood pressure was 238/110. They gave me Vicodin, and Morphine! I had NEVER had any of that stuff before, but I didn’t have much pain after that. The x-rays showed a spiral fracture of the left lower tibia and a fracture of the fibula. I was given a temporary plastic immobilzer and made comfortable until they could get my blood pressure down. (that took a few days) and I was so nervous and scared that I kept having to use the bedpan to pee, so they just put in a catheter and that was a godsend!
    The Orthopedic Surgeon came in the next day explained what he was going to do, next thing I know, they shoved a lot of papers in my hand for me to sign and I waited until late in the evening for surgery. I was loaded up on drugs, taken to the OR, the Doctor explained again what was going to happen and I don’t remember anything but waking up being wheeled back to my room.
    I don’t feel that I was given a choice to say no to this proceedure or anything else, they just told me this is what we are going to do and that was that! I am still very upset that I was told that the incision by my knee would be about 2 inches, instead it is 7 inches long, down the leg and I had 47 staples!! That hurt like H***!
    The leg break did not hurt as much as the staples in the knee. The next day the physical therapist came in with a walker and said that I was going to try to get up to walk. I did ok, that day and the next day and after the catheter was removed I was allowed to get up to the bathroom as often as I needed to. I did ok,but the bathroom was close by the bed.
    By Friday(April 23), they were discharging me. I spent 5 days in the hospital and was sent home over the weekend by myself, with a walker, and pain pills!
    My leg was extremely swollen, and that blood rushing to your feet thing you mentioned is certainly the truth. I didn’t have a lot of pain, but I was so uncomfortable with the whole mess!! But as a nurse, I just gathered up all my nursing strength and nursed myself the best I could. I kept track of my blood pressure, when I took my pain pills, vitamins, meals and all nursing measures.
    I had an appointment with the Orthopedic surgeon that next Monday, I had to drive myself to the hospital to see him, and my car is a 5 speed, stick shift!!! I have been able to figure a very good and safe way to change gears and use my right foot. It’s tricky but it works!
    In the mean time, I find out that I have been terminated from my job, because I had been working there less than a year(9 June is now 1 year) and I was not eligible for any leaves and when my earned vacation time ran out, I would have to use disability benefits. That all was well and good and worked fine, but since I was fired, the disabilty benefits stopped. My last paycheck was 15 May and only for $235.
    I applied for unemployment benefits, but you have to be able to work to qualify for benefits and I was still unstable and not able to walk very well.
    Fortunately, where I work there is a union and a fantastic group of union reps who fought very hard for me, so I was able to get my job back, but that meant that I would have to go back to work before I was physically ready. The doctor had originally said that I would be off work from
    19 April until 19 June. But I had to return to work on 5 June, in order to get my job back. And since I have just started back to work, I am and have been operating on little bits of money that people give me and praying for miracles!
    This has been so hard, but I am getting through it. I am now in week 9. I have very little swelling, most of the bruising has healed, but I have pain every day. I stopped taking the pain pills two weeks ago, and just use Extra StrengthTylenol, because I have to have a clear head to work!
    Going to the grocery store was not so bad for me with a walker, after getting out of the car and to the door, the shopping cart helped me to move along very well.
    Now after working full time for 2 weeks, I am mostly tired and not sleeping well, still not able to walk very well, (I don’t get a physical therapy exam until 30 June and I still have another appointment with the Orthopedic Surgeon 26 June). I don’t use any walker or cane now, but I am very slow and if I step the wrong way, it hurts like mad!
    But I am taking it one day at a time and thankful for all my blessings whether good or bad!
    And that’s my story!

    • jakemcmillan

      thanks for sharing your story! The very best of luck to you and hope the rest of your recovery goes well!

    • Sazofraz

      Sorry you’ve had such a tough time. I guess you are in the USA. I hope UK doesn’t go the same way. Please I’d love to know how you changed gear in your car. Please can you share the information?

    • Rafa

      Impressive story, thanks for sharing your experience. I had this same surgery 2 weeks ago. I was wondering how you feel after almost 7 years? Also, I have the same 5 speed stick shift car,woundering about that trick? : )

    • Jill

      I am 52 year old femal same surgury..3 weekss after surgury i have minimal knee bending and no movement i foot.when walking lots of blood sems torush to my his ok

  • matt bailey

    im only 13 years old, and a few weeks ago i was struck by a car while on a 4-wheeler. i broke my upper leg, they had put rods in it. i also broke my ancle and fractured my skull. i was in a coma for 2 days…i was life flyted to the hospital an hour away. but now its not just inuries were strugling with. the helecopter ride was $19,ooo and the man who hit me was 92 years old and now wants us to buy him a new car. (which i totald) he was going about 50 mph when he hit me ,but it was my fault. I just want you to know im praying for your recovery andwas wanting you to pray for me also.

    -thanks, Matt.

  • Andrew Richardson

    Hi Jake –

    I had the same operation as you about 10 years ago- I was using google to see if I could find a synopsis of the whole procedure/recovery, and your post was excellent !! Informative, some good links, some humour and – most importantly – a happy ending! Well done!

    The pain is still clear in my mind (both getting the injury playing soccer and the weeks of pain during and after the operation) – Horrible, but “character building”!! One difference was that after the operation I was put in a cast for two weeks (after which they removed the cast and the staples) – Sometimes my leg swelled up so much I thought it was going to crack the cast open. The pain!!

    I am originally from the UK but got all this done in USA.

    I have a couple of questions for you –

    1 ) Did you ever get the pin removed? I did. It was after everything was feeling great again, about a year later. It toolk a long time to summon up the resolve to call the doctor and get it scheduled!

    2 ) I know you are trying to help people (not scare them!) but what are the risks in the procedure (I guess I will google this myself). To be honest, at the time I was just happy to get things fixed – I didnt think about any risks

    • jakemcmillan

      Hi Andrew,

      So sorry, just realised I never replied to your comment! Thank you so much for sharing your experience, it is very useful to hear.

      In answer to your questions:
      1) No, I didn’t have the pin removed and my doctor advised not to even consider this until 12mths after it all healed (which will be this summer). I am not sure if I want to do this or not? I take it you have? What was the experience like and how long did it take to recover? (also see Nick’s comment below)

      2) I was told there were some risks that were not trivial, in particular to do with blood flow. They kept asking me before and after if I was getting any numbness/pins or needles feeling in my foot. The doctors advised me that this operation can lead to having to amputate in about 5% of cases. This definitely scared me a little.

  • emily

    Hi Jake
    Me again! Just wanted to say on this site, thanks for your blog – its so hard to ifnd anything of any use on the internet about recovery etc. I broke my tib and fib snowboarding Jan 2010. I’ve had massive knee pain the last 6 the bottom right of my knee (anterior) and numbness al around that area. I cant run or squat… so am having mri scan to see if they can see what it is. Anyway my specialist suggests having the rod out, as sometimes this helps the knee pain but they dont know why. Has anyone had this done?? Has it helped the knee pain?? can you now run??
    And if any of you want a laugh here’s my blog from the time of the accident. Good luck with everyone’s healing! x

    • jakemcmillan

      I can definitely recommend reading Emily’s blog! Thanks Emily and best of luck with your recovery.

    • Nick

      I had my metalwork taken out 10 days ago (18th Feb 2011), and all is good so far. I’ve not needed any pain killers, and was able to move about the house without the crutches within 24 hours. I still use them outside of the house, and will do so at least until I go back to get the stiches out on Monday week. I think the crutches are a precuation more than anything really, as whilst there are holes in the bone there is a risk of new fractures if say you trip or slip. I’m not planning on jumping down the stairs for a few weeks either. I imagine it’s all common sense rehab from here building up strength whilst avoiding impact for the next six weeks. I’m finding it difficult to find information on the recovery timeframes, or any rehab plan as such, so anything you guys might have found out would be useful to see.
      I’m hoping to go skiing at Easter this year (7 weeks after my op).
      My consultant has previously said I’d be ok for skiing six weeks after the removal, I guess that’s the standard healing period for slight fractures/holes in bones !

      Here’s my background and rationale for going for the removal.

      I went through the same experience , breaking tib and fib in my right leg in November 2009 playing 5 a-side football. To read Jake’s blog bring’s it all back, ah such found memories ! I played football for the first time exactly 12 months on from the night I broke my leg, something compelled me to go back that night, and I’ve played a few times since. I’ve not had too many problems although suffered pain in both my ankle and knee that put me off wanting to run too hard. Either way I was committed from early on to getting my rod removed as each time I asked about skiing etc, the doctors just said it get’s really messy if you break it again whilst the rod is in there. That for me threw up some horrible images in my head of where I’d be with a new break and a bent or broken rod, or even what damage I might do to my knee if I crashed skiing to a point were it would normally break the bones, but didn’t because of the rod. Another consideration for me was a family history of arthritis problems (including my mum’s replacement knee joint), and the possibility that would come my way at some point. My consultant said to me the rod would need to be removed before I could ever have any knee joint replacement. He also said that as time goes on these things get harder to remove, I think the bone grows up and around the screws and the top of the nail slowly covering them.

      For me, wanting to ski and play football again today, plus with the possibility of arthritis forcing a joint replacement in later life it was an easy decision.

      Best wishes for your recovery to you all who are going through this process.


      I had my metalwork taken out 10 days ago, and all is good so far (apart from a 24 hour readmittance to hospital for IV antibiotics !)

      • jakemcmillan

        Hi Nick! Thanks so much for sharing your experience. You are the only person I know of who has had the IM Nail removed and there is so little information out there about recovery periods and what to expect. It seems pretty positive if your Doctor thinks you can go skiing within 6 weeks!

        Best of luck with the recovery and if you remember/have time, it would great to get an update from you in a few weeks time?

    • Yamit

      Did this go away? I have the same problem!

  • emily

    Thats great news Nick! So pleased it all went well for you. As my knee pain has left me walking with crutches aavery day a year after breaking it I’m having the op in April to remove the rod. The Dr’s reckon it’s a little bit too long and is waring away soft tissue in my knee! Eek. So it’s good to klnow recovery for the removal as there’s NOTHING written about it! So pleased you’re up and about 24 hours after. And going skiing this season!! awesome. Might be a while for my knee to recover but i have my fingers crossed for 2012 season..
    Good luck with everything and thanks for writing on Jake’s site. It’s SUCH help to read about other people.. It can be pretty lonely!

  • Nick

    Jake, Emily, and to anyone that follows…

    Here is a a quick run down of my recovery three weeks on from my nail removal.
    I have to say it’s gone pretty well, and I’m starting to believe the Easter skiing can be a reality.

    Week 1

    Resting with leg up, managing the swelling. leg was bandaged to prevent too much swelling on or near wounds. This resulted in fluid sitting above the knee, and I could hear squelching noises from knee. This was a little bit concerning so called NHS direct. They said go to the hospital, er thanks for the advice, including call an ambulance if it gets any worse ! There is nothing quite like being put at ease is there.
    Went to A&E and the doctor told me the noises were not a problem, just some air trapped when the knee was closed up, and it will be absorbed by the body. They did however re-admit me to hospital for 24 hours for iv antibiotics due to a high temperature and blood pressure and concern it was an infection. I think those were more to do with the heat in the hospital and the 4 hours or so stressing before someone told my it wasn’t a problem !
    I remeber I was given antibiotics after the insertion op, probably becuase I was still in hosipital, but given nothing (buy your own painkillers on the way home) after the removal.
    Regardless of this recovery slip up I was off the crutches in the house within 24 hours although continued to use them on the stairs for a few days. I used the crutches whenever outside the house all week.
    I was treating the wound areas with a microwave heat pad 2/3 times a day. (it’s something a bit like a beanbag).
    Once off the crutches, I’d be climbing the stairs with left (good) leg first on each step, and coming down with right leg first on each step.

    Week two
    Fluid on knee gone – so has the squelching !
    I did a couple of theraband exercises to stretch ankle and bend my knee, as follows: Whilst laying down, hold the band then wrap round pad of foot and with leg extended push toes out as if standing on tip toe. Second one from same starting position bend the leg as far as possible pulling knee up to chest, and then extend out.
    Towards the end of the week I found I could put some extra pressure through the joints with a degree of weight bearing doing a few mini squats being careful to balance the weight with the good leg. I find it feels good to stretch out and feel a “recovery” pain that you know is going reduce with every day. By this point’ I’d progressed to climbing the stairs left leg,right leg, although still felt more confortable coming down them right leg first with each step.
    Started going out without the crutches towards the end of the second week. You’ll likely feel well able to go out without the crutches before this, and I found it hard to stick with them as I felt a bit of a fraud, and was keen to push on, but then again this is (hopefully) the last part of a 15 month process and you don’t want to go back to day 1 becuase a trip up a step or slip on a kerb. By having them you move slower and people give you a bit space.
    Finished the week back driving the car. Happy Days.

    Week Three

    Stiches out – Day 17. discharged by the consultant. On my own for rehab. I wont bother going to the GP to arrange physio, in case I get stuck with the fella I end up with last year. Instead I’m just revisiting the steps that got me through the pain from the break itself. Compared to a year ago it’s so nice to progress at this rate and without the screaming pain in the shin. Can you remember when your physio said start hopping ? how much did that hurt eh. I changed NHS physio towards the end and the last one was not very helpful at all, offering nothing in advice on how to graduate from jumping with both feet (i.e 50/50 distribution) to hopping on the healing leg. There is only so much you can do in water before you have to do it on land. I couldn’t do it as the pain of landing the first hop was too much to let me push off for the next one. What I worked out for myself was to isolate the movements and do them separately to build up the strength and pain resistence. For landing a hop, I “jumped” off of the good leg from the bottom stair to land the healing leg on the floor (it’s a bit like a heavy step more than anything, and you can start with the good leg on the stair bent so the drop is only an inch or two). Then for pushing off for a hop I jumped from the floor with the healing leg onto the bottom step landing on the good leg (use a bend in the good leg to make up the shortfall as you won’t make the full height when starting out). It hurts like hell, but with gritted teeth it got me where I needed to get to. It may not suit everyone, but if it helps someone reaching this stage of their recovery it was worth sharing the experience.
    I’ve now started some stretching. Whilst standing lean against a wall with healing leg straight and bend the other leg to feel the stretch in the calf and ankle. I’m doing heal raises (both legs at the moment), and calf stretches off of a small step. Plus have started doing a few carefully supported knee bends only on the healing leg (skiing is coming a little bit closer ).
    The progress on the stairs is that I’m coming down left leg, right leg i.e normally albeit a little carefully at the start of the week. By the end of the week I feel like I’m flying up and down them, so much so that I can climb steps two at a time to help build up the strength in my leg.
    I’ve starting gym work using the exercise bike as first step. I’m going to keep off my mountain bike until the six weeks is up, again a long time to get to here, don’t blow it by crashing your bike while you’ve still got holes in your bones !
    Planning to do some running up and down in the shallow end @ the local swimming pool next week when the knee has closed up a bit better (only problem with this is all the “normal” people swimming along think you’re a wierdo).
    Beyond that I’ll just avoid inpact exercises for the next few weeks sticking to the cross trainer and bike type stuff.

    Hope this helps you Jake if you are thinking of having your stuff out, and Emily ahead of your op. You sound like you’re struggling at the moment so fingers crossed once it’s taken out you make a speedy recovery yourself.

  • Andrew Richardson

    I had my rod removed a long time ago (I went through all this about 10 years ago) –
    For what its worth, I was hesitant about getting the rod taken out, because of the memory of how painful it was after I had it inserted.

    To be honest, getting the rod taken out was minor in comparison. It was an outpatient procedure here in the US (ie you are in and out of the hospital in a few hours, and dont have to spend the night there). I limped for a few weeks afterward, but any pain was outweighed by the sense of relief I felt having it over and done with.

    I was also able to get a fair amount of sympathy as a result of the 2nd op, which was nice in the pubs afterward 🙂

    Good luck everyone

    • jakemcmillan

      Thanks for this Andrew. Has the leg been fine (as in completely normal) since it healed after the rod removal?

      • Andrew Richardson

        Actually I do have one thing which is not completely normal – Every since having my knee cut up for the operation, I dont often kneel on that knee (obviously a problem for the highly religious though) – Its no biggie, I have learned to compensate, but it never felt quite right for me putting the weight on that knee

  • Galia

    Hay guys, thank you all for sharing your experiences, it has been very helpfull for me as i have broken my tibia and fibula, i am recovering well i think, but i am concerned about my fibula. The doctors said that it should come in to place once the tibia is fixed with the nail, but sometimes when i move i hear a click sound from the fibula and i’m a bit concerned if it is going to be able to heal properly. I was wondering if anyone had the same click sound? Thank you very much in advance

    • jakemcmillan

      Hi! Sorry, no, I didn’t get that clicking sound with the fibula? I would always ask about the fibula when I went for my x-rays and check ups with the consultants, but the doctor seemed very unconcerned about it. He said the tibia was the important bone and that the fibula would be fine … he was pretty much dismissive of the fibula bone situation.

  • Emily

    Nick that was really helpful! Thank you. I’m really nervous now, I’ve got 6 days till the removal…ARGH! Especially after that comment about 5% resulting in amputation! I’m not sure I should’ve read that….!! Anyway, I’ll report back as soon as I’m able. At the moment I can’t imagine ‘normal’ life as for the past 6 months I havent been able to walk without a crutch. And not since before the break have I been able to run, bend, jump etc. So I’m so excited about the prospect of being ok. Although looking on line there is lots of scary stuff about knee pain, and the link to the the way they insert/ excert the rod (through the patella tendon) and that sometimes the damaged patella is pretty much screwed forever. But I’m trying to be positive, and hope that the pain is what the Dr suspects – the rod being too long. So thanks again everyone for sharing on Jake’s site. See you on the other side. Oh am also excited by the prospect of making my metal into a wind chime! ha! Em x

    • jakemcmillan

      Hi Em … My comment about the 5% amputation was quoted to me by a doctor about the insertion of the IM nail rather than the removal. The removal is a much easier and far less risky operation as far as I am aware. Did your doctors go through the possible risks? In any case, absolutely best of luck with it!

  • Emily

    oh good! thanks Jake. He hasn’t gone through the oh well I’m sure he will 5 minutes before I go in! x

  • Lisa

    Just thought I’d add my story so far;

    17.4.11 fell off horse (minor fall lol)
    18.4.11 im nail operation in the morning
    19.4.11 recover in QMC hospital
    20.4.11 they let me out!!! yeah!

    I was determined to get home ASAP because I have a 14 month old daughter and hubbie, didn’t want to miss the precious moments.

    So a week on I feel anxious and excited, staying positive and just bloody happy to be home. I am fortunate to have family who are really supportive, with childcare, meals etc, but sh*tting it tbh!!

    My 1st appointment is on 29.4.11.

  • emily

    hello all!
    Greetings from me and my metal free leg! Operation went well I think. Although i still havent seen a dr, they discharged me without seeing one. But my notes say everything went well. And they didnt find anything during the anthroscopy. So it looks like the knee pain was caused by the nail being too long for my bone. At the moment its been a week since the op and i can get around with one crutch and sometimes none. But I havent been outside walking down the street yet, I’ll probably go with two for the first couple days to feel safe. the pain has got better but it was pretty intense the first two days. It didnt help that they offered me a nerve block but said i wouldnt be able to go home so i said no. Then when i came round i was in so much pain and on so much morphine that i couldn’t go home anyway! so my advise – take the nerve block!!!
    So the site of the anterior knee that hurt before really hurts now but i’m guessing thats from digging around in there and also the stress of having the nail removed. Fingers tightly crossed that the pain will go. I’m scared to get excited, as the dr did say that having the nail removed might not be the answer to the knee pain. but i’m reeeeeally hoping.
    anyway. just wanted to let people know, having it out isn’t half as traumatic as having it put in with all that pain of a broken leg. and the op only took an hour. no complications. So at the mo, my advise to anyone would be just whip it out if you’re even a tiny bit concerned about it.
    I’ll be back to report on the healing. In case anyone’s interested!!
    Em xx

  • Lisa

    Yep, on crutches, have been gliding around! Since day 2. Can do my 12 stairs (cannot imagine 7 flights!!)

    Bloody painful and swollen, seems to have worsened the last day, my foot goes blue if I try and do too much, and where the break happened has gone like a bulge. Phoned the ward they said fine, it doesn’t feel fine! Having never broke anything before, having a radiating hot leg is weird.

    Feeling a little sad today watching my baby girl playing outside and waving at me, it’s emotional not being able to play with her.

    Though also positive that I am at home x x the rollacoaster has begun lol x

    • jakemcmillan

      Best of luck with everything! My first week at home was very painful and the swelling made me worry the operation had not gone well as I couldn’t straighten my leg/ankle. However, when the swelling went down, all was a lot better.

  • Lisa

    Went to emergency clinic yesterday, have a blood infection, something to go with cell protein and White blood count.

    Feeling alright just p*ssed off! Back to clinic on Friday for follow up.

    Thanks for your support, glad to hear your op went well Emily.

    Great site Jake

  • Nick

    Hi guys,

    A little late coming back, but just to confirm the Easter skiing became a reality. To be able to ski again was my “redemption day”, I’d done the other things I’d wanted to be able to do like walk, run, play football over the last year or so, and this was the box that needed ticking. Seven weeks after the nail removal and 16 months on from the breaks I was back on ski’s, fantastic. I haven’t done much running since Easter, but the early sign’s there are I’m now free of the ankle discomfort I’d had as well.
    For anyone going back to skiing in similar circumstances watch out for your skiboots rubbing on the bump on the healed tibia (I assume we all have them ?), mine got pretty sore over the course of the week. Pack some big plasters ! And make sure your travel insurance covers you for all you want insured post broken leg.

    Emily, I hope you are now feeling the benefits of the removal op. Jake any thoughts on going for it yourself now ?
    Best wishes to Galia and Lisa as you recover, and to all those who might share the experience in the future.


  • Emily

    Unfortunately still got a lot of pain in the same part (anterior of the knee) but am trying not to think about it for another few weeks as it could still be a result of the op and all the hammering and poking! Great news though Nick, very jealous of the skiing!! x

  • ange

    Hi Jake Ive been reading your blog since my 14 year old son had this procedure on 29th june after snapping his tib and fib during a rugby match, it has helped me enormously so thank you, after he had his 6 weeks x-ray he walked out of the hospital without crutches, I was so surprised! He has been walking long distances on it, but i’m too paranoid to let him run on it until after his 12 week x-ray in october, when he sees his surgeon. He still gets shooting pains in his Tib and has had a bit of rubbing from his screws in his ankle, although it is only occasional, he hasn’t been offered any physio yet and he says he dosen’t need it, this isn’t his first broken bone, he has had a few, but this is the worse. He had physio after breaking his other ankle in march, so we still have the green and blue bands. But he hasn’t used them yet for this injury. He is keen to get back to training but i’m scared of him over doing it, he is also part of a potential rugby scholarship program, they are aware of his injury and said they will involve him at his own pace so as to keep him involved. He will also be having his metalwork removed, they have told us 9-12 months tho. He is not allowed to play rugby until it is removed, also his fib is not properly lined up, but the surgeon told us that its not important as its non weight bearing. He has lost feeling on the outside of his knee which has only came back slightly and it hurts slightly to kneel . I hope this helps others and also thanks to all the other comments as it gives me hope for him when he does eventually get his hardware removed. I will update you all when he does eventually go back to training in case it helps others. Thanks again Jake for all your excellent info.

    • jakemcmillan

      Many thanks for posting. It sounds like your son is doing really well! I hope the rest of your son’s recovery goes just as well. I will be very surprised if he doesn’t need some sort of physio, even if he is a very healthy young man.

  • ange

    hi jake thanks for replying, he was given basic exercises to do from day one, like wiggling his toes, stretching his ankle up and down, bending his knee up and down and leg raises, whilst lay in bed, to prevent anything stiffening up (the advantage of not having a cast on) But no other exercises yet. And since he’s been able to walk has been doing a few of the exercises he was given for his previous ankle injury,(but hasnt used the bands yet) and is able to stand on tip toes and stand on one leg already, he has even played badminton in P.E. at school, (But is only allowed to referee things like football matches) he has done a couple of metres of gentle jogging whilst out with his friends, I think forgetting that his leg is still healing and says he gets burning where it is broken/healing. I have to keep reminding him not to try and push himself too soon until the bone is strong enough, but I will discuss all this with his surgeon, its hard to keep an eye on such an active teenager!! Also I put him on a strict diet when he came out of hospital, loads of fruit (especially apples they are rich in boron), protein (fish, eggs, soya protein, cheese, beans), cereals, salad, vegetables, vitamin supplements and he was only allowed to drink water (loads of it) milk and fruit juice. He wasn’t allowed anything with refined sugar in it as i read this is a ‘bone robber’ he is still sticking to this diet now with the occasion treat thrown in, so i’m wondering if nutrition has helped him with his recovery also as well as having age on his side. I think I will get him to start using the bands before returning to training just to strengthen his ankles to prevent any injury and I am also thinking of getting him a ‘wobble board’ too, anyway, I will keep you posted when he returns to training to let you all know if he gets any pain etc. Thanks again .X

  • Ben

    Hi all,
    I’m approx two months since the op. I had a communited fracture tibia and fibula from a bike accident.
    I was told put as much weight as felt comfortable on the leg and after about 7 weeks could make my way across the lounge unaided, if a little lop sided….
    The day before my 8 week checkup I felt some movement when i got out of a taxi and has been difficult to walk ever since.
    On the check up the xray showed that the top screw has bent allowing the bones to move together more. The doctor said it’s all looking fine, but still 3 days on I can put little or no weight on my sore leg.
    For some reason I had only one screw in the top and bottom of the nail. Has anyone else had a smiliar op or bending of the screws?

    • Elisabeth Reinhold

      Why only one screw on top and bottom?? When you look on the X-rays of others there are usually 2 screws on top and 2 screws on bottom. I have 3 screws on the bottom because of the poor bone quality of the bottom part of the bone (tibia) at the time of the surgery.

  • emily

    Hi Jake/ Everyone… I’ve posted a few times on here and just as an update I broke my tib/fib in Feb 2010 snowboarding, had an IM rod inserted everything ok for a month or so then started having lots of anterior knee pain. Nothing showed up in Xrays/ MRI’s so they decided to take the rod out in case it was too long and that was causing the pain. They removed it but there was no evidence of it being too long or causing harm. That was in April. I STILL have the pain. Pretty much every day. I can walk around fine but cant run/cycle or bend down (its the squatting motion that really effects it) More MRI scans and they cant see anything. its very frustrating as you can imagine!! Anyway I am currently 2 sessions in to a course of acupuncture. I am open minded, I think I have to be at this stage. Am willing to try anything! He seems pretty sure that there is some sort of blockage there that is preventing the healing in that area. I still have swelling in the area (to the right of my knee, anterior). So he is trying to promote the flow of blood to that area. I have no idea if it will work. And since I’ve been having it I’ve been experiencing more pain in that area (and at the site of the breaks, and the old pins, weirdly) but it’s easing off. I’m hoping it was just the effect of blood rushing to the painful areas. I’m not going to make any conclusions till I’ve finished the course of 6. I will report back! But just wondered if anyone else out there has had acupuncture to help the healing process??
    Thanks, and good luck to everyone out there recovering from a break! xx

  • stuart pratt

    thanks for this blog was very useful to me, much appreciated gave me hope as i had not long broke my leg and felt i could never get up after reading this i got up!!

  • Doug

    Hi – I had an IM fitted a week ago after breaking my tib-fib while skiing. Your site looks like it’s going to be really helpful, thanks! So far my swelling has gone down considerably, and I’m getting around on crutches OK. Question: does anyone have any tips for flying? I travel regularly with work, and I am committed to a short haul flight only 3 weeks post-op, and a long haul flight 4 weeks post-op. I’m told I should keep my leg up and take anticoagulants, but should I be avoiding flying altogether so soon after surgery? Doctors don’t seem to have a strong view.

    • jakemcmillan

      Hi, I’ve not heard anything at all about not being able to fly shortly after the op? Doctors certainly never warned me about doing it.

      • emily

        Hi Doug. I think it’s if you’ve got a cast, its tricky to fly. But I flew back from France a week after I had my IM rod in. Although it was pretty horendeous as I couldnt bend my leg (they gave me 3 seats!) there’s nothing medically stopping you flying. I wasnt given any meds. good luck and hope you mend well xx

      • emily


        I just wanted to give you a quick update. TWO years after my op for a tib/fib break I have finally found out what my knee pain is. I’ve been suffering from anterior knee pain which started about 3 months after the surgury to insert an IM rod to fix the break.

        After 3 different doctors, I finally had one that gave me an ultrasound. And they discovered that my iliotibial band (which runs from your hip to the outside of the knee) is rubbing on the boney bit of the top of the fibula and also where it attaches to the knee. HURRAH!!! it was like an alellujah moment!! Basically every time i bend my knee it rubs against the bone. Causing inflamation and pain. So the more I walk. And if I tried to run.

        They spotted some fluid where the band meets the bone due to friction so diagnosed the problem. Now the causes of it are probabaly EXCESSIVE INTERNAL ROTATION OF THE LOWER LEG. Because my break was a twisty one. compound of the tib and spiral of the fib. and has left me with 5 degree rotation. And a very pronated foot. So basically my hip knee and foot are out of alignment causing the band to rub on the knee. I hope this makes sense! Anyway this Iliotibial Band Syndrome hasn’t had many medical studies done on it so dr’s aren’t really up on the causes. But hopefully with physio, cortezone injections and shoe supports, my knee pain will be sorted! I need to ask him about long term problems about this twisty leg. And whether surgury to correct the problem might be an option.

        Anyway, I just wanted to post this in case anyone like me spent 2 yrs not knowing why their knee hurt. I thought it was linked to the insertion of the IM rod through the patella but thats all fine. And its basically a biomechanical problem. Hope this helps even just one person who comes across this. As it’s been a horrible 2 yrs having had 3 consultants all washing their hands of me before i was diagnosed. Noone had even thought to give me an ultrasound. Anyway, its a long road ahead sorting this problem out but the important thing is that at last i know whats wrong. Good luck to you all and your healing bones! xx

      • jakemcmillan

        Hi Emily,

        Thanks for the update. So glad to hear you now have an explanation of what was causing your pain and how to deal with it … you must be so relieved!

        Best of luck and let us know how things change for you!

  • Lisa

    Hello, saw Emily’s update and thought I would add mine, it’s 11 months since I had IM nail after falling off a horse, I was due to have an exchange nailing in Nov 2011 due to a non union (it’s not healed at all!) I decided against it.

    They cannot guarantee any change in pain and I didn’t want another 3 months on crutches with a small child (my daughter is 2), so I opted to give it another year and live with it. I go spin, yoga and swimming and the muscle strength is good, physio discharged me as its the bone that’s still broke. It’s painful if I walk long distances, but tbh I just get on with it now.

    Am happy to report that I am 4 months pregnant, so now have no consultant appointment until sept 2012, when I can have an x ray, and I’ve already told him I won’t have any surgery until this bubba is walking so another 12 months after that. I continue to do yoga, swim and walking. Some days are worse than others but like goes on and I really think positive thoughts help.

    Best of luck everyone.


  • Brett

    Hey guys …. a huge thank you for this blog, people don’t really understand what it’s like and there is not a lot of info on the web.

    I got hit by a car on the 16/02/2012 and had an IM nail inserted.. so that’s just over two weeks ago now. The pain is starting to subdue a bit but I don’t like to be up for too long otherwise I get a throbbing sensation. One thing I found amazing is how little information they give you in hospital and how they don’t tell you there is a big risk of it not healing (especially if you smoke…. which I do).

    I was in hospital for 3 nights but couldn’t stand it any longer so made sure I passed the stair test. Got home and for the first week was in intense pain and found sleeping really hard. I was pretty much told I could weight bear till tolerated straight after the operation but am still quite tender when walking as it just feels wrong and foreign, I tend to walk on my toes and find I cant straighten the foot, do you think this is more due to the swelling of the ankle?

    One thing I got concerned about was a few days after being home I developed a sore lump on my shin, not sure if this means there was a complication or is just the site of where the break nearly came through the skin? forgot to ask the doc when went for my first appointment yesterday. My first appointment wasn’t what I expected I pretty much just had the staples removed and was told to try and put as much weight as possible on it but was not told anything about physio or given any excercise’s so am a little confused as to what to do next and my next appointment is not for 6 weeks? When did everyone else start there physio?

    I am finding it hard to get around and my hands ache from the crutches, I had and have little upper arm strength so think that’s why im finding it hard. Not being able to hold anything whilst crutching about is such a bitch and takes away from what I can do.

    I have been lucky as am staying at my sisters during this initial stage and she has been an angel, but am going to try and make the move home this week (week 3), does anyone think this is too early or about right?

    Some friends seem to think I should be doing more, do you think i;m on track or am on the slow side?

    • jakemcmillan

      Hi! Thanks for contributing and sharing your experiences!

      Walking will seem really alien and weird at first and the swelling of the ankle will make it awkward to keep the leg completely straight, but keep trying to do it. I didn’t get sent to physio until after my second visit to the consultant where I could prove I could hobble along without the use of crutches. In the meantime I would strongly recommend you doing simple physio movement with your foot and ankle, e.g. when lying down, do reps of moving your foot left to right and most importantly, reps of pushing your foot away from you and then reps of towards you. This will help minimise the time you will be limping. When you start physio proper they will give you, I expect, these rubber strips to do the same exercises but the rubber strips help create resistance to build up the strength.

      I think moving home in week 3 is absolutely fine and being independent will force you to move around more and that will help with healing and recovery progress.

      Best of luck with the recovery!

    • jakemcmillan

      Oh, and one question, I have not heard anything before about smoking effecting your recovery? What impact does it have?

      • emily

        Hi Brett
        Sorry to hear about your accident. The main advice I can give is that everyone heals differently and at different paces. So don’t worry about where you should be, just do whats good for you. Some people are walking around with no crutches after a matter of days! I was on crutches for 2/3 months. So take it easy. And physio didnt start till about 2 months after. They need you to be fully weight bearing.. As for the lump, this may just be the bone regrowth. As bone forms around the break causing a lump. So that might be it but have it checked out in case its something else. If you want a laugh I did a blog while i was recouperating.
        Good luck with it all Brett and don’t worry about supposed healing times. Take it at your pace. And like Jake said try and do little excersises like rotating the ankles and flexing the foot.
        Emily x

  • Helen-Anne Love

    Hi everyone,

    Thanks to Jake for the blog, like most people have written it’s been very helpful indeed! Here’s my story maybe you could help me with some info…

    I broke my right tibia – Spiral Fracture – on the 12/02/12. I was on a sight seeing university trip to the Isle of Lewis and Harris in the North West of Scotland when I slipped on a grassy mossy hill ( Not exactly adventurous). I knew what had happened right away and was dramatically carried over walls and fences back to our buses to wait for the ambulance to arrive. The strange thing was while waiting on the ambulance I was talking away and listening to music and chatting away as if nothing had happened!? must have been the shock or the adrenaline of a break like that as I had never experienced that to other breaks. When I got to A&E i was put in a backslab for transport back to Glasgow (where i’m from) for surgery to put in a IM nail) but the surgeon on the island had to reset the bone to align with the other. if anyone had this done could they let me know? as I have to say it’s the most painful thing i’ve ever experienced. It must have been for re-aligning the bone back together for the plane journey but it felt horrendous!

    After 3 ambulances, 1 emergency plane journey and many inhalations of gas and air I arrived back in Glasgow and had the OP. It’s now 5 weeks since the accident and 4.5 weeks since my surgery and I feel it’s getting easier but I wanted to know if anyone has a strange feeling on the outer side of their knee? as if it’s still numb? I’m getting feeling back but it’s just such a weird feeling when touched. The swelling is nearly all gone but i’d say my foot and ankle are still a bit puffy and swollen as i’m still finding it difficult to straighten my foot completely! – this is frustrating but i’m guessing it comes with time? Also i’d say i can currently get a 90 degree angle in my knee joint but if i try and bend it further as if my kneeling my knee remains really stiff! is this also something that will just come with time and physio?

    This blog has allowed me to see others with the same injuries and procedures go back to physical normality so that’s really comforting. thank you.


    P.s Did you use bio-oil to treat the openings of the surgery to help the scarring become less apparent? I’ve so far used baby oil on my leg to prevent it becoming dry…also help’s it stop itching.

    • emily

      Hi Helen-Anne

      You poor thing, that sounds horrendeous! I cant imagine having to get on a plane going through all that.
      So, I couldnt bend my knee fully for weeks and weeks and weeks so don’t worry about that. And 2 years down the line I still can’t kneel on it. I think that ones a keeper! Scarring wise definitely use bio oil, I used a similar one and the scarring’s not too bad at all. I aslo had a huge numb patch on the outside of my knee and down a bit. Thats usual for people with IM rods as putting it in shatters loads of nerve endings. I still have it now although it seems to have got smaller and just about a couple of inches in diameter now. You’ll get used to the weird feeling!!
      Any other questions just ask. And good luck with the recovery.
      Em x

      • Mark

        Thanks so much Jake for this resource, broke my tib fib March 23, 2012 skiing and had the nail installed that evening. Compicated by a prior tibia plateau fracture in the same leg. 3 weeks in and reading your blog has been very informative, seem to be progessing very much as you did which is reassuring.

      • Sazofraz

        As far as I can gather, they decided to pull my leg away from my body in order to pull the overlapping parts of my tibia apart and get my broken leg back to the right length. I was on morphine and gas and air. This wasn’t nearly enough. I decided to scream to let the medics know that it hurt but was told that if I stopped breathing in the gas and air it would stop working straight away. It was very painful until they stopped.

    • Alan

      The outside of my knee is still numb 15 months on, although the area of numbness has reduced massively.

      • Nicolo

        I had the same op (left tib, spiral frac) 7 weeks ago and the knee feels the same. A mate who is a hospital physio said this may remain as they can cut through nerves, but it’s basically nothing to worry about…

        BTW HUGE thanks to Jake for the blog, it’s been guiding me through my R&R, every step!

      • jakemcmillan

        Thanks Nicolo! and thanks to everyone else who is commented on their own experiences, it really is very useful and reassuring for others to read.

  • Becs

    Thanks to Jake and everyone who has posted on this blog – it has been really useful to me and now I can contribute something too. I had IM rods inserted in both tibia 15 years ago after a car accident. They always caused me minor aches and pains and after speaking with several different doctors over the years who largely favoured taking them out, 3 weeks ago I finally had them removed.

    Firstly, here are the reasons the doctors I spoke to gave for having them taken out:

    1. if you break your leg again it can cause major complications if there is already a bit of metal in there
    2. you can’t get an MRI on the leg if you need one because there is metal in there
    3. the risk of having them taken out increases with age so if you experience problems like an infection or more pain later in life you might not be able to have them taken out

    All of the above doctors also said it is possible to leave them in forever and one doctor also mentioned that the aches and pains I believed to be caused by the rods might not go away if I had them taken out.

    I had the rods taken out on April 12th 2012. The operation was successful but the left leg rod was really stuck and took 90 minutes to remove (the doctor said his arm still hurt 2 days later from trying to get it out). The other rod was out in 15 minutes. The doctor just opened the old incisions so there will be no new scars once the incisions heal up. The left leg was really swollen afterwards – about twice the size of the right leg and there was a lot of bruising. The right leg was bruised and slightly swollen.

    For the first week I was in pain and taking pain medication but this eased off at the beginning of the second week. I could stand up after a day and after 3 days I could use crutches to walk to the bathroom etc. My right leg, which didn’t have any complications, recovered really quickly. My left leg is still a little swollen and stiff around the knee and ankle and hurts if I walk on it for more than 5 minutes or so – particularly at the knee. I have been getting physio and it is improving. Now, start of the third week after the op I am hobbling around without crutches and can get up and down stairs if I have something to hold on to. I’m a bit concerned about the knee pain in the left leg but I probably just need to be patient and address this with the physio.

    • jakemcmillan

      Hi Becs! Many thanks for posting this … it is very useful to read your experiences. How are you doing now?

      • Becs

        I’m a lot better thanks Jake. It’s now about 4 and a half months on. I’m walking around OK and work is manageable – I’m a teacher and on my feet a lot. The exercise I’m doing still has to be low impact though – I’m swimming a lot, doing leg lifts with ankle weights – that kind of thing. The trick for me is to be patient – I’ve already overdone it once with the exercise and ended up having to take time off work again. I feel quite confident it’s going to continue to improve.

      • jakemcmillan

        Thanks for replying so quickly! Glad to hear things are a lot better and hope they improve as you want them to.

    • Deborah

      Thanks for sharing your experience with having your IMN removed after so many years. I’ve had mine in for 8, and I have pain which seems to be getting more troublesome as the years progress. I’ve been considering talking to my docs about having it removed, but everyone else who has had one removed has only had it for a year or two. The only other story I’ve seen is from someone who tried to have theirs removed after 5 years or so, and the surgery was unsuccessful. So thanks for showing that there is still a possibility that mine could also be removed. You’ve given me hope. If you see this, could you comment back and let me know how you’re doing now? Thanks in advance


        Hi there Deborah,
        I’ve had a nail in my femur now for exactly 50years!! so you can appreciate my anxiety at the thought of having it removed,in the early moths/years after having it inserted,I had quite a few niggles with it,and I insisted that it be removed the surgeon at the time who carried out the “attempted” removal claimed he couldn’t get it out,so he “hammered”it further in,his words not mine,I could not make any sense of this then or even now,but I will say that I’m sorry I let him get away with it so easily,but I was only a 17 year old lad then,I wouldn’t accept that sort of excuse this day and age.
        However, It has never stop me doing anything,having cycled,
        mountain biked,windsurfed,surfed,swam and trained hard as a lifeguard,so I never let it hold me back.BUT, I now need new knees and before I can have them the nail has got to be removed,personally I would advise anyone to have it removed as soon has it has done it’s job,because if later in life you need a replacement hip or knee joints you will be faced with having it rmoved like me after it’s been in place for 50 years and I reall am NOT looking forward to this. Gwyn.

      • Deborah Long

        That is amazing! I try not to let mine hold me back, but there are times when I just can’t. I’ll talk to my doctor about taking it out as soon as possible. It’s outlived its use!

      • Rishabh Gupta

        Did you got it removed, if yes please share your experience, I am considering to get mine removed which I got round 6 years ago, from a bike accident.

    • VISHAL

      Thanks for sharing ur experience

  • Helen-Anne Love

    Hi Everyone, I thought i best leave a update since my last post. Had my 12 week appointment today and it went really well. Consultants happy with the progress of the bones fusing back into place. Was kinda scary to see the xray were there was still a break as I am now fully walking ( with a slight limp) with full weight on the leg. Just shows the IM Nail is doing it’s job taking the weight. (using once crutch outside the house)

    The numbness I once felt in my knee has nearly disappeared and the physio Appointments i got have really helped. I’d also say the bio oil has worked a treat as the 4 incisions for the screws are not noticeable at all and the one on my knee has become less red and now more the colour of my skin.

    I’d say the physio has helped me lot’s and even though the exercises can be sore sometimes they really, really, really help! and the pain from stretching goes away so they are great for getting back on your feet! I’ve still got a long way with physio but i’m just soooooo pleased to be walking again. Running, jumping etc will come in time but to all lying in bed reading this like i was, it gets a lot easier in time and once you start to see physio results the results just keep coming and coming

    Goodluck with the recovery everyone!

    (12 weeks since accident.)

  • Loyal

    Wow! Very nice information on this surgery. I have had the same surgery done on may 1st 2012. I actually dislocated my ankle in the mix to so they had to relocate it as well! I found a $100 boot/air cast that goes to the knee an purchased it! I know the Dr said 50% weight bearing, but he never told me I dislocated my ankle till I got a bill! So not knowing what other issues I have I used that to help keep my leg stable while in a vehicle an it allowed me to set my leg straight an help loosen some of the tight feeling in my ankle. I was post to see a Dr soon as I arrived back home since this happened in another state and Im a month past due now, but plan on getting atleast one check up due to me being stubborn on things! Though it has been a month I can now place my foot flat on the ground an hold my balance with out falling over. I have had a couple slips an pressed alot of pressure on my bad leg, but thats why i must get a check up! Thank you for writing this on your process an healing as it was very informative on things!

    • jakemcmillan

      Many thanks for sharing your experiences, you must be feeling better now you can stand and hold your balance?
      Best of luck with the rest of your recovery!

      • Loyal

        Yes I can stand and hold my balance! My foot still turns purple while standing think due to it still healing! I’m walking with crutches still, but more weight bearing then before and wearing my normal shoe now! and thank you!

  • Julez

    Hi Guys, very nice blog, loads of information, my story, got wiped out on the highway whilst doing 70mph on my bike, “sorry officer, I didnt see the biker”, usual story!, end result after bouncing down the road at great speed was broken fibula, fragmented tibia, right hip not good, right knee damaged,fractured L arm, fingers, various ribs, so, my tibia was wrecked totally not just broke, in bits, the surgeon said there was just enough good bone above my ankle to fix the rod in, but at a 12 degree angle, fib smashed, “dont worry about it” he said, 90 % of body soft tisuue injury, I was lucky, very lucky to survive the crash, anyway, im nail inserted october 21st 2009, day after crash, 12 months later locking screws removed, I was in alot of pain, 50% of my leg and most of my knee numb from nerve damage, surgeon said he probably did that himself during the op to insert nail, 2 years post crash, still lots of pain, swelling, cant kneel on a hard surface, fib only just got a union!!, still unable to run fast, or jog comfortably, now nearly 3 years post op, and I’m having nail removed next tuesday(3rd July 2012), still get pain, knee pain, swelling, i’m a bit worried though, hope it resolves some of my problems, though the surgeon said because of the severity of the fractures I will probably get pain and swelling ongoing forever, he also advised me to give up the Bike, as a similiar accident and injuries to leg would probably result in amputation, oh, also my left leg is now 1″ shorter, so I also walk like Clyde the orang-utan, just hope the removal helps, I’ve had 3 years of pain, limping, swelling, I look on the bright side though, I’m alive 🙂

    • Emily

      Wow Julez what a nightmare! But what a lovely positive attitude you have. Puts me to shame moaning about mine.Best wishes… and Orang-utans are awesome. x

  • Julez

    Hi Em, read your blog, made me laugh, just what I needed, hows the leg, anyway?, got my op in 2 days, im removal, a bit worried now as its getting closer, what a wimp ;), you wouldnt think I was a 6″2 ex navy tattooed biker, anyway will be one step closer to the injury compo from his insurers, and a nice big new Harley :), regards, Julez

  • Doug

    I was operated on a week ago for a broken tibia after an accident rollerblading. I have been home for 5 days now and I can get about on the crutches without problem (though the blisters on the hand seem to be unavoidable). I’m not in much pain and there hasn’t been much swelling. The worst thing for me since going home has been injecting myself in the stomach each day with Clexane anti clotting agent which has left me with bruises at the injection sites. I have a bit of a phobia of needles and it was bad enough having stuff stuck into me in hospital without having to do it at home. All things considered though I can’t complain too much as I seem to be suffering a lot less than many others on here.

    • jakemcmillan

      Hi Doug,

      Thanks for posting. If you’ve not got much pain or swelling then it sounds like you are doing very well indeed! I’ve not had any experience of injecting myself with Clexane. Do you have to do that for much longer?

      Best of luck with the rest of your recovery!


      • Doug

        I have been prescribed 30 injections and I when I visited the hospital for a checkup as an outpatient yesterday the specialist told me I would have to finish them off 😦 . I live in Spain so it may be just a peculiarity of the system here. How long was it for any of you before you were able to bend your leg? I can’t bend my leg any further than what would be a sitting position. It’s not that it hurts if I try, it simply doesn’t feel like it’s possible.

      • Loyal

        I sat my crutches down at 8 weeks and now still walking I get slight pains when I try to pick something up, but for the most part I feel good about being able to walk even though I walk with a limp now! I work my knee an ankle daily before walking on it that way everything is stretched out an ready for my day! So far slight paints in my ankle an knee are once in awhile! @ Doug slowly work your leg while laying in bed! Bend as far as you can then relax it. An slowly move it more each day that you can!

  • Simon

    Hi Emily,
    I’ve posted a message on your blog, but was wondering if you might shed some light on how your recovery is going?
    I am on crutches still with a fractured left hip, femur, tibia and fibula. They put a titanium rod in my femur and also IM nail in my tibia. As also mentioned previously on here, the fibula is pretty much left where it broke. Not an important bone so they say.
    I have also had ongoing pain around the head of my fibula, just below and on the outside of my knee.
    It is whats preventing me from walking to be honest.
    The accident was 9 months ago now, but i have only been in a physio program for the last 4.
    The docs here (South Africa) have done every kind of test possible including an MRI, and cannot tell me what this pain is or why it is there.
    I have been told that it may well be caused my muscle imbalance, and to continue with stretches and strength training to get my leg stronger.
    My leg feels strong, but that damn pain just wont get better…for now anyway…
    I have done a LOT of research, as i am sure anyone with the internet and plenty of hours to kill with the same sort of injury has too, and have found that it is almost always beneficial to remove the IM nail from the tibia.
    It will only be a year in October, but i am going to ask my surgeon to remove the nail and am praying that this will alleviate the pain.
    I read your posts with interest though, as i have pinpointed the pain to exactly the same place that you mentioned you had pain, and also no one could tell you why?
    I have done some research on ITBS, but once again, the internet does not seem to be flush with information about treatment and recovery times.
    And besides, i would prefer to hear it first hand anyway.
    So i was wondering how your recovery is going, and what the docs have suggested to you in order to help you?
    Hope your on the mend anyway.
    We all are i suppose, just some take longer than others…
    Think i might also have a little cry (of joy of course) when i finally take my first steps unaided…

    • emily

      Hi Simon
      Sorry to hear you’re still in pain. You’re breaks sound a lot worse than mine! But hopefully your problem might be the same as mine. Basically they have diagnosed me with iliotibial band syndrome. And they think I have this because after the break (quite a twisty one) and the insertion of the IM rod I have a slight lower leg rotation. (Apparently inserting the rod provokes this). it’s about 5-10 degrees. And because of this the band that runs from the hip to the lower part of the knee is rubbing across the boney bit of my knee. For a more descriptive detail of what itbs is go to – but you have to pay to read the whole thing. Which I have. So if you give me your email address I can send it to you. Normally runners get it but sometimes its a biomechanical thing which it is in my case. so the band rubs on the bone because my leg is slightly twisted. Also the dr’s say that because of the traumer of the break and the insertion of the nail that area is super sensatized. so i’m also taking drugs to stop the pain signals being so super charged. After ive taken those for a while i’m probably going to have an op to elongate the band. (they put a slight cut/tear in it that heals and creates a bit of length). I’m also wearing orthapedic inner-soles that correct my walk – so lift the arch and make me walk less like my knee is turning in. I’m just so glad to get a diagnosis as it was 2 years of pain and dr’s not having a clue! I really hope this might be your solution. The way they confirmed I had it was they gave me an ultra sound and they spotted a pocket of fluid where the band meets the boney bit of the knee. So see if you can have this done. Also my fat pad on the anterior of my knee is constantly swollen which is also a sign (the band causes friction, this agrivates the fat pad and causes swelling, this in turn makes the rubbing even worse!!) So I hope this makes sense. Please do email me if you want to ask loads of questions. And also let me know your address so I can send you the stuff on ITBS. The site i found is brilliant – someone’s done all the research for us!
      Good luck, and fingers crossed this is it!! x

    • Sazofraz

      I am 6 weeks into my IM nail in tibia screwed to fibula. At first it was painful for me to bend my knee, stiff and slow. My physio gave me the exercise of bending my good leg up while lying on my back, then bending my broken leg as far as poss, then straightening it again. A minimum of 20 times a day. The more I did it the further I could bend it and the less stiff and painful it was. Good luck!

  • Simon

    Hey Jake,
    Thanx a mill for this blog dude. Its been really informative. I have my own too, but also tells the story of all the rest of the drama that went with being stuck in a 3rd world country and not having insurance!
    Eventually did a runner cos they were threatening to imprison me, broken leg and all!
    Was a nightmare, but very happy to be in the good hands of Saffa doctors again!
    Thanx for passing on the email addie.
    Got a mail from Emily.
    I am guessing the fat pad she is talking about is the part just to the side of the knee, right next to the patella. On my good knee (right side) it is soft and you can kinda push it in with your finger.
    On my bad knee it seems swollen and hard most of the time. More so when i exercise the knee and the pain comes.
    Judging by this alone, it seems that i more than likely have what Emily has, namely ITBS.
    I have done some research on this on the net after reading her post, and have found a few exercises on that hopefully will help for now.
    I have to wait another 3 months before i can get the IM nail out and see if that helps the situation though.
    In case anyone else reading this is interested, my brother had a miniscus tear and needed keyhole surgery.
    He saw some very good doctors in Ireland, and they gave him some supplements to take which he said really helped. I spoke to a friend today and she swears by them for back pain she had as well.
    They are Glucosamine Sulphate & Chondroitin Sulphate.
    I went shopping today and bought myself a bottle of caps that have both in them. You’ll find them in the pharmacy near the joint relief medication. Get the stronger dosage ones, namely min 1000mg/dosage.
    Do some google searching on the stuff. It rates really well!
    Started taking them with a Deep Sea Fish oil, like salmon oil 1000mg. Have been recommended both of these.
    Will report back in a few weeks and let you all know how they are going. Apparently takes 3 weeks or so to start feeling the benefits…
    Thanx again all, and good luck with your recoveries…

    • emily

      Hi Simon – yep hat sounds like your fat pad. My Dr gave me Capsicum cream (literally cream made from chillil’s!) to take down the swelling and dull the nerve endings. I’m also taking Pregabalin which does the same thing really – when’s something hyper sensatized it’s feeling a lot more painful than it really is. So this drug dulls it all down which in turn makes it less aggrivated…
      Good luck with the op! xx

  • Julez

    Hi Guys, 2 weeks post op removal of IM nail, L tibia, hurts like hell, surgeon was going to discharge me following day with no walking aids, said I was weight bearing and can walk ok, bollox I said, I insisted on a pair of crutches from the ward discharging me, took a week for me to be able to walk, tossers, makes me so angry, no longer have much faith in my surgeon, at least that should be my 3rd and last surgical procedure on my gimp leg :).
    Now 2 weeks have passed, knee has massive wound, surgeon didnt even stitch/staple, just random blobs of glue, had to get district nurse out after 3 days to change dressing, she was appalled by the wound, they come twice a week to redress at the moment, knee still hurts bad, also got a red area now, a bit worried, but D/N keeping an eye on it, think I will be back at work in 2 weeks, light duties :), still cant drive, may try in another week, knee cant bend much probably about 30 degrees, but getting bettter, overall a very disappointing and poor service from the Bradford District NHS at Bradford Royal Infirmary, will keep you updated, regards

    • Becs

      Hi Julez,
      I had the same problem as you – I had IM nails removed from both tibs in April and was told by the surgeon I’d be up and about in a couple of days and back to normal in a couple of weeks. BUT I was in hospital for a week and couldn’t go back to work for a month (I’m a teacher so on my feet a fair bit). I’m now back at work but still on light duties and having to stick to very gentle physio and swimming for exercise. I don’t know if physio is available to you but I’ve also found is a good source of gentle exercises.
      Hope you feel better soon.

  • Doug

    If anyone else has to inject themselves in the stomach with Clexane/Heparin I have scoured the web and found the pain and bruise free method.

    1. Leave an icepack on the area to be injected for 5 minutes

    2. Sterilize the area using an antiseptic and dry it with cotton wool. Do not use alcohol.

    3. inject yourself pushing the plunger down slowly and holding the area injected lightly between your finger tips.

    4. Once you have injected the contents of the syringe wait for 5 seconds before pulling the needle out.

    5 Apply pressure to the area with cotton wool for a few minutes. It is best not to move around for a few minutes after the injection.

    In other news – I am really pleased with the Catalan health service I went to an appointment in the rehabilitation centre for assessment yesterday and they have booked me for 2 weeks of daily physio although I’m sure I saw a sadistic glint in the therapist’s eye when he told me that! So we’ll see how it goes.

    • jakemcmillan

      Many thanks for this Doug, good tips! Hope all else is going well with your recovery?

      • Doug

        Yes, it´s all going well thanks, better than for most. I have had daily physio for the last week and they say that as I am making such good progress in another week I can start to walk with one crutch. That will be 5 weeks since the operation. I was at the specialist today and he said that I can stop the injections yipee!. I think the difference in the recover time for me is that I only broke the tibia whereas most people break the fibula and tibia together.

      • jakemcmillan

        That all sounds really good!

  • Simon

    Jake, it great to hear that you are nearly fully recovered. I broke my tib & fib skiing 4 weeks ago. I don’t know how you made it up 7 flights of stairs after you were discharged. I could barely make it from the couch to the loo without passing out. It is great to read everyone else’s experiences too. Things for me are getting better, I can stay vertical long enough to make breakfast or lunch. The injury does seem to really depend on where exactly the breaks are. I’m not allowed to put weight on my broken leg for another 2 weeks. With the stitches out at least I cam shower without the bag.

    • jakemcmillan

      Hi Simon, thanks for posting! I am not sure how I made it up the 7 flights either … I think it must have been the desire to get to my own bed and not have to go back to the hospital bed. Hope the rest of your recovery goes well!

  • Sazofraz


    In contrast to our blog host, I am over 50, over weight and female.

    I broke by tibia and fibula by slipping on the side of a hill. I was rehearsing for a cultural production for the Olympiad (Olympics). Actually in the choir. I hadn’t anticipated it would be so dangerous! Apparently when I slipped I leapt into the air and flipped over so I faced the other way. Hence I ended up with a spiral fracture. The ambulance crew and others carried me a long distance on a board, then put me in a 4 wheel drive and then in the ambulance. As I wasn’t in any pain and I could move my toes I felt a bit of a fraud. However I and everyone else had heard a loud snapping noise.

    At the hospital I eventually got x-rayed. To my surprise I was told that I “had been and done it good and proper and that I wasn’t going anywhere.” The xray looked quite a mess. I was amazed at how much damage I had done by slipping. I asked to have my jeans cut off rather than disturb my bones. It was decided that my leg needed to be stretched. I think that this was because the broken bits of my tibia were overlapping so my leg had shortened. This stretching was very painful despite morphine and gas and air. If it had been the daytime and I had my time again I would ask for an epidural. I was then put in plaster to stabilise my leg. Having broken my leg at around 7.45pm I was finally admitted to a ward at a round 2.30 am. I then didn’t sleep.

    I was on bed rest the next day. Every time I rang my bell someone came quickly. I was on oral morphine, paracetamol and another pain killer. A surgeon came to see me and said that there were several ways of fixing my leg but they had decided to insert a rod and bolts. I thought of asking questions about pros and cons of each method but then thought that I really knew nothing about fixing legs and wasn’t going to have time to research it. They were the experts and I would just have to trust them. So I asked if I would get full mobility back in my leg and was told yes. I asked how long the operation would take and was told an hour and a half. I gathered that my leg would take about 4 months to heal. I am very pleased that I didn’t ask about risk. The anaesthetist came to see me and asked about all my physical foibles. I was reassured that he listened very carefully and I was very pleased when he told me that before I came round he would put a deep local anaesthetic in my leg.

    I went down for my operation around 8.30am. I finally recall coming to at 2pm. A nurse said she had never seen anything like it. I was delighted. What’s the point of coming around quickly from an operation?

    I think it was the following day that I was moved to my intended ward. This was good because the orthopedic consultant, doctors and surgeons did the ward round. Also a team of physiotherapists came down in the morning. I started on crutches. Unfortunately in trying to avoid a loo door that opened inwards, I backed and got a hand past my waist. I suspect it’s like sculling, if you get a hand past your waist you inevitably capsize. I fell back, crutches and all onto the floor, yelling for help, which came instantly in the form of two running nurses. After that I was tailed everywhere I went.

    On Saturday night we were all moved ward. It was flooding so badly that the county town was cut off from the night shift’s and my home town.

    The next day I managed to pass my going upstairs with crutches test and was discharged. My family came to pick me up going a long way round to avoid the floods.

    That night I couldn’t get up the stairs so I slept on the sofa bed downstairs. In the morning relief came in the form of an assistant physiotherapist from the rehabilitation team who showed me how to get upstairs on my butt, using a stool to transfer to a zimmer frame at the top. She recommended that I use a zimmer frame because it was so important that I did not put any weight on my broken leg. I was given one for upstairs and one for downstairs. I used a crutch for coming down the stairs in the recommended manner. I was also given special perch stools/chairs to use in the kitchen and bathroom. Best of all I was given a zimmer type frame with shelves so that I could move things around the kitchen. Although at the beginning my leg got quite sore so I didn’t do much of that.

    I was very shocked at how little I could do for myself. Also the typography had changed! Some people’s houses were no longer accessible on account of very high door steps. This included the village shop. It took one person to get me into my sister’s house and two to help me out plus the use of a low chair!

    On the whole I found breaking a leg much less painful than I thought. My GP said that the pain comes from the broken ends of bone rubbing together. I suspect that the initial break was so bad that there was no danger of that happening! Before leaving hospital my third pain killer switched to codeine, which is quite strong. The downside is that it made me very sleepy and also quite constipated (for which you can take glycerine i.e. sugar solution). I am a great believer in avoiding pain so I took as many pain killers as possible until I got fedup of the side effects of codeine. Eventually my conscience got the better of me and I gave up morphine but not before I was euphoric. Now six weeks on I just take two 500mg paracetamol when I go to sleep. I do get the occasion twinge in my leg but usually in different places.

    I took sleeping tablets given to me at the hospital. Sleep is very important for healing. I am taking another kind while I am home. I have slept and slept and slept. I think that this is largely because I have been trying to give up tea and coffee because they leach calcium from your body which of course you need for bones. I have been eating jelly as it’s made from gelatine which I believe is made from bone marrow. When I drink coffee I take a calcium magnesium supplement.

    After about two/three weeks I went to the fracture clinic. The hospital kindly organised the transport for me as I was still using a zimmer. They said I’d need to use a wheel chair. The transport turned out to be an ambulance each way, complete with crew! just for myself!!

    At the clinic I had my leg re x-rayed and the staples taken out. This didn’t hurt. I was told I could begin to put 50% weight on my leg. I saw the before and after x-ray. The after is a master piece of really neat engineering. The bones are beautifully aligned. There are several bolts including one through the top of the tibia and fibula so that they are joined. I was told that I could shower after two days. I was also told that it was likely I’d be able to drive after six weeks.

    I had a green blister on my shin. A locum doctor at my local hospital had told me that my leg was infected! So I had two types of antibiotic. However it turned out to be a fracture blister and I was told that it would fall off. It did yesterday and the skin is fine underneath. All of my scars have practically disappeared.

    The physio assistant recommended a shower stool so I hired one off the local red cross at £2 a week.

    Soon after the fracture clinic I went to my first physiotherapy appointment. It was at my local hospital. My therapist asked me why I was hopping and told me not to! He decided I should start walking on a flat foot rather than on my toes. He examined my leg and gave me some exercises to maintain it and to improve my broken lower leg.

    A friend treated me to a trip to the Olympic sailing at the Nothe in Weymouth. I hired a wheel chair from the red cross at £5 a week. It went really well. I got loaded onto a bus with a ramp and driven from the park and ride to the Nothe. A gorgeous sniffer spaniel checked the wheel chair and jumped on my lap. There was a special place for wheel chairs to go to watch. I wanted a walking aid too so I took my crutches. I found it very easy to walk using them.

    I have found that sporting a broken leg brings out the best in people, even though I have no cast. They have been extraordinary nice and very helpful. It acts as an icebreaker too. A zimmer frame is very useful though to protect the leg when sitting in a crowded pub.

    I went for my second physiotherapy appointment two weeks later. My therapist said, “Nice walking” and that he was “really chuffed” by my leg. He said that he would have no problem with me driving but to check with the fracture clinic first. He showed me how to walk downstairs but apart from that no exercises etc because he is very happy with how my leg is. He told me that walking with crutches is good for it but to stop if it hurts. I can use the stationary cycle at the gymn set to the same hardness as my weight on my leg with crutches. Also after soaking off any scabs in the bath, I can go swimming (in a pool) but to mind not to break my leg getting in and out! I am to go back when I am told to start walking with one crutch.

    Fracture clinic day after tomorrow getting there by ‘hospital’ car. Finger’s crossed for driving. You have to be able to do an emergency stop. I’ve got the last appointment of the morning and I don’t want to fall off the end of the list!

    • jakemcmillan

      Hi Sazofraz, many thanks for sharing your experiences … how far into your recovery are you? Sounds like you are coping with things very well!

      • Sazofraz

        It has now been six weeks since the op. I went to the fracture clinic today. The x-ray to my mind showed some healing of the tibia with some gaps still to fill in. The fracture seems to have filled in. However the fibula was x-rayed from a different angle and showed a big gap between broken ends. I couldn’t see any signs of healing. The consultant said there were clinical signs of healing that didn’t show up yet on the x-ray. He said it will heal. However he also said it didn’t matter as it isn’t weight bearing. I am to wean myself off crutches, although I can use one crutch if I want. I can drive as long as I feel comfortable that I can do an emergency stop. They will see me at the fracture clinic in three month’s time probably for the last time. I read on the internet that the fibular is used in jumping and rolling the ankle. Perhaps that’s why I am in pain if I walk across uneven ground such as a mown field. I rang a friend who is a doctor who I trust. He said that a lot of people have wondered what the fibula is for. It will probably join up. However if the ends remain apart that doesn’t matter. The main thing is that the structure is stable which it must be because both ends are screwed to the tibia. So I’m off to the pub this evening to celebrate. I am planning to drive there although my father is nervous of me trying out an emergency stop. Then physio in four days time. I am under strict instructions from my physio to drive myself there!

        Has anyone out there had a fractured fibula that didn’t mend? What happened about it?

      • jakemcmillan

        It seems common, from what others have posted here, that people often worry about the fibula healing during the recovery phase and because doctors seem to be very dismissive of it we can’t help but be concerned that maybe they have missed something or are not giving it the attention it needs in our unique case. I had exactly those type of thoughts as I had some pains in my fibula and it didn’t look like it was healing that well on the x-ray.

        The consultant says people always seem to worry about their fibula and he seemed a little surprised by this. I explained that as we can see a broken bone inside our body we are naturally very concerned by this! I don’t care if the fibula is not considered that important by doctors, it’s still my bone and its broken!

      • Sazofraz

        Thanks for that. Did your fibula heal eventually? How long did it take?
        I have just been for a celebratory outing to the pub in the next door village, driving there and back. It’s so good to be behind the wheel again.

      • jakemcmillan

        Yes, the fibular did heal eventually, but it took a few months. Well done with the driving! That must be good to know you can get out and about.

  • Tammy

    Speaking of fibulas…18 years ago I broke my fibula and had a plate with 8 screws placed in it. 5 weeks ago I broke my tibia and fibula (again) and had the IM nail placed and nothing done with the fibula. This shocked me seeing the fibula was important enough to be fixed before. I have faith the doctor knows what he’s doing but I don’t care for all the popping and grinding I feel the fibula doing!

    • Simon

      Hey Tammy,
      I broke my tib/fib as well about 10 months ago, and was also shocked when they did not repair mine. The broken pieces weren’t even touching! I have done a lot of research about it, and also spoken to quite a few different doctors. The general concensus is that the fubula is not a very important bone in the leg, and therefore when there are multiple breaks, ie. tib & fib, they dont bother with the fibula. They actually use this bone for bone grafts if needed elsewhere in the body. It is not important. Dont stress. I also had the clicking/grinding going on when mine was first broken, and that eventually goes away as the bone mends. My fracture ends that weren’t touching actually slowly grew closer together and eventually joined and grew together again. It has left a bit of a bump on the side of my leg cos the bone is not straight, but it does not bother me at all yet. (i am not walking yet, so hopefully i dont speak too soon here).
      Ps: i should be walking but also fractured my hip, a double break of my femur and messed my knee up. So dont take my case as a meter of how long it should take to walk. I am clueless myself?? Hopefully one day soon. I’m really getting sick of the crutches after 9 months now!! Good luck, and dont worry about it. The damage is only cosmetic(hopefully not even so in your case).

    • Sazofraz

      My bright Dr friend said that it was important that my fibula was stabilised. This was done in my case by bolting it to the tibia. Are you sure this wasn’t done in your case too when the IM nail was inserted into the tibia?

      • Tammy

        I know for sure this wasn’t done in my case. My surgeon explained it to me basically like Simon mentioned. After doing some research and being on other broken leg boards this seems to be the common practice. There must have been an important reason for yours to have been bolted to the tibia. Did you also have the nail?

      • Sazofraz

        Yes, Tammy, I had the nail.


    • Sazofraz

      I have been to see a physio privately which has been really helpful. He got me to balance on each foot with one finger on the counter top in mid line and then the other foot. He pointed out that I was favouring my good leg by moiving it really fast in relation to my broken leg when walking so it was on the ground more. So he’s told me to practice walking concentrating on the good leg and slowing it down. It’s really helpful concentrating on the good leg as it helps my broken leg walk more naturally. I am back to two crutches but using the alternatingly with the opposite foot like walking poles. He says I am not ready to walk without crutches yet and that it will be a month before I am walking properly.

      He told me that the screw fixing the top of my fibula to my tibia may have to come out as it may cause pain in the outside of my ankle as the fibula is meant to move up and down when you walk. Maybe that’s why doctors sometimes don’t fix the fibula Tammy?

  • Linda Banks

    I had IM nail inserted Jan 2010 for #tib and fib. Since then, I’ve had noggling pain where the screws are, especially the top of foot/bottom of leg. I have now decided I want them out because if I don’t, I will never know if the pain will ease or not. This is scheduled for the 8th Sept. My surgeon has stated he is just going to take the screws out and leave the rod in? Has anybody else had just the screws taken out? And I’m wondering if I should have insisted on him taking the rod out too?
    Remembering the pain of insertion kind of puts me off them mauling to take it out!!!

    • Pete Williams

      I had my screws and IM nail removed 3 wks ago and it really was not a problem, I was in hospital overnight and walked (unaided) the following day without pain. All the original discomfort I had walking has gone, I walked 3-4 miles within a week of having the op, which i didnt expect…
      I dont know if ive just been lucky but the removal is nothing compared with the initial break and the recover has been pretty much immediate. Good luck.

      • Linda Banks

        Thanks ever so much for that Pete…feel a bit better about it now. They are apparently just taking the screws out and leaving the rod in though, although he has said it would probably be difficult to get out later if needed to which is making me think I should just ask him to take the lot out!
        Anyway, it’s now a week on Saturday so getting pretty close!

      • Sazofraz

        I’d love to have my rod and bolts out when 12 months are up (7 weeks at mo.) In UK as I am on the NHS (National Health Service) they will only remove the rod if I do dangerous sports or it’s causing a problem. Otherwise they stay in.
        What dangerous sport shall I take up?
        The brother of childhood friends was the first person to do a circumnavigation of the globe under human power only (cycling, roller blading and peddalling a boat) after breaking both legs in the States having rods put in and taken out a year later! So that shows how well they healed. The first volume of his trilogy about his travels has just come out in the States – The Explorer by Jason Lewis.

  • Sazofraz

    Linda, ask the anaesthetist to give you a deep local anaesthetic before you come round.
    Worked wonders for my insertion.

    My physio showed me on a blown up portion of my x-ray that most of the fibula fracture has mended. He told me that I can do anything I want now. I have also been told to wean myself off crutches but to make sure I don’t limp. Any ideas for how I do this? My next physio appointment is in a month.

  • Helen-Anne Love

    Hi guys,

    Thought i’d give you’s an update on my progress, I think the last time I wrote it was 3 months since my accident of a tibfib break. Anyways it’s been going really well. Walking’s really good, I can handle walking down slopes a lot better but there is still progress needed in it. Been signed off of physio and now at the gym building up my walking to jogging to running but i’d say i’m at a fast walk, steady jog level at the moment. I still feel as though it’s not fully healed yet and I was right about this when I returned for my 7th month appointment – Just to refresh I had a spiral compound fracture. The top of the spiral has healed but the bottom of it is still making ways to join so I’m hoping by my 10th month appointment it’s going to be fully healed. My scars are looking really good as well, I can barley see the marks for the screws and the incision is still noticeable but isn’t a big deal…plus scars are cool anyways. lol! I was told by the physio to start trying to get back into high heels again – as I’ll be graduating in November with my Masters – but i’m still a little scared to go anywhere near them! *any tips for the re-introduction to high heels girls?

    Hope your all doing well and are having a speedy recovery. I’ll check back in after my 10th month appointment, let you know if it’s all fused together!

    hal x

  • Doug

    I went on my first plane trip since the operation this weekend from Barcelona to London and back. Like Jake I was curious to see if I would be detected by the security arch. I was detected by the arch both ways and in Spain they have a shoe bomb detector which also beeped. I did tell them I had the nail but I was given a pat down search anyway (in the UK it seems to be particularly thorough these days!) I think my nail is made of titanium rather than steel so perhaps it depends on the metal.

  • Sazofraz

    Helen- Anne Love, Please can you let me know how you progressed from two crutches to walking well? Many thanks, Sazofraz

    • Doug

      Hi Sazofraz, I am now free of crutches after being operated on at the end of June. I started with walking supporting some of my weight on the 2 crutches. According to my physio the key is to try and walk with as normal movement as possible although you are supporting some of your weight on the crutches. After 4 weeks I moved to one crutch which should be used in the opposite side to the fracture. Again I was told to try to keep a normal walking movement walking as slowly as necessary. Finally 2 weeks later I moved to walking without crutches. At this point I had visited a rehabilitation doctor who recommended that I walk on bare feet on sand or on grass on a daily basis. I can now walk without pain as long as I don’t try to go too quickly.

    • Helen-Anne Love

      Hi Saofraz,

      Sorry for the late reply I was finishing of my Masters project. Free now to update you. I really just stuck to what my physio was advising me to do with my exercises. Not doing too little and not doing too much. I also took up swimming aswell as this helps rebuild muscle mass which I lost throughout my leg. I also bought at the pound store a floatation device thats called ‘a noddle’ and used this as resistance against the water for exercising with. Great tool. Another pool excercise bar swimming that I done was I would go into a baby pool which would not be any deeper than 2 feet and I would practice walking here as it would take my weight but would allow me to correct my leg’s movements.

      Once I got down to one crutch I would continue with the above exercises but just push a little harder. I then would go from using the crutch only outdoors and gradually build myself up to not using it outdoors unless on necessary terrain.

      I hope this helps with your recovery. I’m now at the gym building the muscle back and trying to get onto jogging/running again.

      You’ll be back to normal in no time. As soon as you start seeing results they just progress and progress.


  • Sazofraz

    I’ve just been asked to go on an expenses paid trip to East coast USA asap to help a friend out for two weeks. I’m 9 weeks after having IM nail put in tibia. Tibia and fibula are healing well but not fully yet. I’m just beginning to walk without aids but that is often painful. I haven’t been discharged from fracture clinic yet and am having NHS physio. My leg is my top priority. I don’t want to damage it. Am I safe to fly?

  • Sazofraz

    A physiotherapist who has had a broken leg himself, told me to progress from two alternating crutches to walking poles. These don’t bear much weight but are supportive and stabilising. The idea is to use them to prevent developing a limp. They don’t really know which people who develop a limp will get rid of it and who will be the very small percentage who never get rid of their limp. He says that using crutches once fully weight bearing is a recipe for developing a limp.He specilaises in gait.

    • jakemcmillan

      I had trouble getting rid of my limp as in the end it was so subtle I did not realise I was doing it. Life/work meant I was not concentrating properly on how I was walking. It’s annoying and frustrating to do as you just want to be ‘normal’, but it really helps to slow your walk down even and make the placement of your foot and transition of weight as deliberate as possible.

      • Sazofraz

        Thanks for that. It will come in very handy. Unfortunately when I went to see my NHS physio today he told me that I have been overweighting my leg and that when I was experiencing pain I shouldn’t have got a second type of pain killer to take but I should have eased off and used one crutch. All very well but nobody told me this. Everyone said to walk without crutches and he had said to attend his next appointment in a month’s time without crutches. When I asked if I could be seen briefly in the middle to check that it was going right I was told no. Now I have been told to use one crutch and to rest my leg as much as possible for two weeks. He doesn’t know why my shin is tender and looks bruised where the fracture was ten weeks on. He said not to call the fracture clinic unless the swelling of my leg hadn’t gone down in two days time. 😦

  • Sazofraz


    My physio also said when you walk don’t concentrate on your broken leg, think what you are doing with your good leg. If you are walking faster with your good leg and chances are you will be, slow it down. Concentrating on my good leg really improves my walking with my injured leg.

  • Sazofraz

    I got my answer on this from a consultant at the fracture clinic I attend. It was very likely that my leg would swell. There would be a very high risk of deep vein thrombosis. In a word No. Ironic when I’d managed to find a travel insurer to insure my broken leg for the trip!

  • Sazofraz

    Did it hurt you to fully weight bear? I’ve been advised to stop using crutches. However 3 weeks on although I can walk with very little limp it hurts a lot and this seems to be getting worse if anything. My ankle swells up and my shin hurts. The area around where I had a fracture blister goes red and looks bruised. I am on two kinds of pain killers. My GP thought that at 9 weeks my leg should be hurting less not more. Have you experienced this? Is it normal?

  • Sazofraz

    I went to see my consultant to find out what was going on. He told me that my leg was doing really well for 10 weeks but that I probably had over done things and to listen to my body. He explained that the average time for a tibia fracture to heal is 16 weeks (4 months) or if you have a cast 5 months. So he pointed out that if I had had a cast I would still be wearing it! No wonder my tibia fracture site has been hurting! He wants me to keep walking because it will help my leg heal. He says it is a fine balance between doing enough to help the leg repair and doing too much. My physiotherapist had said to go back to using a crutch and to rest my leg as much a possible. Now the Prinicipal Physiotherapist is going to take over my case.

  • Angel

    Hi this blog is fantastic.
    My dad had an accident 10 weeks ago – “blast injury” causing broken tib/ well as head injuries and others that would take too long to list. Luckily he is on the mend and was first discharged from hospital after 5 weeks.
    There is a compound fracture half way between knee and ankle and also fractures at top and bottom. there was a lot of debris so they first flushed the wound and then insterted IM nail. two days after they flushed the wound again and used a large skin graft with a vac to cover the wound from the compound fracture. He was kept intubated and in an induced coma for 6 days and then sedated for another 6 days so his recovery has been a little slower to most here.
    He has been told not to weight bear at all on the bad leg and after 7 weeks was back in hospital with infection and blood clots. they treated with blood thinners and oral antibiotics for 2 weeks but infection levels increased. they started iv antibiotics last week and they discharged him today with a plan in place for a nurse to come to change the iv 3 times per day for another week.
    the consultant says the bone is mending but the IM nail is infected so they will probably have to remove it after 3 months if they can’t get infection under control.
    It is still quite swollen nearer the knee and the anke and foot. It gets hot when the infection gets worse and the foot is always cold especially the big toe. The consultant said it probably isn’t real cold just a sensation as there is nerve damage which he hopes will repair itself.
    Did anyone else find their foot was cold alot and if so, have you any tips for helping keep it warm?
    I find it worrying that the IM Nail is infected and it is inside the bone marrow so why hasn’t the bone got infected?
    Has anyone else had problems with infection?
    He is getting very down about it all as has been in hospital 8 out of the last 10 weeks and is usually active. He is finding it difficult on the crutches (had to use an arm rest crutch on opposide side until last week due to fractured wrist).
    He has taken a few (4 that i know of) tumbles even though he doesn’t go too far on them. Hes had x-ray after falling so no further damage.

    Anyway if anyone has any tips or advice i’d appreciate it

    • jakemcmillan

      Hi Angel, thanks for posting! Sounds like your Dad is having a tough time, I hope the rest of his recovery improves and goes well. I don’t recall having a particularly cold foot so not sure what to suggest there? I’ve also not experienced the infection of the IM Nail, however, a couple of people who have commented above have had infection-related issues they may have some advise? Perhaps reply to their to comments to notify them that you might want their tips/advice?

    • Helen-Anne Love

      Hi Angel, I had experience with a cold foot for about over a week. being told to keep it elevated probably causes this and it did with me. As is was so painful to put anything over the top of my leg to keep it warm I would put hot water bottles underneath the back of my knee and one under my ankle when lying down and this would transfare through the leg. I would also drape a light scarf (silk) over my foot if it was cold. It was warm and didn’t cause me any pain like sheet’s or duvet’s could do when trying to rest.

      Hope this helps your Dad, it did for me.


  • Sazofraz

    No advice to give. My understanding is that the IM nail is hollow inside and does get debris in it when it is inserted but that as the blood supply doesn’t go through it the debris doesn’t get taken away by the blood stream/ lymphatic system. Maybe that’s why it is infected and the bone isn’t? You could google about IM nails to check my information. Just so sorry to hear that your Dad is having such a hard time. I hope that things get much better soon.

  • Steve Manes (@smanes)

    Wow, what a great support group!

    My story: on October 5, I was carving up backroads on my motorcycle in Dutchess County, NY with a couple of friends when we came around a blind curve and encountered the dreaded cold pack… loose gravel that some rural public works depts dump in the road that time of year with the intention that traffic pound it into the asphalt in preparation for ice season.

    Two of us crashed in it. It was so quick that I didn’t even know why I was sliding on my back at probably 50 mph. I knew from racing that the first thing you do is slow count to five after you THINK you’ve stopped sliding before moving. Then take inventory of yourself before you do that. It’s when I knew that I’d broken my lower right leg and had considerable road rash on my right arm because the cuff stay on my armored jacket was torn off in the fall.

    To make a long story shorter, my bike was totaled and I was scooped up for an ambulance ride to Sharon Hospital in Connecticut, where they decided to send me to a Level One trauma center, Westchester Medical Center. After I was stabilized I was operated on on Oct 9th and an IM nail was inserted. I was released from the hospital three days later. I spent the next month pretty much confined to the top floor of my house because my hundred year old stairs are steep and slippery.

    The cast was replaced by a heavy orthopedic boot two weeks ago and I was cleared to put 20-40 pounds of weight on the injured leg, then 60-80 starting next week. Frankly, the leg feels pretty good. I got over my nervousness with the stairs and managed a couple of nights out, although there’s still a lot of swelling after an hour or two in a chair.

    On a few occasions I’ve accidentally put full weight on the bad leg without any pain. I feel like I could get by without the boot but I’m following doc’s orders. I start physio next week and hope they’ll clear me to remove the boot for some activities. I even sleep with it because I’ve got large dogs that jump on and off the bed all night.

    The most annoying part is personal hygiene. I’ve been washing with unscented baby wipes for two months as it’s impossible to climb into my tub without putting full weight on the bad leg. I could if not for the annoyingly narrow shower doors and tall lip on the tub.

    The ortho surgeon says that I’ll be clear for full weight on the bad leg just before Christmas and removal of the boot on Jan 8.

  • Avinash Gajurel

    Hi Jake,

    I had an accident on 9th August 2012 and got by tibia and fibula broken fractured into two halves just in the centre of knee and ankle. I had this same opt on the 10th august 2012. There were no complications during the opt, everything went well. I am in my mid 20’s and I was wondering how long will it take to recover. I am really worried. I havent been able to walk like normal yet. It’s been exactly 5 months since the opt. Whenever I walk, it hurts ( not that painful though) where it had been fractured. I still limp while walking. I left my crutches during the second month. I was wondering if I would ever be able to run again, play cricket, play football and go on a long motorbike drive. I have heard many stories where the victims get recovered in 6 months (like you have said above the soldiers would be able to return to war within 6 months). Moreover, there is a weird click sound in my knee whenever I stretch the leg. I happened to notice it since November 2012. It hasn’t stopped yet. The doctor has looked at the X-ray but there’s nothing. I would be happy if you have any suggestions and things to tell me. Thank You.

  • Hugo

    Hi Jake,

    Reading your blog has made the recovery process that stretches before me a lot less daunting.

    I managed to break my tibia on the 27th December 2012 skiing in Switzerland. It could not have happened on a more flat blue run!!!! I just lost my concentration for a split second and before I knew it I had caught an inside edge. The sound was horrible, it sounded like I had snapped a buckle off my ski boot.

    Luckily a Swiss Dr was skiing past and she did wonders for getting me into a position where I could bare the pain. I was picked up by the ski patrol who called in a helicopter. Despite the pain I was determined to make the most of the ride and got the paramedic to take a picture of me on the stretcher on in the back of the helicopter.

    When I got to Sion Hospital taking my ski boot off was awful, the xrayed me and told me that i had a spiral fracture of my lower tibia and that I needed a rod inserted. I was in the operating theatre 3 hours later for the op which took 3 hours, I spent a very painful 5 days in hospital with next to no sleep and a leg that looked and felt like it was going to burst.

    The trip back to the UK was exhausting but relatively easy, I have been at my parents house for 9 days now and the swelling has gone down a huge amount and I am not having to ice it every other minute.

    My main concerns are that althought there is not much pain from my knee and ankle, they are very stiff, I am just wary about how much I push it regarding trying to get them bending again? Also, I seem to have already lost a noticeable amount do muscle in the quad and calf on the leg, does this slow down or should I be doing exercises to try and combat this?.

    I am flying back out to Switzerland tomorrow (16 days since I broke it) as I had a ski holiday with my friends booked previously…. Determined not to miss out so I think I am going to chill in the chalet.

    How long did it take to get back to work, I live in fulham and have a new job in mayfair starting on the 1st Feb. this will be the five week mark, by then is everything sufficiently mobile to make the commute by bus/tube and do a working day at your desk?

    Any thoughts would be great

    Emily has the pain from the rotation gone? The drilled a hole through my heel and used a rod to straighten my leg before pinning it, did they do this to you?


    • Sophia

      I broke my tibia/fibula about 5 weeks ago skiing in Whistler, Canada. I had the same operation and stayed in the hospital for 3 days.
      I took the flight back to Austria 10 days after the operation and get back to work 3 weeks post OP.
      I have a little chair under my desk to elevate my leg and it helps a lot to make me get through the working day. Although my leg will be very swollen in the afternoon. But after a good sleep, it’s totally fine in the next morning.

  • Joyce

    Wow, thank you so much for posting this – I know it’s been a while but I had the same surgery about a month ago and my doc didnt tell me much so I just have online research. It’s very limited. I am in a cast because I also have an ankle fracture but after 3 1/2 weeks of being in a long cast and now a below-the-knee cast, I’m just working on bending my knee. And yes, 3 1/2 weeks is too long for staples to be in bc the skin starts to grow around it so it hurts like a mf when they pull them out! Can’t wait to get this cast off and start rehab so i can walk again!! Did you do physio? What kind of exercises?
    Thanks again,
    Ps, I laughed really hard at your hospital story cuz it was like mine but worse! Lol!

    • Dave E

      Hi Joyce,

      Most of the exercises my Physio gave me were centered around ankle flexibility (using the rubber band/a towel to stretch the back of the ankle out). She also had me lying on my back and gently bringing my heel up towards my buttock until I felt a slight stretch in the knee. Unlike you though I was partial weight bearing from the start and had no cast so I won’t have lost as much flexibility as you. I’m sure you’ll catch up in a few weeks though once you’re able to start stretching.

      It’s worth mentioning that I had to ask my Surgeon to refer me to the Physio.

      Good luck!

  • Dave E

    Hi Jake,

    I can’t thank you enough for starting this blog. I’ve found it a tremendous help over the past 7 weeks and it’s made the whole recovery process so much easier. It was great to read your experience and the experiences of others.

    I’m 41 and normally very active. I cycle regularly and also go hillwalking and play golf on a regular basis. My story is that I slipped on an icy slope whilst playing golf (who ever thought golf was dangerous!) early Sunday morning on the 27th January. I broke my left tibia in 2 places and also my fibula. The initial pain whilst lying on the golf course and waiting for the ambulance was horrific but they arrived quite quickly and took me to the local NHS hospital with the help of gas and air.

    I was given morphine at A&E and put in a cast. The next 18 hrs were a bit of nightmarish blur. I was left overnight and operated on to have an IM nail inserted the next morning. With hindsight I suppose they didn’t really discuss this with me. A Doctor came round on the evening after I’d just been admitted. He told me that a “nail” in the leg was the best option, drew on my upper thigh, got me to sign a waiver and then left. The next morning when the actual surgeon started telling me what was going to happen I felt terrified!

    The operation went well and I spent the remainder of the day and that night in the hospital with a morphine “pump” at my disposal. I used it a few times at the start but hated the way it made me feel. I made it through the night, dozing, in terrible pain and listening to the cries of some of the other patients in the ward. It was like being in a nightmare. I was determined to get home as soon as possible.

    When the surgeon came to do his rounds on the Tuesday morning (I’d been admitted on the Sunday morning and had my nail inserted on the Monday morning) he did all the usual leg checks and asked me how I was feeling. I lied to him. I said I was feeling surprisingly well, “some pain but but not nearly as bad as I expected” – the truth was I was in total agony and felt terrible! He was happy with everything and noted that I hadn’t really used my morphine pump He said that I could see the Physio in a few hours and if I could pass the crutches tests I’d be able to go home that day! I was totally thrilled. I saw the physio and managed to pretend I was feeling quite good and pass the tests.

    I was allowed home later that day and as you know the relief of being home was fantastic. I probably left the hospital too early though I was in a huge amount of pain over the next few days. I was initially given co-codamol, then dihydrocodeine pills. Unfortunately they made me dreadfully constipated. I’m not ashamed to say that I actually cried like a baby 3 days after I got home. The combination of the pain in my leg and dreadful constipation made life unbearable. The Doctor then prescribed Tramadol which solved the constipation problem. The pain was bad for the first 2 weeks (not helped by back pain from lying on the couch too much) but I remember watching TV on the 16th day after the op and realising that I was actually “comfortable” for the first time.

    Since then I’ve improved dramtically and have had several physio sessions. I started walking (with a bad limp) after 6 weeks. I’m now at 7.5 weeks and the walking has improved quite a bit but my left ankle (the leg I broke) is still very stiff and still a bit sore. I’ve been doing the exercises the physio prescribed but I suppose it’ll be a long process. My knee is also sore and stiff if I stay in the one position for too long. I think this is normal though after reading the various comments.After reading all the stories here I think I’ve actually been quite lucky. I go back next week for my 2 month check up. Hopefully everything will be okay.

    Thanks again to everyone that’s posted. It’s really helped.

  • Rashid

    Hi there! Greetings from Singapore! I had the same exact surgery and am now onto the 18th day. I broke my tibia and fibula during a soccer game.

    I can definitely relate to your story and it somehow gives me hope and strength knowing that I’m not the only one facing this injury. I like the your idea of striving towards short term goals instead of going for the long term one. Will try to use it myself.

    Thank you very much for your story. Hope both of us have a speedy recovery! Would loved to be updated on the development of your recovery.


  • Julie Woods

    hello from sunny Australia! (actually getting a bit chilly now). Hope you are all progressing nicely and back to feeling independent again . . .

    ThankYou for this blog, I came off my bike 4 weeks ago, most embarrassing, compound snap right tibia & fibula. luckily for me i can’t remember ANY pain: possibly because the ambos were on hand quickly & gave me lotsa morphine. . . . my biker brothers closed the road & held my hand the whole time. and probably scared the crap out of the nurses when they all turned up in the hospital to see me!

    woke up after surgery to find I had a titanium rod down the centre of my tibia and no cast. Great news! I’ve had a cast before and they’re horrid. still not as much pain as I expected from such a serious break, was on some narcotic called endone but eased off it ASAP, spacing doses & then halving doses then 10days later off them entirely.

    I found once we rigged up a leg-cage under the blankets so nothing touched my leg the worst of the pain disappeared! At home I’ve improvised one with my walker (aka Zimmerman frame), works great.

    Empathised with everyone else – whenever my leg goes down it starts hurting, swelling & turning blue. So being of a logical mind I decided to keep it up most of the day until it behaved itself! been doing lots of toe-wiggling, gentle point & flex ankle, leg raise & knee bends, but NOT if it starts hurting!

    After a 30-second trial i refused crutches at the hospital – for some reason they hurt my leg much more than using a frame & felt much less stable. Discharged on day 3 after surgery, caught the train home (using my walker), then straight into my daughter’s old low wheelchair which I’ve been using ever since – very easy to scoot around the house and lock brakes & balance against something if I need to reach a top shelf. Crutches are feeling better now, getting better every day, but I don’t allow myself too much time with my leg down – want the bone to heal ASAP so I can start serious physio!

    Don’t know how you guys started weight bearing before 6 weeks – I’m not allowed to weight bear, only touch my bad foot to the ground – fine by me! my ankle still a bit swollen especially when it’s been down not up, can’t flex my ankle all the way back yet.

    At 2 weeks after op I asked fracture clinic doc how soon I could get back on the bike – this is when I found out that titanium makes you MORE vulnerable long term: apparently if i break my leg again the rod can bend, which will also keep my leg bent and/or shatter the tib completely and permanently. Had a dismal week thinking of all the things I love doing like landscaping my backyard, building stone walls, boating, of course riding my bike, bush walking in the local rainforests, etc etc etc – was planning to try hanggliding one day too . . .

    So although I am very grateful to the ambos and the surgeon who did such a great job of placing the rod & bones so they will heal nicely (and all for free by the way – we have great emergency healthcare in australia) I am going to save up & have the rod & screws removed at the opportune time.

    Thanks everyone who keeps saying that removal is easier and quicker than insertion! There’s nowhere else I’ve found with this enormously reassuring firsthand experience.

    Bon journee to you all!


    • emily

      Hi Julie

      Im glad you’re doing well. just to say I had the rod taken out a year after and it was very easy. I was only on crutches for a few weeks. nothing like having the rod inserted and dealing with a fresh break. make sure you have it done around the year mark though s if u leave it in too long the bone starts to grow around the metal so it’s not possible to remove it. good luck with everything! x

  • Wk 1.6 Perspective as medicine – Sarah Lapenta-H & Paul Hebblethwaite

    […] This website seems to match what happened to my right (driving) leg and generally what to expect over those time periods the surgeon mentioned — […]

  • Ste

    I’ve had pins took out and been told that the rod will stay in my leg for life it’s been two years now and have no problem at all, i had two brakes in the tib and the peace ov bone came throwgh the inside ov my ancal and a brake in the fib my spleen removed and collapsed lung and four broken ribs
    Morale to this story don’t crash cars in to trees 😉
    Thanks for reading
    From Ste

  • Brett

    Sorry I have not updated for some time but have been going through a bit of an ordeal, I had an IM nail inserted in Feb 2012 after being hit as a pedestrian by a car.

    Initially I was healing well and thought everything was on track but after about a year I was getting persistent pain in my knee and still did not have sensation on the whole left side of my knee, after going back to the consultant they advised that the rod that had been placed in was to large and was protruding into my knew joint, hence the pain. It was decided at this time the best course of action would be to have the rod removed (hindsight is a wonderful thing), I was booked in for day surgery and all seemed to go well. Once home noticed I was bleeding onto my sisters white carpet and called the hospital and was told to go back in, at this time was told they had a lot of trouble getting one of the screws out of my ankle but was just a case of redressing and back home again. The next week or two the pain was rather intense I suspect due to the trouble in getting a screw out, but after two weeks the pain subsided and even my knee was feeling better. About three weeks after the surgery I started to experience shooting pain that felt like an electric shock running up my leg on a constant basis and the lightest touch would cause pain ( to the point my leg hairs hurt), I went back in to the hospital and have been advised that I have neuropathic pain (nerve pain) as during the surgery either a nerve was damaged or stretched and that basically this was going to be something with me long term or possibly for life. I am now on constant pain medication and dealing with the psychological aspects of such a drawn out and painful experience.

    Please be mindful if considering getting the rod out that it is a surgery and all surgeries carry risk and can make the problem worse such as in my case (I didn’t have much of an alternative though).

    Irony is I now work for the company who makes the IM nail, seems I’m tied to the nail.

    Wish you all luck in your recoveries and hope everything runs to plan for you all.

  • HayleyDance

    Hi jake, thank you for sharing, it really cheered me up reading and relating to your story.. 8 weeks ago I got hit by a car, I broke both my legs, tib/fib, and had the rods put in both… It’s been very difficult… Especially when I have a one year old who I can’t look after all by myself, and I’m a dancer… You have a very good attitude and that really gives me hope that it won’t be too long till Ill be back to normal/ish.. 🙂

    • jakemcmillan

      Thanks! Wishing you the very best with your recovery. Please feel free to share any of your own experiences.

      • Lindsay

        Hey, I’m having my IM rod removed tomorrow, I had it fitted last year after a drunken fall! I will keep you updated with my recovery. I haven’t had much trouble with my rod but it I can’t kneel and it annoys me and I can run with out it hurting me. X

      • Lindsay

        Just an update, I went in for op yesterday, took a bit longer than expected 1 hr 30 mins, I was due to come home last night but I was in considerable pain so they kept me in. Everything is quite stiff and sore still, It feels as bad as the first time just minus the break and that horrific burning feeling if you remember that? I am managing to full weight bear and walk round the house with one crutch, just pushing past the pain (I’m dead soft) ha! Praying everyday will get easier, I’m sure it will. Will update again in a few days – I’m not great at blogging though – so sorry if it’s boring but ask any questions as I’m going through it now and will have forgotten in a few weeks lol xx

    • Kayleigh

      Hi Hayley, I was just wondering what your recovery time was, my boyfriend has done the exact same thing broken both legs (closed bilateral tibial fractures, on new years day he had IM nailing put into both legs. So far he is managing to walk about the house on crutches and get up and down stairs but gets tired quite quickly and find one of shins and knees can hurt quite a bit. Any advice you can give is great because as everyone keeps saying there is not a lot about recovery times on the internet especially for both of them being broken! Thanks 🙂 xx

  • Saz

    18 months on from my break I have been told that I have as near to a 100% perfect mend as is possible. I am very lucky to have been operated on by a senior consultant surgeon courtesy of the NHS. I am in the small percentage of people who have no knee tenderness from the op. when kneeling. The only problem is discomfort in the pins below my knee when I go for a hike of 2+ hours. I am very overweight. I saw a Registrar about possible removal of these and the IM rod but he wasn’t keen on such a major op. and I am thinking that I would probably end up with a tender knee from the op. We agreed that I would wait to see once I am back to full fitness whether there is still any discomfort in the pins. I want to be able to go on walking holidays. Since the rod and pins don’t normally cause me any pain are there any disadvantages in keeping them?

  • Sarah

    12m after breaking my leg, I’ve just had the rod removed. Had an epidural and there was a lot of banging and swearing – took an hour to get the screws and rod out. Evening op so stayed in but went home the next morning – fine. Took a nurofen the first night but nothing since (except those lovely injections in your stomach). Only limping because when I changed the bandage, I’d opened the wound where the knee bends by walking too much (albeit on crutches for the first 2 days) and I’m now trying to keep my leg straight… Staples should come out in 3 days time. One wierd thing I’ve noticed is that the pigeon-toed walk I’d developed has completely disappeared. And it’s really, really, really nice to think that I haven’t got to debate as to whether to have the rod out or not. And I get to lie on the sofa and watch Christmas telly as an aid to recovery and recuperation…

  • Sarah

    Having just posted I’ve been reading some of the more recent posts and it’s brought it all back. Must say that it’s seems a long time ago since I started physio and I have spent the past year pretty determined to do everything I wanted too. And I have. Started swimming as soon as I could and swam and swam and swam. Then added cycling – had a few crashes as I couldn’t stop at junctions – couldn’t put my foot on the floor. After 3 months I started riding again (first few times on a fat pony) and have done via ferrates, caving (hmm – all that crawling on uneven rock), running, scuba diving, skiing etc and have prabably never been fitter. Have got a Garmin and recorded all my activities – brilliant when I went from marking them as ‘recuperation’ to ‘training’.

    Sounds like I’m some kind of activity freak – and I really wasn’t but I found that all these activities can be broken down into tiny goals – getting to the changing room without needing a rest, getting out of the pool via the edge not the steps, getting on the fat pony without the help of three grown men etc etc etc. Whether it will ever feel 100% normal or not, I don’t know – but I’ve had a laugh these past months and seriously enjoyed myself. Not that I want to do it again. Happy New Year. Sxx

  • Christian

    I had the exact same procedure and the exact same break in the same exact place. Although my Fibula was broken as Well up near my knee. I was told I wouldn’t walk until June. This happened Dec 29th my Surgery being NYE. By mid February I was walking without assistance as I am now. The knee I find is the most painful and I have a lot of discomfort. I’m hoping this goes away soon. It’s quite odd also that sometimes I have to limp and sometimes I can just walk. Almost as if I need to get it going a few steps before It’s normal. (Kinda normal) I had No clue the possible complications I could have had. Anyways Thanks so much I was looking foe something to kinda give me reassurance that I too am on track to being Well again. Thank you!

  • Saz

    I was told that the average time for fibular to mend is 4 months with IM rod, 5 without. Important not to overdo things as you can go backwards – I did by about a month in terms of mobility. Good idea to get advice from physiotherapist and then when they’re done a specialist sports coach. My local sports centre (UK) runs a really good GP referral so you get expert advice and much cheaper access. They run rehabilitation classes including water exercise. Unfortunately when they insert the IM rod they do it through the knee by pulling ligaments (?) apart so this does tend to leave people with rather tender knees. But if the knee tenderness is caused by the bolts then after about a year you can get them taken out again if it is stopping your leisure and/or work activities.

  • Saz

    New Topic – Whether to have bolts out and maybe rod as well.

    I broke my tibia (as in shin bone) towards the bottom of my shin and my fibula towards the shoulder in spiral fractures the summer before last. Whereas initially I experienced little pain after the breaks healed, I am now finding that I get tenderness in the bolts below my knee, sometimes after walking for around two and a half hours on uneven ground and sometimes just out of the blue when I have not been doing much. Sometimes the bolts just don’t feel right. It’s hard to describe but it’s a bit like they’ve got out of alignment. My fibular and tibia are screwed together at the shoulder. I am contemplating the merits of having the bolts removed. I’m in UK where the metal work is not removed as a matter of routine. The Registrar who I saw last said that some surgeons might be willing to remove just the bolts but others would insist on removing the whole rod as well. He advised against such a ‘major’ operation. He said he wouldn’t want such a big operation and that I might lose a lot of blood and that I might have to have a blood transfusion. I am totally unfussed by these issues as long as I don’t have permanent damage. What does cause me more concern is being warned that I would end up with a tender knee. I broke my leg sufficiently badly to be operated on by a senior consultant surgeon courtesy of the NHS and I am one of a very small percentage who haven’t ended up with a tender knee after IM rod insertion. I love dinghy sailing. I have noticed that sailors of single dinghies such as Picos often adopt a kneeling position. It seems to me like a question of swings and roundabouts. Do I favour being able to go on walking holidays and longer walks or being able to kneel? Also how long would the recovery period be? Although frankly I love morphine as it makes me euphoric so anyone who is prepared to offer me morphine for a decent period of time would be likely to get me to sign up for an op. And no, I’m not an addict – at least not yet! The leisure centre coach for GP referrals tells me that once I’ve strengthened my thighs through their exercises I will hardly be putting any pressure on my knees and the discomfort will go away. My GP says that patients usually feel their metal work more when it’s damp. I’ve bought a damp house!! Other questions are:
    If I don’t have the metal work removed what will my mobility and the discomfort I will experience be like in old age?
    I’m working on reducing my weight, having been within two pounds of clinically obese. Although I’ve dropped a stone and a quarter I’m still overweight. If I became obese, which is possible, depending on future medication for other symptoms, how would my leg fare? How much discomfort would I be likely to have?

    I am in my early 50s.

    I would welcome any thoughts on these questions.

  • Ian Waddell

    Many thanks Jake for some very useful information. I am 68 years old, 3 weeks since my op and I can tackle one flight of stairs on crutch/handrail and walk around 20yards on crutches until exhausted , trying to do a bit more each day. My first hospital review is in three days.

    One tip is that I find it often easier to sleep on my good leg side with a pillow wedged lengthways between my legs.

    • Brian

      Good tip with regards to the pillow. The blood rush was a real bitch, good tip in the blog was to take your time getting up.

      I’ve to go see the surgeon mid December to discuss the extraction of the metalwork (IM nail and two screws (I only had one at the top and one at the bottom – right tib and fib – and yeah they were not at all bothered about the fib))

      I’m 43 years old male and absolutely terrified about the prospect of another operation mainly coz I had some heart complications after the last one…..

      Any way if your reading this blog it’s because your are or were broken or know someone who is. I hope it gets easier nice and quick but be prepared forbabling haul. I’m a year and a half in and still get pains at the sites of the break / butterfly fracture / knee and pins. I wouldn’t wish it on anyone.

      Thanks to everyone who posted. Wish i had found this blog sooner.

      Brian de Tazzzie

  • Steve

    Hi all,

    I have an IM nail in my right Tibia, was done 6 years ago after a motorcycle accident left me with 7 lower tibia fractures, 3 lower Fibula fractures and a Tibia plateau fracture – when I say lower I mean from the bottom of my ankle to about 100mm up my shin.

    To be fair my recovery was pretty good and I was back at work (very busy factory environment – on my feet a lot) in 3 months, I get some serious discomfort if I overdo it but, usually I am ok trail walking for approx 10km before it gets really sore. Recovery process included walking (on even ground and in the swimming pool), swimming and cycling (turbo trainer).

    Considering that at one point the ortho team were discussing amputation I am happy with my recovery and current capability, I have discussed with the ortho consultant the options in future and the advice I have been given is that the risk of infection is increased should I have more operations, it may be worth asking about the osteomyelitis risk before making your decision about removal etc.

    One more thing, the discomfort I get is from soft tissue, ligament, tendon damage from the accident, a good physio helps me with this when it becomes a pain in the rear – hot water bottles work a treat, I am informed this is because the lower part of the shin gets a limited blood supply, heat increases this and aids recovery..

    Hope this helps, good luck!

  • rahat

    I am from India (27 years, female) My tib/fib broke on the 27th October,2014 in a road accident.
    I had the IM nail inserted on the 29th October,2014. I am still having the pain killers, calcium and multivitamin tablets. 1 month post operation I am going to visit the surgeon and I will be told if i can start 50% weight bearing. At present am allowed toe touch while walking using the walker. My ankle, knee and the point of fracture are still swollen. My physiotherapy started on the second day of surgery. It includes raising the foot up and down, bending my knees, leg raise in sleeping (both normally and and on my stomach) and sitting positions. I am not able raise my feet up because i feel its getting stuck somewhere. There is numbness on the left side of my knee where the cut was made for the operation.
    I dont have much pain but i feel restless at night when I just cant sleep and I just sit. Thanks to God my mom is with me and she is taking care of me.

    • rahat

      1 year 7 months post operation (IM nail, tib/fib fracture)… I am pretty normal now… Almost is the word I usually use now when someone esquires if my leg is fine now.
      All those who are in the same boat as me, please know it gets better 🙂
      Just make sure you go to a good doctor, do all the exercises, eat properly and smile often.

      Lots of Love,
      Rahat Fatma

  • Fab

    How has the pain been during the first week while trying to sleep? I had my IM mail done on Tuesday and I was out of hospital on the Wednesday. They gave me 30/500mg cocodamol. I’m struggling with the knee pain the most when trying to sleep. The best way I can describe it is like when you straighten a limb and you get that pain knowing some air is trapped and it needs to click. It feels like my knee is perpetually at the worst point of that sensation.

    Did you get this and if so how long does it last till you can sleep comfortably?

    Thank you for your blog.

  • Dan Cody

    Hi, I just wanted to share a little of what is going on with me. I am getting ready to have this same surgery. But there is more involved for me than just that. 9 years ago I had a spiral fracture of the lower fibula and had a plate and screws put in. I have had pain on it every day since then. Repeatedly telling my drs that something was wrong but told it was just normal. Now, I’ve had 55 broken bones and 6 surgeries, I know the difference between being achy and arthritis pain, and actual pain. Anyway, getting to the present time. 2 months ago I was run off the road on my motorcycle, ended up with a compound fracture of the tibia. About 2/3 of the way down from the knee. They also (after a handful of xrays) found the non union in my fibula. I told them Dr s something was wrong. Been walking on a broken leg for 9 years. Moving on, because it was a compound fracture where it came thru the front of my shin they couldn’t dothe IM Nailing right away. IInstead I’ve been wearing an External Fixator for 2 months almost exactly. To allow the soft tissue envelope where the bone came thru, to heal. Its finally healed and I go in for surgery in just about 12 hours. They are removing the old hardware in my ankle. I won’t be needing it anymore seeing as how they are also removing an inch of my fibula leaving a gap in it so it won’t touch and stop the tibia from healing. And after all that then they will do the IM Nailing. I am not looking forward to having this done, in general, let alone what its going to feel like after all of that is done together. Will post again and let you know how it goes in the morning!

    • Independent1

      When I was in hospital after the IM rod insertion I can’t remember experiencing pain even when I started physio. I was on four pain killers including morphine. I suggest if you are in pain they are not getting your pain management right. If you are in UK on NHS you may need to make a fuss to get things done. If you are in pain make sure you see a doctor. The nurses can’t change the prescribed meds.

    • Fab

      Pain after surgery was fine. I was actually walking a few hours after surgery while the pain killers were still in effect. It’s about 2-4 weeks of discomfort when trying to sleep that was the worst for me. Co-codamol 30/500mg worked great but I was only prescribed a few days worth. If you get enough to get you through the first few weeks it’s no issue I think. I’m just over a month post-op now. Still a little swollen with mild discomfort in odd angles such as train seats (I’m 6ft6) but it’s otherwise okay.

  • matthew bramston

    my break and surgery was pretty much exactly like yours.even the position of the break is the same.i am about six weeks after the operation.every thing u have described is what i am going through.the only thing i would add is i have been walking in the pool for about a week now completely unaided.mentally it is fantastic and not using crutches is a first physio appointment.yesterday she could not believe how far advanced i was movement in knee and ankle were same as other leg.and i am 52 years old and overweight.recommend walking in pool best i am impressed u did this post

    • Independent1

      My local leisure centre (UK) have special classes for those with medical needs as well as coaches trained for GP referrals in the gym. This was my next step from physio. The aquafit classes which provided exercises in the pool such as walking on tiptoes etc were really helpful for regaining balance as well as exercise. Also pool has concrete steps and a chair hoist. There is no way I would have been able to manage the normal swimming pool steps so the concrete ones were a boon.

  • Lucy taylor


    I hope you are well.

    I got run over by a double decker bus on 12.12.14 and broke the same bones in my leg and had the same operation although the nail was put in above and behind my knee cap so I have a lot of swelling still! I also have had to have a few skin grafts as the tyres on the vehicle de-glove the skin-sounds nice I know! Anyway, after 5 operations and two and a half weeks in hospital I made it home and I’m only a month on from the accident but I’m just discovering all the things you have written in part one! I was proud of making tea and toast too! I ate the toast in the kitchen! Haha
    Anyway, just wanted to say thanks for writing this as it’s making me laugh and helping me too :-))
    Thank you and I can’t wait to be up and about!!

  • Finley Gibson

    Thank you or writing this. Your situation is remarkably similar to mine: same injury, same city even down to the parents in Somerset wanting me to go home! It’s given me a good idea of what’s to come and reassured me that I will cope alright by myself. Can’t wait to get this first week over.

  • Stewart

    Nice blog Jake! and a relief to find so much information in one place after the complete lack of column inches on these injuries elsewhere on the web.

    In contrast to the fib/tib combo popular here, I fractured my femur after going over the handlebars of my pushbike on a Parisian roundabout. Different bone, same operation but with a 6 week wait until i am allowed to put any weight on my leg. I’m a week away from that day now and i must say it can’t come soon enough. Have had the usual worries about how difficult the rehabilitation is going to be especially as knee only bends to about 30 degrees as of today. Well, i’ll know in 7days!

    As the break is near the hip it has caused a different set of problems with mobility- moving from lying to standing, the edges of beds and chairs etc have been particularly difficult due to the different stresses on the bone and sockets. Could have done without the sprained ankle too on top of everything 3 days after the op (same leg) but what doesn’t kill us makes us stronger right?

    Looking forward to getting back on my bike sometime this summer, although am thinking that the 600km per month I was doing previously is a little optimistic 😉 At the very least this blog gives -The IM Nail Crew-confidence that with perseverance and patience anything is possible.

    So, thank you again for your wit and time spent putting this blog out there. I read every last one of the comments on each of your posts and found everyone’s insights and humour quite reassuring.

    I trust you are back to your former self 5 years down the line?
    Power to the (Bionic) people!


    PS; As i was treated in a french state hospital I thought this whole nail thing was a particularly french eccentricity until i delved deeper and did some research. But rest assured if any of you find yourselves in a similar situation, French hospitals rock!

  • Jordan wray

    Im glad i found this blog, having broke my tib and fib in a motorcycle accident on the 3rd of july i had the im rod inserted, having come round from my op and not being given much information i search frantically online for answers. When i first seen the recovery times it got my quite concered as im a self employed joiner so long stints out of work are no good for me. Its been about 6 weeks so far and im making great progress, i ditched my crutches in the 4th week as my consultant said i can weight bear as tolerant, at first it was hard getting around, i had a bad limp and was out of breath virtually straight away. Its now about 6 weeks and i am finding it much easier, i still walk with a limp but its not as bad, i have been going for 2 walks about 1 mile long each day, i have joined up to the gym to focus on my upper body and i have also started swimming as this is perfect for my leg and takes alot of the weight off. I have my last appointment and xray on the 14 th september were i hope to find out that it has healed well and i will be ready for work. Im very happy with the progress ive made so far, i think this might have something to do with my age as im only 20 and my consultant said younger people tend to heal more quickly.

  • Sunny

    Thanks for the blog Jake. I suffered a bouldering accident 12 Nov (not a very high fall – around 2mtrs – but probably weird angle) leading to open fracture of Tib/fibula. After 5 weeks of the IM Nail surgery – was asked to start putting weight. the wound looks better now. Been a week of weight bearing, have put 80% of the weight on the injured leg (checked on scales) and can walk short distance using one crutch. Wound is still a bit painful if I don’t keep the leg elevated (also that the leg turns dark red within a few minutes of keeping it down). Still have swelling at the ankle and knee. Hoping to be able to walk without crutches and carry things around soon.
    I notice that my scar is stuck to the bone, the scab hasn’t fallen off yet. Wondering when it is safe to start massaging the scar so it detaches from the bone.

  • Chris

    Thanks Jake for this blog. I’m a 56 year old woman who has never been in hospital other than having my children. Unfortunately 6 weeks ago slipped in mud and broke tib/fib. Had IM nail inserted. Follow up with consultant 2 weeks after and was told to weightbear as much as I could stand. Not seeing consultant again until 12 weeks. Although I am trying to weightbear I am still not confident with stairs ( up and down on bottom). I have to say I am terrified of what will happen if I fall again with the nail in. My husband and I love walking but I feel this apprehension is going to become a big part of my life. Have you had your nail removed yet or did you decide against it?

    • emily

      Hi Chris! I had a tib and fib break a while ago and had an IM nail. rest assured that nail is like having a bionic bone secured on there! it way more robust than you think! they advise walking on it straight away because it acts like an actual bone. obvsiously take it easy as the soft tissue around the bone is damaged. but really don’t worry about the nail. it’s all secured in there… and is super strong. Good luck with your recovery x

      • Chris

        Thanks Emily for replying. I think my main concern is how the nail will react if I slip whilst out walking in the country again. I’m sure over time I will learn to live with it as its early days now. I just need to stop looking too far ahead and concentrate on my immediate recovery.

    • Linda Banks

      Did mine in 2010..can’t believe how quick them years have gone. Anyway, I felt like my life would never be the same. I had the screws removed 18 months after op but not the nail. The nail is still in ..but I’m back to power walking n even a bit of a run on the treadmill. .never was much of a runner anyway.
      Hang in will get back to normal again. Good luck

      Linda x

      • Chris

        Thanks Linda. Were the screws causing a lot of discomfort?

      • Linda Banks

        Yeah Chris…especially the one on the front of my leg at the bottom as it was kind of on the joint where you bend your foot upwards. Also I could feel it if I had boots on as it felt really restricted and rubbed on my boots. .now it’s out, it’s loads better n the op to have them taken out was OK too x

  • Karen

    Hi Jake, I’m so glad I found your blog! There really is not that much info on the interwebs about this. Here’s my story….so far

    I came off my bike near the end of bike section in a triathlon, I was clipped into the pedals and was trying to unclip as I fell. I got back on my bike, adrenaline is an amazing thing, and finished the bike section. Then the pain hit! Medic told me I just had a bad sprain, go home and rest! Next day, realised this felt pretty bad – A&E were incredible dismissive of me, X-rayed by ankle only despite not being able to weight bear at all and told me I had a bad sprain, refused point blank to give me crutches and were pretty annoyed when I could not use the walking stick. I had to beg my GP to x-ray leg 10 days later – turns out I had a spiral fracture on tibia (it’s about 6 inches long, wrapping round my tibia but completely in place!)

    So I had been walking/limping on a broken tibia for nearly 2 weeks before they decided to put me in a cast.

    Long story short, it has now been over 6 months and I just had a CT scan to check healing – it is slow healing. I still cannot walk without the crutches outside as any uneven ground sets it off and I am still in a moon boot. I can walk about the flat fine but it doesn’t take much to set it off.

    I have been at my wits end this last 2 months, just the constant delays and not knowing what is going on. I just want my life back. I have stayed positive most of the time, I’m pretty proud that given that I was so active before. I used to get angry when I thought of the misdiagnosis’ at the start. My consultant has pretty much admitted that the delay in healing is due to the fracture not being put in cast quick enough.

    So I just got a letter today, asking me to come in a discuss “interventions” based on my pain levels in a couple of weeks. We previously discussed that surgery might be an option, I don’t know why they bothered making me wait yet another month for a CT scan when he knows perfectly well it has not healed. Anyway, it will be a rod as plates are not much good for spiral fractures apparently.

    I am really hoping that my surgery journey goes well, I am finding it hard to get my head around the fact that I am going to have to go through this all again……least I know what to expect and a few tricks now I guess, my backpack is my new best friend!

    Hearing about your journey and everyone else’s gives me good points of references! I know I’ll get there, just more patience required.

    Thanks – it’s good to have found somewhere where people share their stories, funny moments etc.


  • Abdul Kara

    Hi Jake.
    Nice and detailed description of your experience. I got to your page searching for the number of days with pain after operation.
    I’m in a very similar situation at present.
    I hope you are well.

  • Nathan

    New to the thread. Had screws and tibia rod removed 5 months ago. Knee and ankle is tight and still swells after walking around. I am constantly on my feet. How long for a full recovery? How long does it take to get back to 100% were I don’t think about it constantly?


    • kar8al

      hey y’all! broke my tib/fib 6 years ago. soccer accident, goalie came sliding in, cleats up. removed nails 4 years ago. removed nail yesterday. stayed overnight as rod was particularly difficult to remove(operation scheduled for 1.5hrs, took 3hrs). painful, slight weight bearing and the surgeon gave me a Velcro full leg splint he wants me to wear for 6 weeks. it appears the incision is pretty long to, longer than the incision to put the rod in. is that normal? I know he had to scrape away some bone, but is the long incision a sign that he took too much bone out? praying for a speedy recovery. love to hear everyone’s stories, reading these comments helped me make the decision to remove the tibial nail.

  • Lee


    Just wanted to say how much I enjoyed reading this and it has really helped me this week and especially today.

    I broke my tibia 6 days ago and had my nail inserted 2 days ago. Like you I was itching to get out of hospital and when I got home I was hit by how hard everything is and the pain of post op.

    Look forward to reading the rest of you story. Thanks.

  • Sian Mavor

    Just found this blog and wish I’d found it earlier! It’s almost 3 weeks since I broke my tib & fib and had the same operation you describe here. My stitches are now out and the scars and positions look exactly like yours. It’s been so encouraging to read your account of the aches, pains, swelling, crutches, frustrations etc. Thank you!

  • stafford allwyn

    This is fantastic. Finally found an article that i can relate to. I broke my left tib and fib in the shin area as well, looks like it is more common than i thought it was was. I am two weeks in now and have been very anxious about hows and whens but this article and the comments give me an idea of what I can look forward to.

    At the moment i have a cast covering my leg knee down and find it a bit tough to move my leg about but hopefully ill have what you show in your pics once the stiches come off.

    Fingers crossed ill have them say my bones’ placed well so I know im on track.

  • Peter

    Sitting here in bed now, leg in pain after a double break tib and fib Saturday afternoon 8.10.16. Just come across this post and it’s filled me with complete optimism!! Had the sane procedure and now I feel much better. Cheers!!!

  • Sharon Doodson


    My name is Sharon, I am 49 and I had the op on 19 September 2016. I acquired my injury racing as a sidecar passenger, my foot caught the tarmac and it twisted my ankle like a corkscrew resulting in spiral fractures to both my tibia and fibula. On the xray my bones were still twisted so before they could operate they needed to manipulate it back into position, the thought of that terrified me but they advised I wouldn’t feel it and gave me ketamine, wow that was some serious stuff and they were right I didn’t feel a thing, when I came round they had pulled it back into position and cast it. The next step was to go to xray to make sure it was lined up correctly. It was but my fibula was dangerously near my ligaments and tendons so they had to cut away some of the cast so they could check the pulse just under my ankle bone, all was okay so after 10 hours I finally made it up to the ward. I was supposed to have gone down to theatre the following morning but got bumped due to more urgent cases. I went down to theatre at 9 o’clock on 19 September, it was half past one before I was back in the ward but I didn’t come round until about half five. Physio on the Tuesday to get me on my feet, then physio again on the Wednesday morning where I had to go up and down a flight of stairs before they let me go home. That evening I was sat on my sofa. The pain is immense and the swelling in my ankle concerns me still. I have read all the stories on here and each a a little different.
    I am not aloud to put any weight on mine for 6 weeks I am only three weeks in and had my staples out last week. Numbness to the inside of my ankle where the screws are and also a bit of Numbness around my knee. Can I ask if anyone else is like me. I cannot straighten my leg at the knee and my foot is still swollen, my toes look like chipolatas and feels cold. The surgeon didn’t seem too concerned but did shout at me for not flexing my foot enough. Maybe it will just take time but saw a video of someone’s left at 18 days and their healing looked way ahead of mine. Any advice anyone can give would be a massive help.

  • Stewart

    That sounds really nasty but try not to worry. (Yeah i know that’s difficult isn’t it!) but…
    I know what it’s like cos I had a double displaced fracture of the femur 4 inches from the ball socket (Jan 2016) and I was horizontal for 2 months with no knee bending for some considerable time.

    No weight bearing also for approx 8 weeks —you and i seem to be in the minority here, lots of people start a lot sooner—and I thought i’d never be able to walk again! My foot was swollen big time and the pain was bad when anything other than horizontal. (I also sprained my ankle while in the hospital bed and had 2 transfusions which complicated things somewhat but that’s another story 😉

    It’ll take a bit of time but you’ll heal. Patience is the key thing. The biggest thing is staying positive and re-learning how to walk (in my experience… heel first and rolling the foot etc. But that’s for later.) It took approx 1 yr to get back to normal for me (After 156 physio sessions) but now i’m cycling again like before. Nada problem. No pain. Just a titanium rod as a friend for life now…

    Read a lot. Learn stuff. You’ll come out of it stronger. 🙂
    Best wishes n good luck.

  • Karen bourke

    Thanks for this really appreciate it as not been told much with regards to recovery I am in the early stages and having my first checkup with x-ray nxt week. Hope you are well on your way to full recovery and thanks again for the defo x

  • placidum2015

    Can anyone comment on how the leg should be positioned during bed rest after surgery? My husband had a rod inserted after a very serious car accident (many other broken bones) so he was in bed a lot. There wasn’t any supervision from medical professionals about keeping the leg positioned in good alignment (toes facing ceiling) vs allowing the foot/toes to flop sideways (duck feet position) causing torque or twist all the way up the femur. I believe in his case the long period of duck feet in bed caused the femur to heal in a position where he is now permanently duck-footed in that leg due to femur position.

    I would love to hear what advice others got in this regard. Thank you.

    • emily

      Hey! I wouldn’t worry so much about position after the first couple weeks. But there are trough type things you can buy to keep the leg straight with toes pointing up. I think they’re called Harley Leg Trough. Hard to sleep with your leg rigid though! I only felt like I needed it straight for the first 2 weeks then just slept however the leg fell. I don’t think it will affect the healing of it. With all those screws, the leg isn’t going to move. Good luck with your husbands recovery. Emily x

  • emily

    sorry just reread your email and his injury’s sound much more complex so don’t want to sound like I’m being blaze about it! The duck feet may well have affected him. x

  • Sam Thorny

    Hi guys.
    I broke my tib and fib back on the 14th April 2016 playing football.
    Im having my nail removed on Tuesday (8 months from my fracture) as I’m getting some pain from the screw close to my patella tendon.
    Thanks for this blog, it has given me some positive vibes before my op!

    I have tried to keep a diary of my progress via Instagram (my account name is ‘Th4rny’), and through the powers of social media have met loads of other people in the same situation.
    I will report back after Tuesday with how my op goes.


    • Sam Thorny

      Well I write this as I sit in recovery after my op. Woke up with pain in my knee and ankle which was soon sorted with some morphine! I have briefly seen the surgeon since as I had some excess bleeding at my ankle but he suggested the nurses doubled up on bandages and it seems fine now. Just waiting to see the surgeon for a full ‘debrief’!

      • Sam Thorny

        Update. After my op my ankle continued to bleed. It ended up being quite late before i saw a doctor, but he ended up removing all the dressing on my ankle to assess it properly. It was still slowly bleeding so the decision was made for me to remain in hospital overnight so I could focus on keeping my foot raised to encourage the bleeding to stop.

        Fortunately I was allowed home the next day. I left the hospital using both crutches but I was capable of limping slowly around my ward without them. I have now been at home for 3 days and the pain is getting lesser everyday. I have a lot of swelling around my knee and I do get a sharp pain in my knee when I get to confident and bend it a little too far.
        For now, I have been given 2 weeks off work so Im going to rest up!

  • Helen Bickerdike

    Hi this blog is fantastic! Thank you Jake for creating it 7 years ago. My hubby , age 50, broke his tib & fib one week ago (7th Jan). He went to kick a football but thinks he may have struck the concrete floor! He was wearing new walking boots, no give in them. Result was spiral fracture of distal tibia and two fractures of fibula. To make matters worse he was a couple of hundred miles from home, south of London (we live in Yorkshire). He had a reduction in A&E followed by op to insert intramedullar nail in tibia the next day. He was told his leg was now fully weight bearing and walked with a frame for physio on Monday afternoon. Tuesday morning he walked wityh crutches and did stairs. He was discharged Tuesday afternoon. His wonderful friend drove to London to collect him & they set about the 4 and a half hour drive back! We are now at 6 days post op. He can walk with crutches, bearing some weight on his bad leg. He has pain and is taking co-codamol & ibuprofen (though not at the same time!). He had dressings changed at gp surgery on Thursday. There is an horrific blister low on his shin which was covered by the dressing – how had that happened? Now waiting for urgent fracture clinic appointment & to start physio, which London hospital said should start within 2 weeks. His lower leg is still very swollen with bruising still appearing. When will this go down? He needs to have his foot gently braced against a pillow and hard surface when leg is elevated. He finds the rush of blood when standing very painful and unpleasant. At what stage have people been allowed to drive again? How did it go? Any info would be welcome.

    • Claire

      I need to know when I can drive again too! Did mine June 24th had surgery June 27th

      • Helen Bickerdike

        Hubby started driving mid March after op on 8th Jan if that helps. All consultant would say was you need to be able to do emergency stop with confidence. Good luck.

  • Donald

    I’ve just started on this journey. Had my nail fitted 5 days ago and Iam home. I was glad to read your comments on the pain when you stand up. I thought something was wrong but it’s good to know it’s only blood flow

  • Rebecca Ives

    Thank you so much for writing this John. I am currently day 5post op after doing the same thing playing football with my son. Unfortunately it gets worse I am in a French hospital yes! And this is my holiday, my husband and son are at the campsite we are currently sorting all insurance out and I’m hoping to traveling back Tuesday. Your article has given me lots of information and tips

  • Fiona Watson

    Jake I’m just over a week after this op – so far your blog has been a mirror to my experience albeit short – I hope it continues to be so. Thank you for taking the time to write it all down – as you say, there’s very little out there.

  • Desiree

    Dear jake,

    Not sure if you still check this blog or not, since it seems your surgery was a long time ago. I just had my IM inserted 3 weeks ago. I broke my tibia, fibula and back of my ankle. I still have a ton of swelling in my ankle which I’m wondering as to when it will get better. My doctor prescribed something called a Sarmiento splint which really hurts my ankle to wear. Did you have a cast?

  • Rosh

    Hello there! I just read your article (I know, it is 8 years old) and quite comforted that my current experience is similar to yours. I am in my 30s and had a simple fall. I am now on the journey of recovering from surgery (intramedullary nailing of my tibia). All the things that seemed so simple are tasking at the moment. There is so much thought put into how to get my coffee to my table while using crutches. I am noticing improvements almost daily though. I am an OR nurse, so this is quite a humbling experience.

  • charlottesears95

    I am so grateful for this thread. I know it’s a fair few years old but ya know. I’m due to go in hospital on the 8th November to remove my nail in my right leg. I had it inserted in 2013 after a nasty tackle where one girl jumped on my leg during a football match. I’ve had pain in it for about 2 years in March I thought enough was enough and went to my doctor. After a lot of blood tests and several different scans they suggested it is an infection on the metal. Great right. Anyways my first appointment for surgery should of been october 25th. Postponed til November 3rd. Then postponed again til November 8th. Hopefully they will go ahead but safe to say I’m extremely nervous

  • Lisa

    Hello. I broke my tib, fib and ankle by tripping over some logs on our driveway. I fell but my ankle stayed in the same place. Accident happened 1 month ago. Had nail knee to anke with an additional pin to ankle. Reading everyones posts I can relate to loads!. Am healing well thankfully tho my knee is really limited in movement at the mo.I am walking about on crutches with a black support boot. Tbh ankle gives me more jip than my leg which was broken far worse than my ankle. I saw Consultant just before xmas who told me tp gradually increase weight bearing in the next month to as much comfortable.Anyway my question is does anyone know how long I should keep boot on? Its so heavy! Am desp tp be rid of it. Thanks

  • Yamit

    Just wondering. I had a similar surgery 5 weeks ago, and my knee hurts every time I put my full weight on it, as in alternating weight from leg to leg when you walk. And it’s a very sharp pain. Does this go away? I can’t imagine walking with this kind of pain every other step.

    • kar8al

      It went away for me after about a year but returned when I got into physical activity. After pain meds got pretty hooked on like aleve and other things like that. Eventually had surgery to remove the nails (3 years later). Then had surgery to remove the rod (2 years after that) and it feels awesome now. Don’t take no pills for nothing. Only time the pain comes back is when I sit and drive in the car for too long. Other than that, it’s golden.

  • Nicholas Zemenski

    This was a wonderful read about things to come, I just had the same thing happen to me last week, a tibial break. I have been worried about why I’m so sore and swollen but I feel that all is as it should be and my recovery process is doing just fine after reading your personal experience. I appreciate you taking the time to write this


      Hello Nicholas, my tib/fib break was on Feb 11, 2018, so we are probably at similar stages in our recovery. My stitches came out last week, and I am using crutches most of the time. In the last few days I’ve started to be able to take a few limping steps without pain, but my leg starts aching afterwards. I’ve just started water walking at a nearby pool, which is amazing. I’m thinking I will be ready to go back to my desk job week after next. Let me know how you’re doing.

  • Michelle

    I’ve just come across this article.
    Thank you, I can relate to all of you words. I’ve only been out of hospital for a week and feel a bit lost with it all. After reading this I’m feeling very positive. Thank you again

    Michelle x

  • Charlie

    Glad I found this article as well. I had a rod and screws put in about 15 years ago (from a failed skydiving attempt), and just recently had it taking out. I have my 2 week checkup on Thursday. Based on what I’m reading, it’s hard to say whether my recovery is on schedule, since everybody’s injury or issues vary. Right now, I have some fluid build-up above my knee, walking with a limp, and plan on doing some light physical therapy soon. I can go upstairs alright, but going down, is still an issue. I seem to get a cramp in my affected leg, when going down. Not sure if this is just from lack of use for the past 2 weeks or something else is going on. I starting to wean myself off the pain pills and switching to taking Advil. I think I’m building up a tolerance to the pain pills anyways, as they seem to be less effective compared to using them at first. At this point my biggest concern is some fairly acute pain (away from the knee screws) up towards the back of my leg, around my inner thigh. Not sure why, but this area is pretty sensitive to the touch, and obviously, there were no screws in that area…I’ll follow up with another email once I’ve had my 2 week check-up. Thanks for everybody’s input on this thread. It helps to read what everybody is going through and kind of gives some peace of mind, on how your own prognosis is doing.

  • Holly

    Hi! So glad I found this site! Thanks for sharing your journey Jake – and everyone else.

    I slipped on ice and fell on Mar 24. Thought I had sprained my ankle until I tried to move my leg and it made a nauseating crunching feeling. After an ambulance ride, drugs and X-rays they told me I needed surgery. I had a comminuted dislocated fracture of the tibia and I’m still not certain how badly the fibula was broken.

    I ended up with an IM nail in my tibia and a plate and several screws on my fibula. Had a split plaster cast for the first three weeks and now an air cast. Next appt is on May 18 and at that time they’ll decide if I can slowly start putting weight on it and start physio, or if I have to wait longer.

    Reading through all of this it seems like I have to wait a really looooong time comparatively before I can start what I call the “getting on with it stage” of weight bearing and physio. On May 18 it will have been 8 weeks and when I asked at the last appt how likely it would be that I can bear weight at 8 weeks he basically said not to hold my breath.

    My biggest concern is that at 5 weeks I can barely move my foot (about 2” range of motion up and down), I can’t “scrunch” my toes at all, especially my big toe, and my knee still really really hurts. It’s been like that since I left the hospital with very little change. And I still have significant swelling.

    Anyone else have anything similar? I’m feeling discouraged 😦

    • Sahil

      You have to relax Holly, your procedure is slightly different compared to mine and jake’s, I have a simpler injury and am at my 7th week mark, I broke my tibia on the 15th of March 2018, I have to say at the 5 week mark I felt very discouraged like you do rite now, but I am 2 weeks ahead of you in recovery and I can assure you things are going to only get better from here, the worst has passed. The range of motion in your foot is probably because your injury is lower down at the ankle, as far as the knee pain in concerned, rest assured, my knee pain is almost gone at 7 weeks, agar week 5 my knee was killing. Hope this helps, have a speedy recovery 👍

      • Holly

        Thanks so much for replying Sahil! You really gave me hope, which I really needed. And I had to laugh – my husband said those exact same words. I am trying to be patient but it’s hard as you know. It just seems like gett8ng back to semi-normal is so very far away. I hope your recovery goes very well and keep me posted! Thanks again! 😁👍🏻

  • Sahil

    I must say jake, your story was the only guiding light I had these past weeks, I’ve been counting weeks ever since I had my motorcycle accident. I broke my right tibia right at the centre on the 15th of March this year, now as you can see I am completing my 7th week today. I have started driving (car) again, which is helpful. I stopped using two crutches a week ago, I would really like to know when the strength in my knee is going to come back, you know so as to be able to climb stair without the one crutch I am using, or may be just do squats and lunges. As my job requires me to be able to do these things. How many more weeks would you say it would take me to be able to really be like that?

  • Lily

    This article has been so helpful for me, I’m 18 and 5 weeks ago broke my tib and fib trampolining, with a rod put in my tib. Just wondering if anyone else has a very stiff and painful knee? I gather it’s because of my knee scar tissue and lack of mobility, it’s just very annoying not being able to get my knee fully bent. My physio said I shouldn’t worry at all, but I’m worried as it feels very tight and bumpy. I also only had a cast on for 12 days but because it was tight I have nerve damage on my foot so it feels really numb and fuzzy, don’t know if anyone else experience this? Have looked everywhere on google to see if this is normal and have found nothing!!

    • Holly

      Hi Lily. I’m 47 and broke my tib and fib Mar 24 when I slipped on the ice. I have a nail in my tib as well as a plate on my ankle. My knee is very stiff still, though I’ve started physio and it’s getting better little bit by little bit. Others have said it takes a good while, but the knee will get better. My foot is also a bit messed up. It feels numb on the top and especially at my big toe and second toe. My big toe doesn’t move very well but it is moving now after a few physio sessions. The whole process is just very very slow. I have at least 4 more weeks to go until I see the surgeon again and he hopefully tells me I can fully weight bear again. Hang in there. It’s normal.

  • Sue smith

    Hi Jake -I cannot tell you how you post has
    Helped me – I’m 60 – a badminton player – and dog walker – had the nail in my leg and trying to recover with not much help and understanding – feel guilty for moaning about the pain – and I’m a tough old bird – but everything you have said in your post absolute
    Hits a nerve – and is so comforting that what I’m
    Feeling is normal ? I don’t want to be injured
    But it’s happened and I have to get on with it
    But I don’t think that anyone understands how it feels – I feel so humble to all the guys and girls in the armed forces who loose legs etc and just seem to cope !? That’s an amazing strength -I thought I was but this has tested that – I had my accident 6 weeks ago and they are not happy with the alignment- so no movement for another 6 weeks – I will never take walking or playing badminton ever for granted again -I would love yo sleek to you as I noticed it was a while ago when it happened
    To you and wonder how you are ? – sue – Sunderland x

    • Sue smith

      I’ve always been the strong person in my family – only 5’2” and feel very vulnerable at the moment x

      • kar8al

        I balled like a 5 year old when I finally unwrapped my leg after surgery and saw the scar and had swollen it was. It’s a very humbling experience. I’ve had my rod out for about 2 years and man it’s aweosme. I had it in for like 5-6 years. Got the screw out. 2 years later, got the rod out. I’m now training for a triathlon and I bike swim and run and no longer need anything for the pain. Eat healthy. Do the physical therapy and don’t rush nothing. It does get better.

  • Dani

    Hello. I broke my tib/fib on 30th may and had an IM nail fitted the next day. I have been told to fully weight bear with crutches but the pressure In my leg is unbearable so am really finding it hard to use my leg at l. I’m getting more bruises everyday, a new one surfaced yesterday. I have a month old baby and a 3 year old son so this injury has really come at the worst time. How long does it take for the pressure/swelling to go so I can actually put my foot on the floor. I would like to be able to pick up my baby sometime soon!

    • Lily

      Hi Dani, I had the same problem The main thing to focus on is elevation- prop your leg up above heart height and it will go down in no time. Also use icepacks too on the affected areas. I’m now 6 weeks in but when i elevated my leg the swelling went down within 1-2 weeks very quickly! I was shocked at how quickly the swelling reduced as the point of my break and ankle looked like a balloon at first!! Also if it hurts when you get up, sit on the edge of the bed for the few minutes as with me the blood rushed so quickly and made it hurt, therefore I let it calm down before I walked on it. Hope it gets better, Lily 🙂

    • Holly

      Hi Dani. Hang in there! What Lily said is spot on – elevate as much as possible and keep trying to wiggle that foot and ankle. I hate to tell you but my foot is still swollen 12 weeks in, but not nearly as bad as it was. I am still not fully weight bearing, but I have been putting partial weight on it and yes, it does hurt. A little hurt is probably ok, but a lot? I would go slowly as you know what your body is capable of. It will get better. It just takes way more time than you want it to.

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