Me and My IM Nail Part 5 – 6mths since the Op


<< Me and My IM Nail Part 4 (5mths on)

Me and My IM Nail Part 6 (1 year on) >>

In January 2010 I broke my left tibia and fibula and had an operation to have an Intramedullary Nail (IM Nail) inserted. The doctor at the time told me, I thought rather vaguely at the time, it would be “6 months before you could do the things you want to do”.

It’s now been 6 months since the operation and I can confirm the doctor was right. I can do the things I want to do, but the leg does not feel like it is completely normal and back to full strength and capability. This is not the end of recovery; there is still some progress to be made.

The leg is really starting to feel like a normal leg. I have finally lost my limp and this was confirmed by my physio and friends are very impressed with how easily I’m walking about.

Me with a couple of friends as I am stretchered away from Clapham Junction where I had the accident

I started jogging 2 weeks ago. Not on the treadmill, but proper jogging in my local park, Clapham Common. I just did 10mins and it was at a very slow pace. When I finished I felt so elated to have been able to do this and my leg felt fine as I walked home.

My physio recommended, after hearing of my initial 10mins run, to do 3 runs of 10mins every other day (to give the leg time to rest) to see if the leg was able to cope without any problems and then to slowly build it up from there.

I didn’t quite follow her instructions and have increased each run by 2.5mins and yesterday did a 20mins jog. I’m a lot slower than I used to be, at the moment, and it takes me 11mins to reach a marker I used to do in 10mins. I’m really quite unfit as have not been to the gym in ages, but in a way this is good as if I was fitter I would be tempted to run for longer and maybe push the leg too hard too soon.

My visit to the physio last week ended up being my last visit, touch wood, as she gave me the all clear. I still have physio exercises to do:

  • 3 sets of standing on tip toes 15 times on my bad leg and once this is quite easy, to start hopping
  • One-legged (on bad leg) lunges or rather lowering my body through bending my left knee
  • Using the wobble cushion (see below)

My physio recommended buying a wobble cushion as she said the receptors in your ankle basically go to sleep when they aren’t being used for some time and standing on a wobble cushion helps wake them up and will prevent you from falling over when on uneven ground. This type of rehabilitation is sometimes referred to as proprioception or proprioceptive re-education.

Firstly, you stand with both feet on the cushion and try to maintain your balance. Hopefully you will find this quite easy. To make it harder, try closing your eyes whilst doing it. It’s amazing how much you rely on your eyes for balance. With your eyes closed it just the receptors in your ankle giving information to your brain about how to stay balanced. Then try it with one leg (the bad one) on the cushion and then with your eyes closed.

I still have my scars and bruise from the accident and kneeling on my left leg is not really an easy thing or comfortable thing to do. A friend of mine who went through the same thing just over 18mths ago thought perhaps he would not be able to kneel properly ever again and then gradually he was able to.

Walking down stairs is easy but I am still very aware of my leg’s limitations and it doesn’t feel quite natural.

As it is 6mths since the operation I thought it might be useful to reflect on the recovery period so far.

I feel I worked really hard and put a lot of effort in the first 3-4 months, but after that either my will or energy seemed to diminish. Once I was basically able to move about (although with a limp), work and socialise I stopped trying so hard. It wasn’t a conscious decision, it just sort of happened that way.

I think I was really trying hard to beat the 6mths recovery time and when I realised I wasn’t able to, particularly when the physio told me I shouldn’t start running yet, I lost some of my motivation. But this could be a good thing in a way as I know others who have pushed themselves too hard and that has ultimately led to a delay in their recovery.

However, I am pleased to report to anyone else who is or about to go through the same thing that after 6 months I really do feel quite good and, as the doctor told me, I can do all the things I want to do.

In January, now (as in July) seemed so far away and I didn’t want to think about all I had to go through to get there. Although the pain largely goes away, it is still sore and you are reminded of your leg problem pretty much the whole time, in every step you take, when you lie down, having a shower, etc. That is not the case anymore, thankfully. Yes, I am still quite often physically and psychologically aware of my leg’s limitations, but this seems to lessen by the day.

My advice to those recovering still remains the same, you should be very short sighted and set yourself small goals to achieve, try not to look a long way into the future.

Me and My IM Nail Part 6 (1 year on) >>



25 responses to “Me and My IM Nail Part 5 – 6mths since the Op

  • Eleri

    Hi,

    I stumbled across your blog last night when I was, once again, looking up stuff about IM nails after breaking my tiba. Whilst reading I found myself giggling and agreeing, ‘yes, that’s exactly how I felt’ or ‘yup, the same thing happened to me!’

    I managed to break my leg by walking down a hill, nothing exciting, just slipped on some loose stones, ankle went, heard a god-awful sound and realised something had gone very wrong! The joy of it all was that I was up in Edinburgh and was supposed to be travelling back to London the following morning….obviously that plan changed rapidly and I spent 4 days in hospital before having to endure the most horrendous train journey back – I can totally sympathise with you not wanting to travel back to your parents when home was much closer! I too was desperate to get out of the ward they’d put me in with 3 little old ladies and turned into a completely petulant 8-year old who just kept telling anyone who came near me that ‘I wanna go home!!!!’ Luckily the physios were quite happy with my performance on the crutches and my assurances that if I got stuck on the stairs I’d shuffle up and down on my bum!

    Then I had the joy of trying to transfer my care from Edinburgh, who’d given me all my notes, a disc of my xrays and a variety of painkillers in a goody bag to my GP in Croydon who didn’t quite know what he was supposed to do with me! After chasing up my referral, I finally got to fracture clinic 3 1/2 weeks after my op. I started physio yesterday and was also given exercises and one of the sex aids – lucky me, I got the green one!

    I’m now 4 weeks post-op and it’s great to read about someone else’s experiences and know that the aches and pains, the frustration at not being able to carry a cuppa from one room to another and the times it swells up when you stand for more than 30 seconds are all normal and that all these things are going to get easier!

    Small goals are definitely the way to go – I was absurdly excited when I managed to get a shoe on my right foot for the first time! But, do you think I’m overdoing it by being determined that I won’t need my crutches to at least walk down the aisle when I have to be a bridesmaid in 2 1/2 weeks?!?!?

  • jakemcmillan

    Thanks for sharing your experiences, you sound like you are dealing with the situation very well indeed!

    Walking without crutches in 2 1/2 weeks might be rather optimistic, but who knows how your recovery might go? However, I would say a bridesmaid with crutches will get far more sympathy and respect than a bridesmaid who hobbles down the aisle 🙂

  • Peter Gaughran

    Hey!

    Delighted to have found your site when I slipped on ice and snapped my tib and fib in January of this year – really helped me through some dark times! The IM nail seems to still be a relatively new procedure here in Ireland?

    I’m at the 100% weight bearing stage now, have been for about a week, but my ankle is *killing* me. My hobble has got worse as a result! In fact, my physio even made a pun on me being lame 🙂

    Anyhow, just wondering if you had a similar experience? My walking was better for the first day or two, and now it’s so, so sore. I took some Anadin extra in work to alleviate the pain and it worked wonderfully, only to discover it’s a NSAID so I can’t take any more.

    I know I’ll get there, but would love to hear your experience pain wise with the early walking?

    Cheers!
    Peter.

    • jakemcmillan

      Hi Peter!
      Thanks for getting in touch. When I began walking/hobbling with 100% weight bearing my ankle did swell and it was definitely sore, but I didn’t experience the level pain you seem to be having.

      Hope the pain dies down very quickly and best of luck with the rest of your recovery!

      Jake

  • Peter Gaughran

    Cheers Jake!

    Just to hear from someone in the same boat is fantastic – a huge encouragement. I’m thinking of putting together something about my experiences, as barring your (excellent!) blog there’s nothing else, really? The more the merrier I reckon!

    Anyhow, thanks again, and all the best!

    Peter.

  • Lisa

    Thank you for doing this blog, I broke my tib/fib this time last week! Fell off a horse, so one week in I was looking for support and answers, I am still in the fragile stage and finding it all hard as I have a 14 month old daughter I want to recover quick!

    Thank you again for an honest account x

  • Lisa

    Hello,

    Just thought i’d give everyone a quick update, I’m 9 months post breaking my leg and having IM nail, last x ray in mid November showed 40% heal so still classed as non union! Was due to have exchange nailing beginning of December but I decided (after 2 consultants and family chats) that I will wait another year. I can live with the pain, but not missing out on doing things with my now 22 month old daughter.

    So i Spin, body pump and Yoga weekly as they told me weight baring is the best thing for promoting growth, and that the better your general health is good for healing. I take a bone supplement and last night went to a Kasabian gig jumping around. Yes its painful but I remain positive.

    Best of luck all,

    Li

  • Dave

    Just thought I’d chime in here as well. Thank you for posting this blog. I followed my doctor’s instructions, ate as properly as I could (taking a few vitamin/mineral supplements as well), and thought I’d be able to beat the standard recovery time. This was not the case. While I did improve faster than my doctor anticipated (and I started working on standing on my tiptoes/working on my balance as soon as I could thanks to this blog), I don’t think I’ll be more than 80-90% recovered for a while longer (I’m at almost 7 months and improvements seem to come weekly/monthly nowadays). Thanks again for providing your story–it really helped prepare me.

  • Robyn Clark

    I was so thrilled to find this blog and know that I wasn’t just a whining softie. My story actually began thirty years ago one week before a turned 30. My son and I were on a horse that reared completely backwards falling on top of me (luckily my son was thrown to the side.) I had some memory loss, a fracture in my tiibia the size of the stirriup and was in the hospital for 2 weeks. Since this was 30 years ago I did not get a rod. Just a plaster cast from the tips of my toes to the top of my thigh for 9 months. My children were young at the time and I had to hire someone to come in and tak e care of them and drive them to school. Fast forward to 59 years of age. I was supposed to go in for a knee replacement but 2 days before the surgery I went to the pre op appt. and the doctor informed me that my leg was to crooked to do the knee without breaking the tibia and fibula and inserting the rod first. He assured me this would not be as difficult as the first time around. Wrong. I am four months in. My pain is still quite significant , have had to continuously increase the pain medication, walking (or hobbling) with a cane and no end sight. . When I had the cast the first time I didn’t have nearly this much pain. The first two months I spent aclamating to the pain pills. Could hardly hold my head up. Went into severe depresseion and got on prozac which did help. I didn’t drive for three months. I so wish I could be more optimistic for those of you out there but so far it has just sucked. I will keep you posted so maybe some of my normal non addicted cheery self can come out. A good deal of the pain is coming from the screw at the ankle. I still have a hard big lump where the bone graph was. Every one I know keeps telling me I should be doing so much better by now which is why I went on this internet search. The doctor did say six months but I expected to be walking freely at this point. Doc wants to wait a year before doing the knee and taking the rod out at that time but I told him it will be longer than a year. I’m not struggling through the holidays this year.

    Robyn

    • jakemcmillan

      Hi Robyn, thanks for sharing your experiences! Sorry to hear you are having so much pain, it does sound like you are getting more it than is normal. Are you doing many physio exercises at the moment?

  • Helen

    Its great to share with people in the same situation. Had a nail fitted last week . When can I ease off the painkillers?

    • jakemcmillan

      You can ease off as soon as you feel you are able to. After two weeks the worst of the pain should be over.

    • robyn1952@sbcglobal.net

      Hey Jake:

      It has been nine and 1/2 months since my surgery. Just started being able to walk without a cane and the doc says I am 50% healed. Didn’t start healing until 6 months. My life and routine are pretty much like I have a broken leg. I can’t be on it very long. Have severe limp and take 8 pain pills in 24 hr. period which make me so drowsy it is difficult to get alot accomplished. I figure it is going to be a 2 year process. I quit smoking when I had the surgery so due to that and inactivity and inproper eating I have gained 40 pounds. That 40 pounds is reeking havoc on my bad knee which was the whole reason I had to have the leg broken in the first place. I am not a happy camper but do count my blessings daily. Two months ago, I watched my 37 year old son have a massive heart attack. Luckily I got him to the hospital on time and within 20 min. he had emergency open heart surgery with two bypasses. He is doing okay now but not as well as I would like for him to be doing as far as exercise and eating right. I am having the screws taken out of my leg the end of Oct. It hasn’t healed enough to have the rod taken out but the screws really bother me so hopefully that will give some relief.

      I’m glad you are doing well. Keep it up!

      Robyn

      • jakemcmillan

        Hi Robyn, thanks for posting! Really sorry to hear about your recovery has not gone as well as you would like and really sorry to hear about your son, but glad he is doing okay now. Are you doing much physio exercise?

      • robyn1952@sbcglobal.net

        Actually none. Just living my life the best I can. The doc said he didn’t think it would do any good. The only thing we can figure out is that healing is slow because of my auto immune diseases. Do you thank therapy would help?

      • jakemcmillan

        Physio will definitely be able to help reduce the limp as well as cut down soreness and reduce the pressure on your knees, etc.

  • Mary B

    Oh ..thank you thank you thank you the 1st few months of my accident all I did was cry and pray I would be able to walk again its now 5 months and I see the light at the end of the tunnel thanks to ur experience wish I had found you sooner.. For anyone going thru this is does get better. My leg feels almost normal. Going back to work soon ( I am a bartender) my Dr. Said I will be fine. M.B.

  • F Watson

    Hello, I thought I would share my experience of a tibial nail so far. I am a 23 year old female. I broke my tibia and fibula after a pretty bad slip and collision playing touch rugby.
    I chose to have the tibial nail as it was proposed to me as having a much faster recovery time than a cast. I could never sit down for long prior to the accident and the thought of spending summer in a cast did not suit. I was also starting my first job in 3 months time.
    I am pleased to say that I was walking without aid by the end of month 3 and normally at 4 months without a limp and at my normal pace. I was so happy with the outcome that I am back in the gym using the bike and crosstrainer. However, I still take it easy increasing my time or resistance each session.
    I think that the main contributor to my speedy recovery was determination to go back to work and combatting my fear of weight bearing early on.
    I hope to return to my usual sporty self in a few months time.
    I do have one question for everyone. Has anyone attempted skiing again with a tibial nail? I was planning a ski trip 9 months post surgery but is this too ambitious?
    Best wishes! F.

  • Denise

    Hi there I’ve been following this blog for the past 6-mths. I’m 55 yrs old and broke my Tibia in two places (segmental fracture)and my malleolus
    ( ankle) and also my fibula in an innocuous fall from my horse. My left foot caught in the stirrup and sadly my horse caught my tibia with his hind hoof. I was lucky in so far as the bones didn’t come through the skin although I did have blisters. I had an I.M nail and varied screws in my left tibia.

    It’s been quite a journey thus far, and will be 6-months next week. I’ve been pretty relentless in my recovery regime, swimming, cycling and still caring for my horse. However as suggested in your blog I think I’m pretty fed up trying so hard, clearly the healing process will take as long as it will. In fact my physio said as much, saying I have to give myself a break and cut self a little slack. Sadly I have to admit also whilst my brain is 35 my body is 20yrs older than that! And we don’t heal as quickly as some who have posted.

    I’m still restricted in so far as going to shopping centres as I tend now to get a lot of calf pain where my calf goes into cramp whilst walking. Which is pretty awful and of course frustrating. My limp varies, it’s still there worse sometimes than others depending on pain that day, varying on how much I’ve done that day. When I sit I can forget I’ve a problem till I stand up and then I’m very stiff, I tend to stand up sooner than I need to giving myself a few minutes to stretch out and straighten. I often equate myself to a wind up toy in so far as it takes me while to get going.

    I did say to my consultant about the pain still, he said….”perhaps the definition of a badly broken leg should be, lots and lots of soft tissue damage, and a few breaks in the leg” I think what he means really is that soft tissue will take a long time to recover. I do know all this really but it’s hard when your living with the weeks and months of recovery. Additionally being a retired nurse matron I should know better!

    I guess what I’m saying is when the medical profession tell you when you do have such severe breaks following an accident that you will be looking at at least 6-mths, what this means is that it will be this time frame before you can start to feel you can at least start doing more normal things without thinking beforehand.

    I’ve remained positive and as said previously set myself goals which I’ve achieved. I’m now able to ride my horse again ( have for about 6-wks) in a safe area but it’s still an achievement and I’m pleased for that. I say to people ” I can ride better than I can walk”. I think we all have to remember these are nasty injuries and in some ways we are the lucky ones..

    Thank you all for your experiences it’s certainly been useful for me even with knowledge.

    Denise

  • Nadine

    Finally I don’t feel so lost anymore. Thank you all for the posts. I broke my tib and fib two weeks and three days ago (IM nail op a day after break). My motorcycle fell onto my leg, snapped it clean through (lucky no open wound). I was not going fast nor riding recklessly. Was just bad luck.

    Anyway, got a nail in as doc said out of the three options this is the best. I live in Namibia and it gets really hot here so a cast would have been terrible. Also, I reckon as the leg and joints are free one can immediately begin with the recovery of the muscle, joins, tendons… I stopped taking painkillers after the first week. I don’t find it very painful in general…

    At the moment the leg is still pretty stiff and as soon as it is not elevated it turns slightly darker due to the bad circulation. But its only been two weeks. The main thing I keep telling myself is to be patient and to do the exercises the physio gives me.
    The main stiffness is in the ankle but its getting better and the area on the knee where they had to cut. The actual fracture area is ok. The thigh muscles of my broken leg has disappeared which is a sad sight.
    So, mainly its frustration, as Eleri pointed out, not even being able to carry your own cup, asking your loved ones to do this and that for you. I am lucky that I have them though.

    I am planning on going on a diving tip in three months. I thought since water is supportive it should be alright. Just have to get someone to carry my gear 🙂

    regards from sunny Namibia
    Nadine

  • Dave

    I am very happy to have found your blog. I am one week away from the 6 month mark from a tib/fib fracture nearly identical to yours. I also had surgery to have an IM nail inserted into my left tibia. I found your blog within a few weeks of my recovery and immediately figured I would easily beat your recovery timeline. For me, so much progress was made early on that it seemed inevitable I would be back to normal by Christmas 2014 (I broke my leg on October 12, 2014.). How foolish I was! After that initial progress, improvements with my leg plateaued quickly.

    At the almost-six-month mark, I can unequivocally say my overall recovery has almost exactly mirrored yours. I, too, was an avid runner before my accident. Today was my first completely uninterrupted run since the day I broke my leg. I made it 2.25 miles! This is nothing compared to ‘pre-break’, but I can definitely tell I’m nearly back to the old me.

    Thank you for your blog!
    Dave
    Minnesota, USA

  • Sujithira Padmanaban

    Hi… I broke my tibia and fibula nearly seven months ago…on Oct 26 2016…as I met with an accident.. it was a worse case where the bone pierced the skin coming out… So initially they had an external fixator…and worked on the skin doing plastic surgery..
    After three months they said that the bone growth was fine and removed the external fixator putting on a cast for six weeks to support the bone growth to complete stage…. But after six weeks when I went for the review….,my bad luck worked out there very well….. The bone displaced after the external fixator was removed and so the six weeks in cast became totally waste….
    The doctor said I would need an im rod put into my bone to make my healing better….
    Your blog was very helpful during the time I suffered…. It is now three months after I had gone through the surgery.. I started walking two months ago with crutches… Initially it was very wierd when I started walking.. but now it is good… One week before I was walking a little good even without the crutches… I was doing that for three days and felt much better to walk independently… The next day the fracture site began to pain so horribly….. So that I couldn’t even walk for the next two days…
    Is this usual when we start bearing full weight..? Or does it seem to have any problem…?

  • Denise Baldwin

    Hi my name is Denise I broke my Tibia and Fibula in 4places over two years ago. Ive been back riding nearly two years and soart from finding kneeling quite difficult or squating Im pretty good 😃. You must remember to everyone is different. An open fracture is a huge adfitional complication so time frames as you have found are hugely variant. However Im guessing you have checked this out with your orthopeadic consultant ? You certainly have been unlucky and going through this certainly means your time span aware! I know for me if or when I did too much my body certainly let me know it. Personally I would check out before surging forward Good luck

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