Me and My IM Nail (Part 7) – 2 Years On

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Wow! It is hard to believe it has been two whole years since I broke my tibia and fibula at Clapham Junction Station and had an operation to put an intramedullary nail (IM Nail) into my left leg in January 2010. Getting to this point now seemed like a lifetime away shortly after the accident as I only let myself concentrate on short term goals. I took things a month at a time and 6mths seemed too far away to think about, let alone two years. However, here I am and happy to report things are good!

Before getting to specifics, I would like to say a massive thanks to everyone who has contributed to this blog, not just for some of the nice things said, but especially to those who have shared their own experiences.  I started writing about my own experience as there wasn’t (and still isn’t) very much on the interweb about IM Nail recovery and what to expect. It has been very helpful and reassuring to me and to everyone else that others are going through similar problems, worries and issues. Please do keep adding and updating your own experiences as well as any handy tips as lots of people have got in touch to say how useful it is to read them all.

Right, a few people have asked me some questions of how the leg is 2 years on, so I will answer those:

Does the leg feel like a normal leg now?
Almost, but not quite. If you have broken your leg to such an extent that you need an IM Nail inserted, then your leg is never going to be quite the same again. You have to accept that having a large bit of metal in it means that it is not a normal leg any more. Two years on and it feels normal most of the time, but not all the time. For the first 6mths and year of recovery you will be very aware when walking that one of your leg feels noticeably different. However, as time goes by, it starts to feel less and less different to the extent that you don’t think about it much, but you are still aware of it. Don’t be disheartened into thinking you can’t do the things you did before, as you can, you will just be much more aware and careful with your leg. Doing the physio and exercising the leg can actually make it stronger than it was before the IM Nail.

Do you still get pain?
No, I wouldn’t describe it as pain, but I get niggles from time to time. For example, yesterday I had a few niggles just below the knee whilst in Central London. I’ve been ill with a fever and been stuck in bed so it was the first time I had walked anywhere in a few days. I had to sit in an uncomfortable chair for an hour or so and when I got up and had to start carrying/moving stuff around I noticed the niggle. No great pain, just small blasts of it feeling sore and a bit weird. It didn’t prevent me from walking around or doing what I was doing.

Have the scars gone?
Nope, they have faded a bit, but not a lot. As you can see below there is still an annoying brown/bruise type mark where the tibia broke. I had hoped that this would have gone away as it’s nowhere near as sexy as an operation scar. Oh, and apologies about the hairy legs!

Will you have the IM Nail taken out?
It’s definitely something I am considering doing, but because I don’t get lots of pain, just niggles, it is not a priority. I am going to organise a visit with the consultant to see what the options are and review the risks.

Have you had any other issues?
Two months ago (November), I had a problem with a shin splint type pain in my bad leg so had to rest it for a few weeks. Shin splints are caused by muscle imbalances in the legs and I think because I hadn’t been keeping up my exercising (I cancelled my gym membership a few months beforehand) this caused this issue.

Any words of advice or encouragement?
Yes, absolutely. Although the above has focussed on issues I have had, I feel my leg is really good right now and I am happy with it. Although doctors tell us that it takes 6mths to recover, it is actually longer than this. We will still get pain and soreness for much longer even though we can be very active on our leg. Be patient with any pain, it should subside eventually. If you are still getting a lot of pain after a year then definitely go back to discuss with your consultants. Even when the leg is feeling good a year after the operation, do keep up some of the physio. I still do the standing on tip toes on my bad leg from time to time (sets of 15).

Can I get in touch with someone who posted a comment as it seems they experienced what I am going through now?
Potentially yes, this has happened already. I will get in touch with the person and ask if they are happy for you to contact them.  Please send me an email:

Please share your experiences! It really is useful for others to hear about what you have gone through. Also, if you have any questions or worries, then maybe others have an answer.

Jake McMillan

<<< Me and My IM Nail (Part 6) – 1 Year after the accident

Me and My IM Nail (Part 8) – 3 Years after the accident >>>

120 responses to “Me and My IM Nail (Part 7) – 2 Years On

  • Lindsey Grimwood

    Hi Jake,
    It was good to read your two year anniversary post. It is my first anniversary, as I had my accident in January 2011.
    Like so many others, I have really found your blog very useful and I refer to it often, especially when I feel as if I’m not going ‘forward’ very quickly.
    I too have had what I assumed was a sort of shin splint type of pain, as my shin bone, further up from the break area, really was quite painful when I walked but after a few weeks it did go; and I get a few niggles in the ankle area now and then. I have decided to have the two locking screws at the top of the IM Nail removed, as I am experiencing some discomfort in that area. I have seen the consultant and he says it is an easy job; but I do have to have a full anaesthetic. He said he can’t say if removing them will stop the discomfort, but thinks it can’t do any harm. So I guess it’s fingers crossed! I was wondering if your screws bother you at all, and whether anyone else on this blog had had their screws removed and whether or not they felt better for it.
    I look forward to hearing how you get on when you see your consultant re possible removal of the Nail.
    Thanks again.

    • jakemcmillan

      Hi Lindsey,

      Thanks for your comments! When are you having your screws removed? I haven’t experienced, as far as I’m aware, particular discomfort from the screws.

      I will definitely feedback from my visit to the consultant (not been arranged yet). Please do let us know how you get on with your screws being removed.


  • alp

    i had exactly the same thing different story(motorcycle accident).Broken tibia&fibula, rod,nails etc. 1,5 years already.Definately want to have it removed soon.And i’m really wondering about the process… i’ve been following this post for about 15 months now.Great Share…Thank you!
    Greetings from istanbul

    • jakemcmillan

      Thanks! I’m going to put up a new post shortly directing people to the experiences some have shared on this blog about removal of their IM Nails. This is so little on IM recovery on the web and even less about IM Nail removal.

  • Darren

    Hi I broke mt tib an fib in october 2010 playing football. I started playing football again about 4 months ago an at first I felt ok but the last few weeks iv been getting pain in both legs an I think it may be shinsplints as you mentioned above, can you give me any advice? I really love my football but find myself unable to walk properly for days after playing because of the pain. Also did yoy consult your doctor with it? I have found your blog a great help during my time of injury, thanks in anticipation of your reply. Darren

    • jakemcmillan

      Hi Darren, thanks for getting in touch! Shin splint pains are very annoying and sometimes can take a few weeks to go away. They are generally caused by muscle imbalance between the legs and once you start getting them you will be more prone to get them again apparently (so someone non-medical told me).

      First thing to do is to ensure you warm up very well before doing any sort of running around. There is one stretch/exercise that is meant to particularly help with shin splints: Standing up, start the action to kneel on one leg but only go halfway, so that the top side of your toes are touching the ground. Your other leg will be bent slightly (use your arm to lean against something if you need to). With the leg that your are stretching, push the toes up (into the ground) and the ankle down slightly so that the muscles and tendon between your foot and shin are being stretched. You should feel that soreness that comes with doing a good stretch. Hold this for 30 seconds and then do it with the other leg. Repeat again if you feel you need to.

      If you still have problems, then it may be advisable to get into the gym and work on your leg muscles so that there isn’t one weaker than the other. I did go to my GP when I had bad shin splints at the end of 2010 but the doctor didn’t offer much help other to say rest the legs and be patient. I was given the advice of spending one day resting and then the next day walk a little bit, then rest the next day and so on until shin splints have gone away. I think a physio rather than a doctor will be the best help with this matter.

      Hope that is of some help?!

  • Stuart McStuart

    Thanks for this blog. It has been a great help in giving me piece of mind. I had a glorious motorcycle which left me with compound fractured tib/fractured fib and a snapped collar bone. It has been 61 days and I have been able to walk for the last couple of weeks with the use of a cane. It is a bit dicey as I have to use the cane with the busted collar bone arm. That being said, I took your advice and have been walking slowly, concentrating on good form.

    I have been stretching my calf so that I do not have to keep going down stairs granny-style. I do have a question for you. The treatment here in Australia (surgery) was good but there has been no physio to speak off. What sort of exercises did you do? Additionally, when did the swelling go down? My lower leg gets a bit blimpy after walking on it. Thanks again for all the information.

  • Ben

    Found this blog whilst searching for recovery information after breaking my tib/fib whilst playing football. I had an IM Nail inserted in my tibia last week. However mine was also an open fracture (bone pierced the skin) so I required a seperate complex skin graft operation to be done a couple of days later to lessen the risk of infection.

    I’ve found doing ankle exercises and regularly stretching my calf muscles has helped me improve my range of motion fairly quickly but if I don’t use my crutches I’m limping quite badly simply due to the pain and swelling when I put weight onto the ankle. Literally just about to purchase the wobble cushion and will have a look for those rubber bands….hopefully they’ll help me out a bit!

    Lots of very useful info on this blog – cheers for keeping us updated!

  • Claire Lee

    Hi Jake,
    I too want to add my thanks for your blog. I am writing this on my Tab from my hospital bed 2 weeks after IM Rod insertion to my left tibea. i was searching for “recovery after IM rod etc.” And yours was the only helpful info that came up. I am due to go home tomorrow, they olde crutches. Your blog was a bit of let down 4 me. I thought I’d be up and running and playing tennis again in 4 weeks! Well, thanks for the inconvenient truth.

    • jakemcmillan

      Hi Claire,

      Thanks for posting … hope you are coping okay outside of hospital? Sorry if the blog was a bit of a reality check. I’m surprised your Doctors didn’t go through the recovery time with you? Perhaps your situation is slightly different?


  • Claire Lee

    Hi, this is Claire again,
    I forgot to ask a question maybe u or 1 of ur readers might be able to answer. 2 weeks after my op i can still feel this clicking in the shin bone whenever i extend and retract my leg, while laying down, or when trying to place some wheight on the leg. I am worried that since it is clicking, this means parts of the bone are moving, and hence not joining / knitting together as they should be. Did anyone else xperince this clicking inthe shin bone? If so, how long did it take before it stopped? Can you feel when the bone starts joining and setting? Any replies would be greatly appreciated.

    • jakemcmillan

      Hi … I do vaguely remember a clicking sound I think, but as far as I am aware this was not a bone clicking, but more to do with joints clicking as they had been out of action for a while? Is it still going on?

      • Claire Lee

        Hi Jake, thanks for your swift replies.
        The doctor’s didn’t tell me much because I am in teaching English in Korea and they don’t speak English much at all…just very abrupt directives. But they did a good job. I think my situation is a fairly normal IM nailing, no damage to knee or ankle joints, fibea intact. The clicking is definitely coming from the broken area of the tibea, not from the joints. It is as if the broken parts of the tibea (surrounding the IM nail) are not meshing but slipping around still, and clicking softly whenever I move. Anybody had this? My guess is it will settle down when the bones reach “union” or joining (if found this concept in the literature…ha ha…). As of yet, things still feel pretty “loose and jelly-like” in that broken section. Did anybody have a similar sensation? Does it go away?
        Thanks Jake

  • Claire Lee

    Update on the clicking…the doctor has now told me the clicking is due to loose pieces of bone moving around at the breakage site. He said that all of it should settle down and be reintegrated into the new bone formation during the healing process, the final result and objective being that magical “union.” He said when we have union, all the clicking will stop. The most important thing he has been concerned about is “alignment.” Fortunately in my case, he says the alignment is “good” and that when it all heals, things should work pretty much as normal again.

    QUESTION FOR YOU JAKE…Would you say that you can walk, run, and do everything quite normally at this point, at present? Let us know please…I’m hoping for encouragement!

    • jakemcmillan

      Claire, great to hear that the clicking is not an issue and your alignment is good … I remember my doctor talking about alignment early on.

      In answer to your question … Yes, I can walk, run and do everything quite normally. I can still dance badly. However, my leg is not exactly normal as it was … it still gets a bit sore occasionally. If I sit cross-legged it can get a bit sore/stiff. I also don’t like kneeling for very long. Hope that gives encouragement that you can get back to doing all you could do before, but also is realistic that you will always have a few niggles and that the leg will not be ‘normal’ again.

      • Claire Lee

        Thanks for that hopeful note. As long as I can play tennis again…I’ll be happy. Please let us know if you decide to have the IM-nail taken out. Until then…take care and thanks for the great blog.

      • jakemcmillan

        Thanks Claire, much appreciated! I hope you are back playing tennis even better than you were before!

  • Linda Banks

    Hi Jake
    It’s now just over 2 years since I had my IM nail fitted (jan 2010) and I have left a blog on here when I had my surgery.
    Just wanted to give an update!
    I went to see the Ortho’s on Weds as I am having some discomfort where the screws are, especially the one near my ankle/top of my foot as it is quite close to the surface of my skin.
    They have agreed to take the screws out but leave the nail in as they said it might be more difficult to take the nail out but they wouldn’t know that until I was in surgery. I have agreed to this as I don’t seem to have much of a problem with the nail, it’s more where the screws are. Anyway, I have now been placed on the waiting list.
    Hope this helps anyone with the same problem
    Will keep you posted!


  • Bob

    Hi Jake, and all the other contributors

    First, many thanks to you all for the inspiration to put this site and your stories up – it really is a light in the dark!

    I had my IM nail in on January 8th this year (broke tib and fib on right leg – looked uncannily like your photos Jake – but reversed!)) but have only just discovered this site – wish I’d known about it earlier!! I’m now 20 weeks post-op and, like many others, searching for answers to questions that just don’t seem to be answered by the medics. Can anyone help me with the following?

    After any exercise involving weight-bearing on my healing
    leg alone (i.e. standing on one leg) I get a sensation of pain through the foot, ankle and lower leg (including at the tibia break site) as I take the weight back onto both legs – does anyone else experience this? I also cannot go up on tip-toe on just this leg either – lots of pain within the foot. Again, is this ‘normal’?!

    Worryingly, my latest X-ray shows the fibula has not healed at all but the Fracture Clinic doctor did not appear concerned by this – has anyone else found this to be a problem later in their recovery?

    And finally – the dreaded limp? The same doctor has hinted that this does not always disappear; I hope he is wrong! I’m not sure I want to ask this but for all those further down the line – has it gone?

    Thanks again for your help, and best wishes for a speedy recovery to you all.


    • linda banks

      Hi Bob

      I certainly got more pain in the foot and ankle during recovery and I too thought the limp would never go….but it did. It took me nearly 6 to 12 months but it will go. I am currently waiting to have the locking screws out but that’s because the one on my ankle is causing me alot of discomfort and if I don’t have them out, I will always be wondering if the discomfort would go or not. If it doesn’t, hey go, I tried


  • Daniel

    ‘Worryingly, my latest X-ray shows the fibula has not healed at all but the Fracture Clinic doctor did not appear concerned by this – has anyone else found this to be a problem later in their recovery’?

    Hi Bob my name is Dan I broke my Leg 21st Feb 2011. In regards to your comment above the fibula only bares 10% of your weight, Therefore it does not matter if this still has not healed. Eventually it will heal! I was worried like yourself and the doctors also tole me not to worry.

    I wanted to know since alot of people on here have broken there legs playing football like myself. If they had an IM nail placed into their leg if they have played football again have they felt their tibia throb all the way from the ankle to the knee for a few minutes after playing? This is something after playing football for the first time competitively on a 5 aside pitch 1 year and 4 months later!

    I look forward to hearing if anyone else has experienced this?

  • ian clark

    hey everyone,im nearly 4 weeks post IM nail op now,and was feeling a lot better until a couple of days ago,when i developed an awful (muscle) pain in my calf,very tight and sore to the touch,i cant even rest my leg flag on cushions without discomfort,my fracture area feels a lot better with very little pain and i had all but ceased my pain relief medication,is this a normal part of the recovery process or is it highlighting some other problem,the back of my leg is very yellow and bruised,which it wasnt initially,my first physio appointment is actually today,so ill see what the physio says.
    thanks for any replys guys.

    • jakemcmillan

      Hi Ian, sorry to hear about your calf pain? I don’t remember experiencing anything like that. Has it subsided?

      • ian clark

        Hi Jake and everyone else,18 months since that fateful evening,i still get a bit of pain,especially around my knee and shin area when i walk for too long or sit in one position for a while,kneeling down isn’t even an option,im meeting my consultant next week to discuss IM removal…hmmmm,im not too sure what to do to be honest,he thinks the nail is giving me the knee problems and may be better off being removed.All in all,im not too bad now,i can do most normal things without too much discomfort but im always very concious of slippy floors or uneven ground etc.I had the locking pins bar one removed in March as my leg was very uncomfortable and that helped a lot.I’ll check in again and let you all know if the IM nail is to be removed,and keep you informed of the procedure and progress,the removal of the pins was straight forward enough,an overnight stay,and a few stitches,,,simple really,i was up walking the following morning unaided,and it was quite a relief on my leg after the removal,so hopefully the same can be said of the IM removal…fingers crossed.

  • Robyn Ferguson

    Hi Jake and everyone else?

    It has been over two years since I broke my tibia in my right leg, I slipped on some ice on a manhole cover:( I spent 6 weeks in a cast with no improvement and then had the opertion to insert an IM nail into my right leg.

    Unfortunately during my operation there was some nerve damage (to both my legs) which they said was known as neuropraxia – I was told this was either due to the spinal tap I received or because of the position of my legs during the operation. This resulted in no feeling to either of my legs for the five days following my operation. Although my IM nail has not yet caused any problems and my broken leg feels normal most of the time, I still suffer with tingly sensations and numbness. Anyone else experiencing these symptoms from neuropraxia or otherwise?

    Thanks a load

  • Ruth

    Hi Jake and everyone else?

    I’m a newbee tibia IM having my break on 29th June 2012.

    As an internet surfer I thought it was time to search up on the subject and this is far the best i’ve found. Not only informative but funny with it (also strange that not too long ago I worked in Battersea and would get off a Clapham Junction).

    There is only a little I can actually relate to at the moment due to the age of my accident. But you have made me laugh and I can totally relate to some of your experiences. The overwhelming discomfort, that feels like your entire blood supply is rushing into your leg, when you go to get up is my challenge at the moment (hopefully a distance memory for you now). Everyday brings new challenges from cancelling holidays to getting a banister running the full length of the stairs installed. I can go up and down with the double crutch thing but when I have to use both crutches it’s right at the top of the stairs and I have to have someone a step below me blocking my view of the drop. Especially since I broke my leg on said stairs.

    Thanks Jake it’s also put a lot into perspective for my recovery time. My hospital wouldn’t say, but i think it’s because it varies so much due the patient (age, determination, patience etc). I really want to be ready for my trip to Marakech next April – i’ll let you know if i set off the alarms 🙂 Have you got any paperwork from the hospital to put in your passport to state you have metal work?

    Thanks again,


  • Sue Rogers

    Hi Jake & all the other IM Nailers (sounds like a band!)

    It’s almost a year since I brole my tibia and had the nail inserted. I’m back to normal now except for the kneeling thing – it really hurts if I kneel on my bad leg. Consequently I’ve stopped trying to kneel at all and I think I’m not as flexible in the legs as I was because of this.Has anyone else experienced this and if so does it get better? Also the area to the left of my knee is still ever so slightly swollen and numb. I do get the occasional niggle where the break was and I have the bruise still, but no limp at all and on the whole I’m really pleased with my recovery. The other thing I would like to know is – has anyone fallen over since their initial accident? Well I have twice now and cut my knees but nothing serious – it’s just so embarrassing! Before my accident I never fell at all, so just wondering if it’s related.

    Great blog by the way – have found it really informative.

    Sue (used to be called Hopalong, but not any more thankfully!)

    • jakemcmillan

      Hi Sue, thanks for posting! Jake and the IM Nailers … sounds like an excellent band name! We shall book ourselves in for the Glastonbury Festival next year. However, I can only play the maracas so hope the IM Nailers have more musical talent and can sing!

      Glad to hear on the whole your recovery has been good. I’ve had a similar experience kneeling on my bad knee. It doesn’t super hurt but it is immediately uncomfortable and so I avoid it. It is better now than it was, but I still avoid kneeling if I have to and will sit in a different position.

      I’ve not experienced an increase in falling over, in fact, I would say I am more cautious since the accident and have only actually fallen over once since I broke my leg (2 and half years ago). But I did feel good that I could fall over and get up and be fine … I guess I had the nervousness that everytime I fell I might break my leg as my break occurred during what seemed like a simple fall.

  • Tom Bell

    Hi all,
    Having read the blog, Im in awe that this wasnt available when i broke mine. I broke both legs in 2007, Left leg been the worst to come off. Ive got an IM to the Tib. Both fibs (L&R legs) Healed ok. However, My left IM was inserted and done within maybe 3-4 days, its a bit of a blur now. It was put in and a tiny air gap was present, This was my downfall for a very considerable time. I think 9 months was about the figure i want to say.

    Regular X-rays and visits to the Hospital showed no callus forming. Once it was realised that the bone wasnt going to grow, It was decided that the bottom two screws in the ankle would be removed and thus allowing the bottom half of the leg travis up the top half to meet & knit. However, This wasnt as planned, So within a short while, I was back in and having the original IM nail removed and a newer (Larger Diameter) installed, Its now knitted. Although this was in 09. Im still getting pain. Ive had all the screws out bar one in the bottom of the leg, This is because its bent.

    Even now when in very hot countries, I still feel pain/discomfort. I miss been able to run. Thats one of the things that affecting me the most, Given i quite enjoyed running. It was one of the main forms of fitness.

    Im now contemplating going private to seek removal of the rod, Maybe this could be the answer to my pain i feel.

    I hope that everyone makes a speedy recovery, Its certainly a life changing experience!


    • jakemcmillan

      Hi Tom, many thanks for posting! Sorry to hear you’ve not had the best experiences with your IM Nail operation(s). Are you not able to run any more due since the accident?

      I think IM Nail removal may be the answer, but it is definitely not guaranteed. The consultant I spoke to during my 6mth recovery phase said that only 50% of people who have their Nail removed get a reduction or elimination of chronic pain.

  • Elizabeth

    Hi all,
    I am a recent member of the IM Nail club. I wish I could tell a cool exciting story but unfortunately I was simply roller skating and lost my balance. I had my surgery on July 1rst. I am getting married on September 22nd so I was searching to find information on how soon the Doctors let you walk. I am currently in a boot with no weight bearing. I have been working on range of motion. I was very thankful to find this blog. To hear some of the things I’m going through is normal. Although the last 4 weeks have felt like a lifetime it seems to be healing nicely. I also fractured my fibula at the time of the fall. I have sharp pains at times that feels like it is in my fibula. Did anyone else experience this? I have also recently had the calf cramps. I believe those are just from the stretches. I am really curious to how soon they will let me walk on my leg? I have a follow up appointment on August 13th. I would really really like to be able to walk down the isle but am trying to find out if that is even a hope at this point. Doctors tend to focus on the now. Where I am focusing on that special day. I would like to say thank you to everyone who has posted their experiences it is nice to be able to read that others have been in the same place. Any info would be very much appreciated.

    • ian clark

      hi Elizabeth,its 10 weeks since my IM nail operation,i broke my tib/fib…and i found these blogs a great help as the doctors were very vague with the information that they give out…im now walking with one crutch when im out and about,and walking unaided when around the house,although its more of a lop sided hobble,i was told initially that i was to be non weight bearing for 16 weeks,and was given that big daft moon boot to wear,i wore it once and developed a clot,i was advised by my physio not to wear it anymore,so i never wore it again,i was putting a small bit of weight on my leg after about 3 or 4 weeks,and standing on it after 6 weeks,although not full weight..even now after 10 weeks im not putting full weight on it,but i think thats just a mental thing as my physio is encouraging me to aim for no crutches by the 10th august..what i do find is that my leg is still very weak due to the muscle wasting and i sometimes feel that it could easily give way under me,but it doesn’t,the whole experience has certainly been life changing so far,but hopefully only temporarily,best of luck with your recovery and your forthcoming nuptials… Ian 🙂

    • jakemcmillan

      Hi Elizabeth,

      Although you would not have chosen to be a member, welcome to the IM Nail club! Sorry to hear you having to organise a wedding whilst going through the recovery process. However, the first 4 weeks are the hardest and so it all should be improving from here on in.

      Everybody heals at different rates, and you obviously will need to take the advice of your consultant, but if your recovery is at a similar rate to mine (and there was nothing special or quick about mine) then you have a good chance of being able to walk down the aisle on the 22nd September. If I walked slowly then I was able to walk without a limp at that stage of the recovery period. However, be aware that your ankle and feet will have some swelling and walking long distances or standing up for long periods of time could be quite sore.

      If not started any formal physio yet, then make sure to keep your foot and ankle active by moving the foot from left to right and vice versa. Using you muscles to pull your toes towards you and then pushing them away from you.

      I didn’t have calf cramps as I recall but I do remember being worried by pains caused by my fibula break. However, the consultant I saw seemed very unworried about it. I think, from reading other comments and what the consultant said to me, this is quite common.

      Best of luck with the rest of your recovery and hope you are able to walk down the aisle!


  • Elizabeth

    Jake & Ian
    Thank you for the responses. I have been working on the motion of my foot. I do exercises each morning and night. Although, my calf muscle for my leg is almost non-existent. I have been itching to bear weight with the boot but am waiting till my next appointment.
    I am a nurse and a previous physical therapy aide. With my experience I tend to want to do things with my recovery faster than I should. After reading all the blogs I have thought more about the eventual removal of the nail. I have so many questions about the strength of the bone after removal. I really appreciate all the advice and tips. I have not actually seen any of my x-rays yet. The pictures on here help. I look forward to hearing more about others experiences.
    Thanks so much,

  • Carl

    Hi Jake/ all

    I have read some very interesting posts!

    I fractured my tibia and fibula Aug 2011 during a football match. At the time of my break I was more devastated in not getting a penalty, until I realised what I had done!!!

    I had an I.M nail inserted with screws etc into my right leg and was attending physio. Things had been goin well up until 6 months and then I started getting pain in my ankle region and my knee was regular swelling like a balloon.

    After regular reviews with my consultant they have agreed to remove the nail and screws as they were concerned the nail had moved up into my knee. My operation is on Aug 13 2012… Getting nervous but really wanting it done!!

    I will let you know how it goes!!

    • jakemcmillan

      Hi Carl, thanks for sharing your experiences … how did the nail removal go? Hope all is well!

      • rensy1

        Hi Jake

        The im nail and screws are no longer in my leg! The consultant stated it was a complicated procedure and in my case was more difficult to remove the nail/screws than the original insertion.

        The operation took 2:30hours, however I was told in most cases it will take approximately an hour. The complication with the removal was not the nail itself but the screws had imbedded in the upper part of the tibia. In order for the screws to be removed they had to make a window in the bone which took time and I was told was difficult.

        Post operation I was fine, apart from some swelling which is standard given the positions I was most probably put in!!!

        To reassure people I would go through the procedure again, Andat this stage I am not experiencing any concerning pain other than mild discomfort which is managed by paracetamol and ibprofen. Here’s the start to my rehab to get back playing sport!!!

        I will e-mail you some pics I took…



      • jakemcmillan

        Hi Carl! This is excellent news! I’m really glad to hear your removal went well (although there were some complications). Please do send across some pics 🙂

      • jakemcmillan

        I’ve not received anything yet? My email address is:

  • blake

    hi to all, i am a 17 year old boy who lives in South Africa and i broke my tib and had the whole nail and screws put in. i am having problems with my leg clicking everytime i walk on it and the clicking is coming from the break. it only started clicking the past 2 weeks and it has been just over 7 weeks since my accident. has anyone had anything like this before? thanks.

    • jakemcmillan

      Hi Blake … thanks for posting! I remember a little clicking, but nothing very noticeable or concerning. Is it hurting in the area it is clicking? When is your next check up/consultation?

  • Helen

    Hi all
    Jake- a huge thanks for this blog. There is so little information on the net about this injury, I feel so much better for being able to read other peoples’ posts & have much more of a realistic idea about recovery.

    I’m now 8 weeks post nail insertion following an accident whilst trying (unsuccessfully) to stop my daredevil 3 year old from riding her balance bike into a lake. We are very lucky – my girl wasn’t hurt at all but I ended up with a spiral fracture to my R tibia & a comminuted fibula, didn’t realize what I’d done until I’d fished her out of the water & looked down to see my foot swinging in the breeze! I had surgery on 19 September.

    I’m still only partially weight bearing, wearing an air cast boot, doing lots of water walking. My Dr doesn’t want me to start formal physio until I’m fully weight bearing (next appt is Dec 4) so I’m concentrating on range of motion exercises for ankle & knee & working on my gait whilst I’m in the pool. If anyone has any tips etc I’d be grateful to hear them.

    Thanks again everyone. It’s great to hear all your stories & all the best for you recoveries.


    • jakemcmillan

      Hi Helen

      Thanks for posting! Sounds like you are being very positive and doing all the right stuff. Before you start physio properly it is really good to keep doing the motion exercises for ankle, knee and also for the foot and toes. It will all help speed up the recovery process, however, you will still need to be patient during the physio stage. When you are weight-bearing and able to walk a bit, it is much better to walk slowly and properly rather than rush it as you can pick up bad habits and it could be hard to lose the limp.


  • Dale

    Hey Jake
    Wow got to say first off your blog was really informative! Although you seem to be doing better than me, I’m a little jealous. 😛

    I fractured my tibia and fibia, one break up top by the knee and one down below near the ankle, one of which was a spiral fracture, luckily I didn’t have one of my bones pop out of my skin which sounds nasty!

    This happened on the 14th October, I got my surgery the next day, but afterwards, I was doing fine for a few days, hopping on crutches and placing my foot on the floor straight away, but then a week later I was readmitted to the hospital with internal bleeding, that feeling you get when you put your leg vertically with the blood rushing, damn that hurts!

    It’s been almost 5 1/2 weeks now, I had x-rays yesterday, unfortunately my bones havn’t healed fast enough and my unnasissted walking date has been pushed back from 26th December to 14th January!

    Also I’ve noticed my right leg (the broken one) has started to shrink alot, apparently thats’ normal for the muscle to degrade a bit, I’m sure it’l grow back when I’m walking again.

    Anyways I’m rambling what I wanted to ask was about long term damage to the leg, since I’ve been doing gymnastics for years and it can be a bit of an impact on the legs (yeah I broke my leg doing gymnastics but it’s not gonna put me off!).

    Not only that but I work in a kitchen which involves rushing around and being on your feet for 10-12 hours at a time, will this still be possible for me as I was planning to return to work in January but it’s starting to feel unlikely now.

    Doctors have been very vague about what my limitations will be in a few years time, I know you said it’s good to concentrate on short term goals, but I’m 20, and if I have to consider quitting Gymnastics and mabye getting a career change then I’d like to start considering now.

    Thanks again for the info and hope to get a reply,

    • jakemcmillan

      Hi Dale, sorry for slow reply and thanks for posting! Sorry to hear you had some internal bleeding and your recovery has been delayed a little.

      If you recovery goes well then you should be able to do all the things you did before, but you may struggle to rush around a kitchen in January … that may have to wait a while, but you will just have to wait and see how you feel and how confident you are. Given that you are a gymnast, your doctor may advise you that it may be best to have the IM Nail removed if you are going to do gymnastics on a regular basis. Did they say anything about having it removed?

      • Dale

        Thanks for replying, yeah I’ve gotten myself another month off work so I’m aiming for february, still non weight bearing though.

        I’ve asked my consultant about IM Nail removal but they’v told me “We’l get to that when your leg recovers” but from what I’ve read people can get it removed a year after the accident, guess I’ve just got to chill for a year. 😀

      • jakemcmillan

        Yeah, that’s right, they won’t remove until at least 12mths after the operation. Chilling is not too bad 😉

  • Kieran

    Hey guys, very good blog. So I broke my fib and Tib 4/11/12 playing football, I was not a happy bunny at all. My bones did not break the skin and both are clean breaks. I have had the Im nail and few screws, I’ve got slightly curved shins which I gathered from the doc was a bit of a problem. My main problem at the moment is, I have these tingling, shouting, pins and needle pains in my foot. My foot and ankle are swollen which I presume is normal, but are the pains above normal? I have checked with the hospital about these pains they say to just keep it “elevated”. I’m only coming up to my 4th week and I’m loosing the plot 🙂 I just think its hard when you’ve spent the last 10 years been so active and working daily to just stop but by the sounds of thing the majority of you guys recovered pretty well on time or ahead of what I have in mind so finger crossed.

    And well do to jake for this blog!

  • Sarah Fisher

    Hi Jake,

    I just wanted to post a thank you for you writing your blog! I am now 6 months post accident and surgery – I was hit by a car whilst cycling, subsequently broke my tib & fib…

    I had blocked a lot of things out since my accident, and it is only this week that I have started to research the surgery I had! Part of my tib has still failed to knit and so am returning for X-rays every 6 weeks or so…

    Your blog has made me realise there is a light at the end of the tunnel! I have a very similar bruise at the site of the break, fairly disappointed to see yours still visible after 2 years!

    I hope you continue to improve, and thanks again 🙂

    • jakemcmillan

      Hi Sarah,

      Thank you so much for your kind comments, it really is appreciated!

      Sorry to hear that your tibia hasn’t healed yet as well as hoped, but hope this improves very soon. I’m sorry to report that after 3 years (and 1 day) I still have a visible bruise on my leg. I will be providing an update and photo very soon.

      Wishing you the very best of luck with the rest of your recovery!

  • Sarah

    Reading this in bed with leg up. Yup – me too. Clicking, swelling, bruising – but I have organised all my photos and am now receiving thanks for the Christmas cards I wrote whilst on morphine..hmmm… When I left hospital I was told to do nothing, inject myself in the stomach once a day with heparin and take anti-inflammatories – the crutches I got from a relative, and I’m going up stairs hopping sideways – one crutch on one step up and the other one, one step down. Moving around on my bottom a lot – can’t put any weight on right foot yet. Surgeon told me it was ‘normal’ to take the screws out ‘soon’ and the nail out after a year. A nurse did tell me that the nail can ‘misbehave’ when being taken out – but she didn’t expand. And no-one’s the slightest bit interested in my tibia either.

    Thanks for blog – just found it – til now I’d been reading medical articles and helpful tips about having more time to pray…

  • Sarah

    What about going back to work? I’m self-employed too. No work – no money. Problem is, as soon as I start again, I’ll have little time for exercising. Not sure what my priority should be – suspect it should be exercise. And what about driving? How long did you have to wait?

    • jakemcmillan

      Definitely make time for exercising, it will really help with the recovery process, otherwise it will take much longer and may make it harder for you to do your work.

      I’m not sure about driving as I don’t use a car in London. Anyone else want to let Sarah know when they were first able to start driving? I broke my left leg and I think I would have waited 6wks-2mths before feeling confident to use a clutch properly, but that is a pure guess.

      • Kieran

        I’ve just started driving 2months it’s been since my op. I’ve been aloud to put what ever weight I’m comfortable with throughy my leg. My leg feels good though, if you don’t have good movement around the knee and ankle I would not advise it.

      • Sarah

        Hmm – two months – that’s not bad. I thought it would be much longer. How quickly could you put weight on your leg?

      • Kieran

        At 6weeks he said I could start puttin a little bit of weight through it, and to see the physio. I went to the physio over Christmas and they seemed happy for me to put as much weight as comfortable through it.

      • Sarah

        And how comfortable is it when you put weight on it? Do you feel safe when you drive? I’ve got a van so it’s quite heavy. I can’t see how I can go from now – no weight on it at all – to driving in the next 2 weeks! Brilliant if I could.
        What kind of physio do you do? Can you go swimming? Sorry about all the questions.

      • Sarah

        Ok – 2 months tomorrow since op. I’ve driven, I’ve swum – and for the last month I’ve been going round the village on a mobility scooter. Only started driving 2 days ago – perfect. Looking back on things – progress is quicker than it feels, isn’t it?

      • jakemcmillan

        Well done! Sounds like progress is going well!

    • Sarah

      Starting walking without crutches – KILLS where the fracture is – suppose it’ll calm down. Dr says limping is entirely psychological – hmmm, not sure I agree. But bone hasn’t started healing yet – he assures me that this is normal – so why am I allowed to walk now and not a month ago if the bone is still broken?

  • Sarah

    Am thinking of buying a 2nd hand mobility scooter. Am I mad?

  • Caroline

    Hi Jake (and everyone),

    I’ve been checking in on your blog with interest since breaking my leg in April – it’s been a really useful point of reference for me.

    I broke my left tibia while playing roller derby and had the IM nail put in on May 1st, with two screws at the top and three crammed in at the bottom, as the break is fairly low. I was non-weightbearing and on auxiliary crutches for three weeks, then given elbow crutches and began to bear weight after that. Stopped using the crutches pretty much altogether after 8 weeks. By this point though my left leg was pretty withered and useless (a depressing sight – I had been proud of my sturdy thighs!)

    After that I was doing my exercises pretty religiously, going swimming and to a (free) weekly lower-limb class and making good progress. However, my mum suddenly became quite ill and had to have brain surgery, just after my dad had to have surgery himself – I ended up moving in with them to help out for a few weeks. At the same time I had had to take a job in a cafe (financially I was really struggling by that point, having been self employed at the time of my injury…2012 was rapidly becoming a very crappy year!). Unfortunately my exercising took a back seat for a while, with just the odd bit of table tennis, and a very gentle jog or two. I also got discharged from physio at this time as I couldn’t make an appointment.

    I had my last hospital appointment on 31st Oct. They were happy with how my bone has healed. But I had been having pain around my knee, which I told them about. It had started first when I had to do the exercise where you go up on your toes. I could barely manage one (and that was digging my nails into my partner’s arms) when I started but eventually did get to twenty without assistance – but by that point when I stopped and put my heel back down it felt like the interior muscles were going into painful spasm.

    This never really went away, but it did move round so it’s now at the front of the knee. The first doctor I saw suggested it might be a screw at the top of the bone that could be taken out, but he got a consultant through who said it couldn’t be that due to the positioning of it; he also mentioned there would be little chance of removing the nail itself as it’s too deeply buried. He also said “you should just expect some pain from now on”, but that I could basically do whatever I wanted to – including contact sports – and discharged me.

    I did go back to roller derby in November, and managed skating once a week with the rec (non-competitive) team. I was glad to find I could still skate – really thought I might have forgotten! Falling over is a big part of the sport, and I found that quite hard to cope with as I sustained my injury with what looked like just a normal fall….but once I got the first couple out of the way I was fine. Similarly with contact – it is a contact sport, but I was pretty terrified – but I managed to participate in contact drills, and took part in a scrimmage (practice game). I have quite a lot of fear, I guess because now I know what can happen. But I mean, I could have just as easily fallen down the stairs, or tripped over in the street. I just need to think positive!

    So Christmas and New Year and much sitting around eating then got in the way. Now I want to get back to competitive roller derby, and a general exercise regime. My concerns are:

    pain below the knee, at the front – occasional spasms, fairly regular niggly pain
    very loud crunching in the knee joint, particularly on stairs
    ankle is still very swollen, and tender to touch
    andle is also numb on the inside where the two incisions were made – and occasional movements cause tingling in the toes
    my left quad feels really weak and had a tendency to cramp easily
    I am still slightly limpy (some days more than others) – and have had problems with my right lower back and hip from being on crutches and then limping a lot

    Basically I’m just wondering if anyone has any advice/reassurance/pearls of wisdom for me?! I can cope with a bit of pain, and I know my leg will never be the same again – but I don’t want it to get worse, and I would like to try and be as fit and active as I can.

    Oh god this is the longest post in the world, sorry! If you’ve got this far – well, you’re probably on the sofa with a broken leg and have run out of dvds to watch 😉

    • db

      Hi Caroline, I broke my Tibia 4 months ago – IM nail with 2 screws in top of tibia & 2 screws above my ankle. I had 2 screws removed 6 weeks ago – 1 from the top & 1 from my ankle area. The pain I had from the btm screw was killing me, and that relieved the pain completely. However, I have alot of pain below my knee and my knee clicks now…So I’m goin to get my last 2 screws removed (hopefully next week)

      Hopefully that takes the pain away. I’ll update on hear when I get my last 2 screws out.

      All in all, I wish I never did have surgery, it was the definately a mistake. I think everyone should try to heal the traditional way first, then have surgery if it doesnt heal. The complications from surgery aren’t worth the risk.. Good Luck!

  • Susan

    Hi db, I wonder how long was your recovery from the IM nail screws removal? When did you get back to more strenuous exercise? I had my two distal locking screws removed last Thursday. Apparently went well (I was pretty out of it when doctor visited briefly). There is swelling and much bruising around the site they pulled the screws. I was up walking around, driving the day after. I am wondering if I should take things more slowly, is there a risk being active so early?

    In terms of my IM nail: I broke my R tib and fib April 2010. I am still protective of my leg (never have forgotten floppy break trauma). Did lots of swimming the first 12 mths. I resumed jogging last year; although my kids say I run like a zombie. I don’t kneel on R leg: too uncomfortable. I am very thankful to be living in a country where there is Medicare near an excellent teaching hospital.

  • Richard

    Thanks for these blogs, they make me feel a bit less worried about my recovery, I broke may tib & fib 3 weeks ago, skiing in Italy. I was it initially concerned about the lack of a cast, especially with the fibula still badly broken.. But the doctors ‘relaxed’ attitude towards this didn’t quell my concerns, your posts and other subsequent comments has eased my worries!! Looks like a long road ahead! My break is the left leg, anyone give me a clue when I could be able to use the clutch pedal on my car? Sick pay runs out in 3 weeks… 😦

  • Bailey

    I’m surprised about the bruising, I have that too and at this point I’m wondering if it will ever go away. (19 months for me)

    • Sarah

      Played basketball yesterday – first time since I broke my leg 7m ago.. I was BRILLIANT (well, I wasn’t but I was very. very happy to be playng). Played tennis last week – felt leg then and went caving a couple of weeks before – crawling along tunnels not that comfy. But have also done loads of swimming, riding and have danced all night with no probs. whatsoever. Can’t believe how quickly time has gone.

  • Mr Hello

    Thanks for this site.

    I had tibia fracture with extensive wound for abt 14 months now. The leg has bn on ex-fix and due to exposed bone I hv undergone series of operations: muscle flap, skin graft, etc. & taken diff. types of anti-biotics.

    While waiting on the Surgeon for their proposed bone graft, my toes with other leg digits developed wounds around the nail edges. This hv also lasted for over 4 months now with no significant improvememnt. The spots were later cultured and was said to hv heavy growth of stapyloccocus.

    My questions are: 1. Has the ex-fix not over-stayed? 2. What could be responsible for the wounds around the skin graft area not to have healed after a year, same to the donor site? 3. What could hv given rise to wounds on the toes & other leg digits?

    NB: Pls you can also reach me thru

    Thank you all in adv.

  • Gavin Bell

    Jake, many thanks for this blog! I broke my right tib and fib on 31st August on the rugby pitch – but I was the referee! Had my op 2 days later and therefore just over 3 weeks since the op and almost 4 weeks since the break. I’m still on crutches, but have had a fair amount of physio already (benefits of private medical insurance!). Have still got some swelling around my ankle and knee, but got much more mobility on both than I had when I was discharged from hospital. I am back at work (in fact I got back to work the day after I was discharged from hospital) – the benefit of being able to work at home, and hope to get into the office for 1 day next week. I hope to be able to walk without crutches in the next 2-3 weeks and have been advised by my physio to try to walk properly with the crutches just helping to take the weight – will probably help long term in respect of limping!
    A couple of hints from me – we managed to get a wheelchair, so just to get out and about was a big bonus for me – we live in a rural area so walking with crutches to the nearest pub would probably take over an hour and I would be so knackered I wouldn’t be able to walk back home!
    We have a shower over the bath so I just sit at the moment to take a shower. In a couple of weeks, I hope to have the confidence to stand up – I can already stand on both feet without pain, but lack confidence to put all my weight on my right leg just now!
    Learn to hop – it’s easier to get around the kitchen or such, just by hopping, and you can carry things too (perhaps not tea/coffee though, unless it has a lid!)
    I broke my left leg when I was much younger (30 years ago!) and was in a full cast, then a knee cast. The biggest thing I remember about that was trying to get the ankle and knee moving again after being immobile for so long, so I think the IM Nail is a good thing – I’m just hoping that some of the horror stories I have read are a small percentage overall of the number of IM Nail patients!

    Finally – I have a question – did you have any numbness around your knee after the op and did this go away at all? I cannot feel an area to the (as I look down) right of my scar for about 3 inches. It’s not causing a problem, just annoying!


  • Michelle

    Hey all,
    I broke my tibia and fibula three weeks ago. Since then I’ve had some low moments and some high moments. Jake I could really relate to your first post when you were in the hospital ward. I was dying to get out and I think they took pitty on me even though I was absolutely rubbish on crutches and cried at the stairs.
    I was told I could put about 25% worth of weight through my leg but I was terrified and did a sort of non weight baring crutch movement instead.

    My 1st appointment went well I got to see the rod In all it’s glory on the x ray and Jesus, It’s huge! When I break a bone I break it well. I did it on roller skates at a roller disco, but I was going to the smoking Area to remove the skates and lost my balance.

    Anyway I’m now about to reach week 4 and my pain is much less, I can walk on crutches and weight bare. I’m still very scared of losing my balance but I plan to go back to work next week as I have a desk job and see how I get on.
    It does get easier. Everyday. It’s terribly slow but as they say time is a great healer.

    This blog has been really helpful and I’ve referred to it several times. My scar is prettier than yours Jake but I did make a huge fuss pre op about wanting scars that I could get rid easily with bio oil and I’ve got a nice neat line which is nice.
    Two years seems like ages, 3 months seems like ages. After reading your blog I’m confident that recovery will be slow but steady I’ve been told I can cycle and my leg swelling is going down daily.

    Thank you Jake for your really informative blog. Until something like this happens its hard to even imagine. I wish everyone a speedy recovery.

  • Bailey

    I am coming up on my 2 year anniversary and I have a question. I still cannot kneel down with out some pain. It only hurts when pressure is put on the area of the actual scar but I still feel some pain. What was your experience?

    • Sarah

      Have you had the rod taken out? My surgeon suggested that removing it may help with the pain.
      I’m waiting to do it after Christmas.

      • Bailey

        I have not had the rod taken out. I still don’t feel 100% recovered to be honest. I don’t have full flexibility in my ankle either..

    • Linda

      I’m 3 years down the line. Still can’t kneel on that knee and don’t think I ever will so given up trying. My consultant told me it was the scar tissue that was the cause, not the rod. Had my screws taken out 12months ago but left the rod in

      • Justin

        Magic..Chuffed..1yr ago this June I had the joy of a car knocking me off my Lammy. Snap..Gustillio Anderson II open fracture of both Tib and Fib.To see your own leg hanging is a sight one never forgets.My IM nail went in a treat and the first 6-8 mths at times got to me a lot.The sense of weakness in the long term is still tough mentally.The same for me in respect of the deep tissue scarring leaves,what feels like a small stone in the knee.Now and then I forget and my it hurts.when trying to put weight on it.Still strange numbness around break area..But it gets better all the time. No evidence to suggest that the removal of the IM nail has any benefit..just as you start to heal,and marrow,blood vessels fill the reamed bone..people want it taken out.the op is carefully done these days trying not to destroy the patella. And if the IM nail is correct it should not affect the knee..that pain is done and comes from it going in..why would I go through that again on a very loose notion of pain reduction…screws may be but IM..not for me..Great site/blog ect..Good Luck people.

        Healing Vibes..The IM Club.:)

  • JET

    Hi all
    What a great blog.
    Joined the T&FClub July 2013.
    Not on the bike or in the surf or any other dangerous stuff .
    This big 55 year old boy slipped in the bathroom washing up for dinner.
    So from a self employed contractor to a wimp in 30 seconds.
    Now the pain, trauma, mental scare, now thats been my gig.
    I need this clear, Im not into pain, I just have always been fit +plus.
    So my complaint is I really had trouble concentrating.
    Strong pain injections for 2 week in hospital, two tab packets over 3 week out and then nothing. Total of 5 week of meds and I started to have these days merge. No real day awareness no care and grumpy as.

    Week 13 now and walking (no sticks for 3 weeks now) the muscles in the leg still go to sleep and lack strength but getting stronger all the time.
    But its the memory , and the grumpiness to out watch for after meds.
    As for the pin in or out question? My Ortho considers the screws first option if pain persists. The pin and even the screw can be complicated to remove depending on the bone re growth.
    So the advise is bad habits are easy to pick up so walk slow, straight and long.
    This is a good reflection time and my boat is looking much better.
    Grumpy is under control also its just the whole change you have to get grip of.
    hope this helps .

  • Crystal

    This is so great! Really nice to connect with others that have an IM nail. I’m considering having mine removed this fall. It’s been in since 2007. I broke my left Tib/Fib and had the distal screws removed, but the leg still bothers me, and I don’t have full range of motion/flexibility in that ankle. I still have bruises on the high ankle like the ones in your photos. They never went away.

  • marion stanley

    hi everyone….

    i read all of your comments…also i have IM NAIL on my lower leg…i broke my tibia and fibula…and some wound and scratches this coming oct. 13 2014 i have checkup…my doctor said they will xray me first then first time to teach me trying to walk without crutches or walker…my question is…is it hurt?and sometimes i feel itchy on my wounds and something coming out from wounds like color purple in the wounds…have u guys experience it when you trying to stand or a long time without putting my foot on the ground…help guys im so scared… if you have facebook message me or marion stanley thanks guys i learned something here…im not so good in english im so sorry for that…

    • sarah bishop

      Hi Marion – don’t be scared!! Yes, the first time you walk it hurts A LOT, the second time, not so much and finally not at all. I had some stitches that came out of my scar – yes, sort of purply-black – I pulled them out with tweezers. Good luck with your doctor’s visit and don’t panic! Go slowly and I’m sure you’ll be fine.

  • Jenny Howells

    Hi Jake, I came across your blog by chance on the internet, as
    It is just over 4 years since I had my femur IM nail inserted, after a car crash and very messy break. I still get quite a bit of soft tissue pain in all areas between my knee and hip and still take 1 Dihydrocodeine each day, and it does depress me sometimes that I think it will be like this forever (I’m 48 so that could be a while!). And being a woman the pain is worse once a month (we are more susceptible to pain then).

    I was signed off from my consultant 18 months ago, but I am thinking of seeing him about having just the screws removed, the one at the top is really long and I’m sure it interferes with nerves etc.. However, I don’t really want to go through more surgery, especially taking the whole nail out as I know I was lucky not to get any infections with the first two ops (two weeks apart), plus I’d have to go through some recovery again and I’ve been working really hard at getting fit again (as much as I can anyway!). It might be possible to get keyhole surgery for just the screws.

    Anyway just to say thanks for posting and I hope that 2 years on you are doing well!


  • Jess

    Thanks for such a great blog.

    I had my IM nail op 3 days ago following a stress fracture in my Tibia that was not healing. I had been treating it conservatively and had been wearing a moon boot since the beginning of October.

    I have been searching the web for info on recovery post op and came across your blog. It is fantastic and good to read someone else’s experiences that have been so similar to mine over the past few days. I did not expect the level of pain nor the amount my mobility had been reduced post op. I take my hat off to you returning home when leaving hospital – I’ve had to move in with my mum for a while and am so grateful for her help.

    The blog has made me realise it will be a long road to recovery and not to rush.

    Thanks again!!

  • Sandy

    Hi Jake

    Found this by chance while trying to research tibial nailing. I am only 7 weeks post operation right now. Broke Tibia and Fibula falling on ice. So glad you have done this blog and there is something to really relate to. Have two young children 5 and 2 and have really been finding it difficult but just so helpful hearing from someone that has been through it. Started walking one week ago, struggling with the pain just now and kinda feel like I’m never going to walk again just now but reading your posts definitely making me realise this is not forever.

    Thanks again


  • David Rizzi

    hi, anybody powerfliting or weightlifting with a IN? I had a traffic accident, resulting in tibia and fibula with intramedullary nails. One year after the surgery I’d like to do some powerlifting, the doctor just said it should be ok but don’t exaggerate… Thanks!

    • Bert

      Thanks for the great info dog I owe you bitiggy.

      • davirix

        Hi, I have been deadlifting up to 80kg at 60kg bodyweight, doc said the same, Ok but don’t exaggerate. I think that was 1 year after the insertion, the longer the heavier. I had it removed and the problem now is ankle reduced ROM and shorter leg, squatting is a bit problematic. I recommend you to work on mobility and go slow with weight.

  • Kara

    Hi! I came across this blog after breaking my tibia and having an IM Nail inserted on 30th August 2015. This blog was a god send to me and reassured me that everything i was going through was quite normal in terms of recovery. I found my doctors to be quite useless except to say “everything is fine”. That didn’t really help when I was bawling my eyes out, feeling sorry for myself! Anyway I finally managed to become free of my crutches in January 2016 (I was down to one for quite a while and felt I had no confidence to go any distance without having a crutch for support). After having problems with my knee (pain, can’t bend it for any length of time and kneeling is completely out of the question) and my ankle (completely numb, can feel the coldness of the screws if I move a certain way, and lack of ankle movement) I am having all six locking screws taken out in a few days. I’m assuming this will be a general anaesthetic but again the doctors haven’t given me much information. I just wondered if anyone else had had all their screws taken out? Whether you were able to walk unaided? And what the bruising/swelling/pain was like after the surgery? I really don’t want to be in the position I was in after the initial surgery – although I am told it will be nothing as traumatic as this – but I am still concerned about recovery after the screws have been removed. It doesn’t appear as though this blog has been added to for some time, but hopefully someone will answer! My surgery is in 5 days and it can’t come quick enough. Thanks so much.

    • Linda Banks

      Hi kara

      I had all my locking screws out. I was dreading the operation but I was surprised to find after the general anaesthetic n back on the ward I managed to get to the toilet n back with minimal pain..honestly, it was the best decision to have the screws out and I’m so glad I went ahead with the op
      Good luck and let me know how you get on

      Linda x

      • Kara

        That’s great! Thank you so much for taking the time to come back to me. Only three more sleeps 🙂

      • Linda Banks

        No probs at all and if you want to send me your email address I’ll send you some pics of afterwards!!


      • Kara

        Had my screws taken out on Friday. The pain actually isn’t too bad at all. Think it’s more of a niggle with the stitches. Although I am bandaged up like a mummy so will see what state my leg is in when the bandage comes off tomorrow!!

      • Linda Banks

        So glad it went well Kara. ..I did have some bruising round the screw sites but I’m sure you’ll be back to normal, if not better in no time!! X

      • Kara

        Just had a thought – how have your scars healed? I was six months after the initial op and the scars were really still quite red. I suppose I am now back to square one with the scars again. I had been using bio oil but I don’t really think it was making any difference. Have you used anything on your scars? 🙂

      • Linda Banks

        No I haven’t really used anything on them…they only really stand out when I’m on holiday and stay white when you have a tan lol. To be honest they don’t really bother me. It’s a reminder not to get drunk and fall off kerbs!! 😊

      • Kara

        Haha! I did mines raising money for charity 🙂 thanks for all your help!

      • Linda Banks

        Hi Kara..just wondered how you were and if you were feeling better after the screw removal?

      • Kara

        Hi Linda. Thanks for thinking of me. I was sore for a few days and had to use my crutch again for a couple but I think that was just me being cautious in case I fell. The only complaint I have is that the doctor has opened my scars up too wide (two of them are four times their original size and I’m told the screws came out easily so don’t quite understand the state of my scars) but aside from that I’ve felt instant relief in my ankle and knee. All in all it was a success, aside from the cosmetic issues…

      • Linda Banks

        Glad you are feeling relief Kara…if you want drop me a pic at as I took some after my op too and I’ll send mine as they are now. I’m just grateful that nowadays they can just make 4 cuts rather than a massive one down the front of your leg as that would have been way more noticeable!
        Linda x

    • Jenny Howells

      Hi Kara,
      My sympathies for your injury and ongoing pain. I had the two screws at the top of my femur removed after 4.5 years in Jan 2015 because they were too long and I felt they were hampering my full recovery. I could feel them catching sometimes!! It was under general anaesthetic and I went home the next day in a lot of pain, and over the next week got the most amazing bruises from my hip to my calf. But once it calmed down from being cut open again it has been much better and I finally got off the Dihydrocodeine on the 5th anniversary of my car crash.
      I now feel much more positive. I hope your op to remove the screws has a similarly positive outcome.
      All the best,

  • Abigail Yardley

    Thank you Jake! This is still the most informative IM rod blog. I’m 8 weeks post surgery. I needed a reality check and this certainly helped. I’ve been driving which I know I’m not meant to but I thought it might stimulate some bone growth as well as get me to work finally. I hope you are doing well and wonder if you still have your rod. Best wishes, Abbie

  • Blake

    Hello! I was wondering if you ever had any itching near the screw sites during the second year of your recovery? I’m about 18 months out from my tib fib surgery and have been experiencing some occasional itching at the screw sites for a couple weeks now. Thanks so much!

    • Kara

      Hi Blake,
      Yes I’ve experienced a lot of itching near the screw sites. Which is really annoying because I’m one year post op and my scars and skin surrounding same are still completely numb!

  • Belinda Murray

    I’m having mine out after 15 years anyone done similar and how did they go … How is the recovery in comparison to having put in …

    • Kara

      Hi Belinda. I had my nail taken out on 22 September after having it in for just over a year. To be honest I was expecting the worst however the recovery has been great. I was in pain but let’s face it I had just had surgery so it’s going to hurt! It was nothing like the first surgery though. I was sent home with crutches which I did need to use for about a week or so. I was signed off work for two weeks but to be honest I probably just milked it and could have gone back earlier. Just now it feels so much better. Before I was very aware of the nail in my leg. It feels like a relief now. My knee trouble has eased although it’s still healing so is quite tender and weak. One thing I have noticed is a feeling like my knee needs cracked or popped, like a knuckle. Not really sure what that’s about but I’ve been discharged with no issues. I’ll keep an eye on it and see how it feels after another few weeks. Hope the op goes well. Kara.

  • Muhammad

    I also have IM rod inside my femur because motorcycle accident..almost 1 year..and i feel better right now..i can do everything without any pain..seriously..

  • Peter

    Great reading about your journey with an IM nail.
    I badly broke my left femur. And shoulder and a few vertebrae. My leg was at 90 degrees while I was lying there, until the ambos straightened it – ouch. Well I’m nearly 9 months with my nail. The bone has healed but I’m still on prescription pain killers. The screws top and botton cause much pain. And I’m now looking to get the nail removed to see if I can make a comeback. I can walk but nothing faster than that. Can’t ride a bike, can’t walk far without a walking stick, can’t do many of the things I once did.
    You say your leg is nearly normal. Good on you mate I’m happy for you.
    Keep up the blog !

    • Kara

      Hi peter. I experienced the same pain as you. It transpired that my bottom screws had moved and were coming out of their own accord! I had an operation to remove the screws but I still had problems. I was still taking painkillers every day and if I didn’t take them before bed, I suffered from a restless leg where the nail was. It was awful. Went back to see my consultant again and decided to remove the nail completely. The operation went well and my leg feels like a leg again. I am no longer taking painkillers. The only issue I have is that I can’t kneel and I still have nerve damaged in my knee, but nothing major. If you decide to have yours taken out, I hope it goes well. This blog was a god send for me.

      • Peter

        Hi Kara.
        Thanks for your comment.
        Don’t know whether the bottom screws are coming out but xrays show the heads are proninent and causing obstruction of the tendons/fascia connecting to the knee cap. Top screw is too long. It protrudes 5 to 8mm at the back of my femur when it should be 1 to 3mm according to the orthpaedist. Much pain even while resting and I know what you mean by a bad night’s sleep. Also know what you mean about knee damage. My femur IM nail was inserted retrograde through the knee. Still cannot kneel snd assume I never will again. I have a patch near my knee with no feeling at the skin and sustained some ACL damage which I hope is not made worse during removal. But I have to have the nail removed to have any chance of normality again. Will post with my experiences once I have an operation date.

  • Amelia

    Hello, I haven’t had time to read through all of the comments but it is nice to read other peoples’ experiences. I spiral fractured my left tibia and fibula in a hiking accident 9 months ago and had an IM nail and 4 screws inserted. I’ve been walking without crutches for 2 or 3 months now and everything has been going great. My limp is slowly going away, I am walking much longer distances, can go up stairs fairly normally, and I am working out at the gym. However, I just started a new summer job and there is a lot of sitting so I don’t get much activity there. Today for some reason after coming home from work my ankle is super swollen and I have pain around where the break occurred. It feels weird that I am only experiencing this now because a few weeks after the accident and surgery I was sitting in uni classes for long periods without too many problems. Did anyone else start to see more swelling months after their surgery? My knee doesn’t really hurt that often, but it’s odd because I don’t have complete feeling near the scar/in the area where the screw heads are sitting. Has anyone else encountered similar problems? I don’t have another appointment until August and the pain seems like a normal occurrence and it isn’t unbearable, so I don’t feel like I need to call my doctor, but how long does it take for most of the swelling and pain to go away? Maybe I am just impatient but it’s a bit of a bummer because my leg has felt surprisingly good for a few months and now it just feels like all of the hard work I have put into rehab is somewhat wasted. Of course I know in the long run strengthening my leg is a good thing, but it just feels a little disheartening to go back a step.

    Thanks for any input!

  • Emily Lusty

    Please could you connect me with anyone who has had a tibial nail exchange after non union? I am now recovering from my second IM nailing in 5 months, and finding it really hard. Thank you for your blog. It has made me realise that this is a really long process, and that I have to stay patient.
    Thank you.

  • Melissa Weidner

    Hi I had a bad break of my tibia and fibula I now have 4 plates and roughly 19 screws -it was a year this passed May but I’ve noticed s bump that hurts like a bruise and I can see a bruise beginning and I’m thinking maybe one of my screws came loose and the bottom of my foot goes numb quite often

  • Cory

    Hello, I had the same surgery a year and 4 months ago. I still have a lot of stiffness in my angle and a sharp pain in my shin when I walk. I hike a lot and do yoga. I find that massage and stretches help a lot. I still feel that my left leg is weaker than my right. My doctor told me to run help improve the muscle strength. Which I don’t really do enough. But even after over a year I still notice small improvements.

  • Michael

    An interesting collection of personal experiences though I often wonder if these types of experiential blogs are biased toward those who have had a less than positive outcome? I’m no stranger to sports injury and recovery as an off – road motorcycle enthusiast for more that 50 years. R&L ACL reconstructions in the mid80’s; displaced clavicle fracture x4; fractured scapula x2; numothorax x2; displaced thumb requiring external pins; fractured just about every rib, some displaced and lots bumps, bruises and strained bits. I’m almost 8 weeks post op after twisting my foot 180 degrees that resulted in a displaced distal tib fracture and proximal fib fracture. I’m 65, exercise regularly, ride dirt bikes as often as possible and I am consider to be in excellent condition, albeit a bit crazy about my motorcycle habit. I have managed to recover fully and usually faster than the average patient and until this Injury, avoid any permanent devices such as the IM nail and 5 screws no resident in my right leg. The procedure was performed in the USA – sunny Arizona by well trained ortho doc with fellowships in both trauma and sports medicine in top programs. Since the force of the spiral fracture split my Tib through the joint surface, I was not allowed to weight bear until 6 weeks post op to ensure the ankle joint would not be affected. The nail was insert above the knee with a small incision through the muscle and tendon under the patella. The nail was a 9 mm diameter (I am told I have small bones for a 6′ tall man) and 330mm long. Like so many have reported and as I was advised, my knee/quad was very painful for 4 weeks plus. I was allowed to stretch my ankle, massage my thigh and as tolerated, flex my quad. The pain went from 8 to 2 in less than a week – week five if you are counting. Of course my leg is noodle by as I approached week 6, I was already regaining some muscle tone in my thigh. The first few days of baby steps, I used my crutches to try and balance out my walking. I also managed to aggravate the three bad lumbar discs with my uneven gait- mitigated by a very intense myofacial massage- just make the transition s little more uncomfortable, I contracted a nasty respiratory virus that put me down for 5 day. So at almost 8 weeks I’m feeling a bit behind on my rehab- given history and exercise regime the doctor was more than comfortable releasing me to my own rehab. I did resume my upper body weight training 4 days after my surgery- it was exausting I confess.
    6 week X-ray showed very good alignment but of course the callus is just forming on both major fractures so walking with full weight I reall feel the fracture sites, especially the tib, that was a big one.
    In all likelihood I will have the two longer screws that anchor the nail at the base of my removed at 6 months. Much of the impact forces of dirt bike riding are transmitted from the feet through the legs when stand on the foot pegs- the consensus is I will bend or break those screws when I resume riding at full tilt. I’m hoping the nail can remain in place without any problems but I guess I’ll have to see where my progress is at say, 6 months. It is a fight to stay positive, I suppose my age doesn’t help as I recall my fierce determination and spectacular come back 38 years ago from an ACL replacement that require 8 weeks in plaster. My goal for the next two weeks is to regain full extension of my foot and restore my quad and hamstring so I have a normal gait. Realistically, I’m hoping the fractures will have callused by week 12 but understand that 8-12 more weeks before my bones will fully healed. I’ll post up my week 12 doctor visit and how I think I’m doing. Have to say, never thought I’d break s leg nor did I understand how much this would hurt.

  • Mark Stangl

    2 years since my 2/2/16 spiral fracture of the left leg. I was 63 years old. Tibia was a mess. Fibula fractured 2 places. Got an IM titanium (no airport detection) in the Tibia and a plate on the Fibula. I was skiing and was hit by an out of control snowboarder in Steamboat Springs, Colorado.

    After 2 weeks with a dressing, I received an orthopedic boot with an air bladder. I also used a knee cart to get around. After 4 months I required and ultrasonic bone stimulator to heal a 10mm gap in the tibia fracture. After 6 months healing had progressed and told to resume activities as tolerated. At 8 months I was clinically healed and resumed skiing and racquetball. I had been cycling after 3 months wearing and a leg brace used for sports. During this time one of the upper IMT screws broke off. Last September (17) I had a lower screw removed since the head was breaking through my skin when active.

    Last December of 17 I began to feel pain in my right knee after surviving the accident and recovery of my left leg. I do feel some pain in my left leg and angle when sitting and self-massage helps. Currently, I am at 85-90 % of my physical ability and in pain occasionally from left leg and often from my right knee. In the end, I will never be the same and may have affected my right knee from the stress of favoring my left leg during the recovery. I am lucky to have been active for so long and plan to continue sports activities and may need a knee replacement int he foreseeable future.

  • Francisco

    Awesome blog dude. It’s been a year and 2 months since I broke my left tibia. I’m 23 yrs old. I broke it playing soccer complete spiral fracture. I lived a very healthy lifestyle before and I’m happy to say I still do. I don’t play soccer as much anymore though but that’s because i don’t have much time. When I do however I definitely feel that I’m more careful and some people even have said that I run weird. I guess I’m still not completely somewhat back to normal. I know ill never be exactly the way i was before because I have a titanium rod in one leg and not the other. I’m a gym rat so when I was in recovery it was tough not going to the gym. But once I got back at it, it was awesome not having to do leg day for awhile. But I’m happy to say that now I hit legs as hard as I did before all this happened. I’ve thought bout whether I should remove the rod and i honestly dont want to cuz then it to be a whole other recovery period and then there could be complications and I besides I don’t really notice the fact that I have a rod in my leg. Thank you for posting your experience in this blog I just now decided to post mine after a year I had read your blog about a month into my recovery phase and it helped me with my recovery and post recovery. Thank you I will continue to share my experience as well :). And to everyone who unfortunately has to go through the same experience keep your head up and be patient with your recovery. Everyone is different and therefor heal at different rates. Also be careful with the pain meds. I wish you the best and good luck till the next post.

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