Me and My IM Nail (Part 8) – 3 years on

by Jake McMillan

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Broken Tibia X Ray

X Ray of IM Nail in Tibia

Three years ago I broke my tibia (see X-ray above) and fibula and the brand new term IM Nail (Intramedullary Nail or Rod) was introduced into my life … and my leg. Three years on I can still remember the pain, thankfully I don’t have that any more. Since the accident I’ve been blogging about my recovery as there was so little  information about it on the internet.

Unfortunately, three years later, there still seems to be very little information out there. However! One positive has been all the people who have taken the time to get in touch with me and comment on this blog to share their experiences of going through the recovery as well. A massive thank you to all who have commented and especially those who have said kind things as I really did not expect anyone to read my long posts about limping and pictures of scars and hairy legs.

For those who are not aware or have not yet filled it in, I have put together a short survey and will produce and share the findings with everyone. I’m just waiting until there are a 100 responses, with 80 people having filled it in so far (at the time of writing).

Scars and bruising
Over the three years the scars and bruising have gone down, but have not completely disappeared. Being a hairy-legged man helps cover them up.

Bruising and Scars after 3 years

So, three years post operation how is my leg doing generally?
It’s very similar to being a normal leg, it just has niggles. For example, if I leave it in one position it feels stiff/sore and kneeling on it is not comfortable (but is a bit better compared to a year ago I feel). There are some days it feels better than others, but generally speaking I can walk about, run and dance as badly as I ever did.

I am still cautious when it is raining and slippery, as if I expect my leg to cause a problem and always feel relieved when it is perfectly fine. I was in Singapore in March last year and I was wandering around, exploring after it had been raining and on a slippery stone I managed to fall straight down to the ground on my bad leg. It was just a case of poor grip, but I was so happy that I hadn’t hurt my leg or broken or bent my IM Nail I actually forgot the embarrassment of falling over in front of lots of people.

I haven’t done a lot of sports or exercise this last year but that has nothing to do with my IM Nail, it is been more me not making the time and effort to do it. I fully aim to do much more this year (we all say that don’t we?).

Last Sunday, I went to Richmond to meet some friends and I did so with some trepidation as it was a repeat of the exact same activities I did three years ago that ended up with me breaking my leg on my way home at Clapham Junction Station. I’ve been to the station and walked through the underpass (where I actually fell over and broke my leg) many times before so it should not really have been a big deal.

However, a friend made a joke over Facebook that they would break my other leg. They did not mean or intend any malice by this, just making a joke, but I did not take it in my normal good humour and realised that breaking my leg, the operation and its recovery was still a big deal. Apart from the pain and discomfort of the main recovery period, I was self-employed and it meant I couldn’t fulfil a contract that January or go for one the following month. I almost went bankrupt and barely managed to get by. My attitude remained positive, but it was a really tough time that I would not want to go through again.

In Clapham Junction Station Underpass

In Clapham Junction Station Underpass

As I walked through the underpass at Clapham Junction station last weekend I remembered the time laying on the ground 3 years ago whilst my friends decided that I actually did need medical attention (I had told them to leave me and I would hobble home to bed). I hoped I would not have a similar fate that evening. I am pleased to report that on my journey home I had completely and utterly forgotten about the accident and that it completely escaped my mind. Although, to give full disclosure, I had realised I was totally desperate for the loo and that was utmost on my mind. Nevertheless, although it’s something I still think about, the whole incident is very much in the past and the ongoing niggles of my leg don’t affect my life or bother me that much.

Will I have the IM Nail removed?
I have given this some thought and have still not yet arranged an appointment with a consultant to discuss this. I will do this as would like to know more information and will, of course, share it here. I would like to remove the IM Nail as would prefer it not to be in my leg, I think most people feel this way, but the question is whether it is worth the risk of further complications and pain. It does worry me what happens if I have another accident, how the metal might cause more damage, but then I cannot predict how bad that accident would be anyway? Some have had very successful removals and I know others where it has not given the desired result and caused further pain and problems. As I don’t get much discomfort and it doesn’t really prevent me from doing anything I think a consultant would say there is not enough justification to do it.

Sharing Your Experiences
Please keep doing this, I will continue to keep updating this blog and it really does help others to hear about as well as give support to others going through the same or very similar experience.

Thank you again to everyone who has contributed to the blog and wishing you all the very best with your recovery!


93 responses to “Me and My IM Nail (Part 8) – 3 years on

  • rensy1

    Great blog Jake..

    All the best


    Sent from my iPhone

    • jakemcmillan

      Many thanks Carl! Hope you are well!

      • ahmad

        Hey jake
        This is Ahmad from india I have read all your blog about im nail experience ..
        Tell me hows you?
        Well last month I have struck with a road accident in which my right leg tibia and fabula broked its about a month gone till my operation I don’t feel pain but niggles a lot but there are too many things always runing in my mind that will I be better or not people visit me everyday and say u will be fine ..
        But I need to know that after 2 month how will my leg be…..

  • Ian flannery

    I got the same injury in 2009 don’t get th ed bruising and can now run as far as I could before but do get slight discomfort around the Side of my knee and notice we hen stood up my leg with the nail in the veins are more prominent but I am happy with my recovery in general
    and walked up a mountain today 🙂

  • Ian flannery

    one more thing sometimes not sure why I tend to loose Balance and lean into walls weird and also not the same walking around ccorners

  • Helen

    Hi Jake & all the Nailers
    Thanks again for taking the trouble to continue blogging after 3 years. I’m now 4 & a 1/2 months post op & until reading this blog i had huge fears that i would have to change careers.
    I returned to work as a nurse in a busy emergency department this week. I’m doing light duties for now but am confident after reading everyone’s posts that I will be back to full function before too long.

    Keep on recovering everybody!

  • Robyn

    Hi guys.

    Also broke my tibia about three years ago and now have an IM nail. One huge nag I have is I still can’t kneel fully on my bad knee. This prevents me doing a lot of exercises at gym. Is this normal? Any suggestions?

    Thanks everyone;)

  • Tom

    I had a spiral fracture to the mid shaft of my tibia 3 weeks ago skiing in Vail. An IM nail was placed with 2 screw near the knee and 2 above the ankle. I do not have any pain at the injury site but still have significant knee pain and ankle stiffness. It feels like it is never going to get better. I started working after 2 weeks. Will be on crutches until the end of March (total of 6 weeks, no weight bearing). Not sure what to expect after that. I was very active before the injury and hope to get back into running and am able to ski next season.

  • Raquel

    I’m so glad I found your story! It’s very disheartening that there is not much info out there about I.m. Nailing. I broke my tib/fib feb.28 2013 I’m 4 weeks post op and going to physical therapy. Mine was a clean closed fracture. I had a lot of damage to the soft tissues that bones wouldn’t align so my surgeon and I decided a nail would be the best option. I’m having issues with my foot since I broke the bones. My foot is numb from the tip of my big toe to the heel. My p.t. And I feel that it might be nerve damage and unfortunately I’m in constant pain with little to no relief no matter what I do or take. Swelling still comes and goes but after reading your story it makes me feel a bit more optimistic about the whole ordeal. Thank you for posting

  • Jamie

    I suffered a sprial fracture to my tib/fib on feb 27, 2013. On march 1, 2013 I had the im nail inserted. The first two weeks were the worse. I am still no weight bare at the 5 week mark. I go to doctor next week. I have some pain in knee and ankle area when I move them. Stiffness is horrible. However overall so far I am pretty happy with my results. Ready to walk. Thanks for writing this. It is like a light at the end of the tunnel. Happy healing everyone. Stay positive!!!

  • sattersley

    Jake et al. It’s been wonderful to read Jake’s and everyone else’s story. I am 6 weeks post tibia IM Nail surgery after a tib/fib break from a fall off a small ladder. I had it in my mind that I would be back on my feet by now, and more importantly able to drive my car (right leg broken). Alas, after seeing the surgeon a couple of days ago, he is recommending another 4 weeks of partial weight bearing using only 1 crutch before trying to drive. This was hugely disappointing but after finding this blog I feel better knowing that my recovery is not dissimilar than other folks. Pain isn’t a problem other than some aches around my knee and in my foot along the big toe axis. Hopefully physio which I start next week will help with that. Thanks everyone!


  • Nic

    I had a spiral fracture 27th April, so 4 weeks yesterday, since my nail/screws etc, frustrated & can’t imagine walking unaided, never mind driving or gym!!

    Good to hear stories/experiences, positive & honest….. Everyone different / individual, so healing will also be different ….. My brother in law did the same, & was back playing rugby 1 year after his op. I wonder if I will ever be able to wear a high heel again, if anyone can tell me if they have experience of that?? Small thing on the grand scheme of thing, but I just wAnted to know if anyone could say “happened to me, & I happy in heels so long after accident”!!


    • Sarah Fisher

      Hi Nic,

      I wore heels 10 months after my nail was inserted! I did try sooner however couldn’t actually walk.

      Hope you’re recovering well.

  • Richard Primbs

    Thank you so much for your great blog. I broke my right leg one month ago, and I got an IM nail the day of the injury. I have never had to recover from anything so challenging so I really appreciate being able to read about your experience. It gives me hope that my leg will be “normal” in the future.

  • Sarah Fisher

    Thanks again for sharing your experience Jake.

    I am now almost a year post injury/operation. I have recently started running at physio however the screws at my ankle were causing me grief. My consultant suggested removing the screws, so on Thursday I returned to hospital to have the operation.

    They have now removed the 2 screws I had at my ankle, and the 1 screw that I had at my knee. As the bones have not yet completly ‘knitted’ they have said that removing all the screws will allow the bones to settle. The tibial nail remains and they have said this wont be removed unless it was to cause me any problems.

    I was able to walk out of hospital after the operation, thanks to a local anaesthetic as well as a general! I am back on fairly strong painkillers but the pain is easing already only 3 days post op.

    I know it’s only cosmetic, however the scars serve as a reminder of the accident which caused me to have this operation. I had almost a year of these fading only to have the cuts opened up again! (The surgeons have opened up the old scars to remove the screws).

    I am hoping that now the screws have been removed I will find running a lot more comfortable, and won’t be inhibited by the screws any more.

    Being unable to exercise & take part in pre-accident activities (I’m a keen cyclist, runner & scuba diver!) has been the worst part of this experience, however I am almost back to my old self – with or without a few loose screws!

  • Peter Gaughran

    Hi Jake,

    It’s Peter, the Irish chap who slipped in the snow 🙂 I’m now over 2 and a half years over my IM nail incident, but I don’t think I mentioned I had two of my ankle screws removed as well, about 6 months ago.

    As anasthetic wasn’t an option before, it wasn’t this time either, and they didn’t want to go for a spinal again. I still have strong memories of the surgeon leaning over the ‘modesty’ curtain, and explaining that the local anasthetic would only really work on a surface level, and not on deep tissue (!)

    I’ll not go into the grisly details, but siffice to say, it was damn painful. I felt every turn of the scew, and there were two of them!!! Although I couldn’t keep them, they did show them to me afterwards, and I was shocked at their size! Very large, and that dull gold titanium colour. Also, quite covered in gristle… Ewwww…

    I’ve also had the ‘niggly’ leg thing. A medical friend of mine is convinced it’s psychosomatic, but I don’t believe it for a second!

    Anyhow, just wanted to share my most recent experiences!


  • suhayle master

    Hi Jake I posted previously at about 4 months, I am now 15 months post double break and I am recovering well. I played my first game of 5 a side only 2 days ago, although i wasnt 100% i could get around the pitch. I have not kicked a ball with my bad leg yet though. I was fine walking the day after too although i probably wont be able to play again for atleast 7 days.
    I found the NHS physio useless during my rehab and up until month 9 i could run but would get very painful on one side of the leg (not the fracture sight). My private physio then solved that problem within a few weeks with some simple exercises. I had stopped with the exercises after 6 months (big mistake!!).

    I too get the odd niggle here and there. Not sure if it is all the deep lying tissue/nerves getting used to the old sensation or if it is the screws interfering with the nerves/tissue. If i wasn’t aiming to start playing football again i would be back to normal. But for vigorous activity i think you need that extra rehab in order to get the leg back to its best. I think i am about 3 months away from playing with my 11 a side colleagues finally!!

    Anyway its nice to read other stories and always gives a great insight and motivation to keep plugging away.

    There is light at the end of that tunnel my friends!


  • Dawn Renee

    I experienced a tib/fib fracture on July 15, 2012. IM Nail was deemed the best repair option — closed fracture, but spiral. Now, over 1 yr later, I want to get the upper screws removed but my surgeon won’t perform the surgery. I am active in Tae Kwon Do as an instructor and in August 2013 was comfortable trying spin/jump kicks.The kicks don’t hurt anymore, but landing after a jump kick does! The top screw is the worst. The surgeon told me back in July 2013, to “keep challenging” myself — running, jumping, etc — to see if the pain would subside or go away completely. It hasn’t. And now, the top screw hurts all of the time when I am standing, walking, etc. One of my past Xrays revealed that all 4 screws were actually slightly bowed down / curved downward in the middle. The surgeon asked me what i had been doing — it was right after I began working with a personal trainer to regain strength. I wonder if the top screws are now more curved and bent from landing the jumping kicks? I have calls in to a couple of different local ortho surgeons to find out if they will remove some of my screws. Thank you for posting your blog. It gives us “survivors” needed information and reassurance that what we are experiencing is normal. Dawn R.

    • Julie

      Hi – I’m in Australia, I go to the free fracture clinic here, they just removed the top 2 screws from my tibial nail because I complained about unreasonable pain, and they’re very happy to pull the whole nail out once my tibia is healed (which may be another year – it’s only been 6 months since accident). I’ve decided to have the whole thing out when appropriate because I’m only 56 and lead a very active life and I don’t want to worry about bending the IM nail whenever I do something physical for the rest of my life!

      My bone has delayed union (ie not fully joined yet) and I’m getting around fine with the top 2 screws gone – MUCH less pain than before top screw removal.

      If you have union of the bone (check x-rays), don’t let them talk you out of it, simply asking to remove some or all of your painful screws is perfectly reasonable.

      Keep looking for a surgeon who will do what you need.

      Good luck!

  • Johnny

    Hello: i read your blog 5 months ago when i broke my tibia in two playing soccer with my friends. Like everybody else i was so hungry for information, because there is not much about recovery times, or just how you have to feel. Reading your blog inspired me to do one similar blog in facebook, but in spanish with puctures and videos. I figured that i can do the same for someone else, like your blog did for me. At the beginning i was so afraid, and the unknow is the worst, but reading your blog made me realize that i was in the right track. At this moment i can run on the tearmil, and in two weeks i will attemp to run on a regular surface. Am still sore on my left foot, and from time to time some little pain on the fracture. But i am on the right track to full recovery. Thanks again.

  • Johnny Perez

    Yes that is the link to my blog in spanish, about my fracture.

  • michelle parry

    Hi really good to read your blog, I cant believe what a traumatic journey this has been! I broke my tib, fib and ankle 2nd june 2013.
    When i did it I thought 8weeks plaster and id be skipping around again like nothing ever happened!! How nieve was I. Had Im nail and a screw in my ankle… 5 months on Im loads better, however still far from right.. the wortst bit is knee pain and the screws attatched to top of bone I can feel all time, very uncomfy.. and as for kneeling forget it.. hoping gets easier over time.. any comments on this ? cheers guys michelle

  • Julie

    Hi! I broke my right tib/fib between my motorbike and a slow-moving car, all my fault (rider fatigue), May 2013. Inspired by Jake’s blog I was walking without crutches at 7 weeks, driving an automatic (painfree) at 8 weeks, back to my landscaping course in 9 weeks (%$@&ing hurt sometimes but didn’t want to put it off a year), back on my motorbike about 12 weeks (which doesn’t hurt at all).

    However as is apparently normal in about 1/3 of open tibial fractures, I still have “non-union” aka “delayed union” at 6 months – the symptoms are lots of pain on weightbearing & exercise – if I lie around I get no pain at all. So they’ve just pulled out the top 2 screws to “dynamise” the break – ie stop the screws keeping the 2 halves of tibia apart & let weightbearing close the tiny gap. Weightbearing as tolerated was recommended straight after the procedure: I’m walking fine straight after waking up from general anaesthetic, minimal pain now which is excellent! Just a tiny itch/pinch occasionally at break site. Still limping protectively though, and kneeling still feels really weird. Putting off riding my bike again for a week which is my idea of taking it easy!

    I’m still planning to remove the whole nail when healed, which now looks like more than another 6 months, but I get to do everything I feel like doing – just slower! Thanks for blog, have been checking it regularly.
    And high heels hurt! Not that I’m really a high heels kinda gal – physio recommended to invest in some Birkenstocks, beautifully comfy and supportive.

    best of luck to all
    Julie (age 56)

  • Caroline

    Thanks for your blog. I snapped my tibia & fibula 6 months ago ice skating. I also have an IM rod through my tibia. So thanks for the updates on what happens in the future 🙂 x

  • Sam Wills

    Compound, spiral, butterfly fracture tib/fib to IN in May 2002. 9 months on crutches. Lots of phyisio. Snowboarding again in December 2003 two seasons of riding with the IN, I could only ride for about half a day before I got tired and my leg started hurting. I was getting increasingly worried about the chance of an injury re-occurrence so I persuaded, (and had to persuade), someone to take it out.

    Definitely the best thing I could of done. There was some pain and recovery after the removal op but my leg has gone from strength to strength since then. The scarring on my knee is worse where the existing scar tissue was recut and healed but I can kneel without discomfort and no longer have any fear of damaging the nail. Over 10 years later and 14 back to back winter seasons I can say that taking the nail out was a good decision. I still find ways to trial and exercise the damaged muscles and nerve damage and occasionally I get an electric sensation from the arch of my foot to the inside of my knee when I stand up – old nerve pathways and muscles trying to fire – but I really am not limited by it at all. My advice is that it a rest of your life healing event, psychologically and physiologically. Whenever I hit it on something for a long time my brain would automatically go into emergency mode and I would feel a lot of pain – similar to your situation in Singapore – but over time I have learned to modulate that response by repeating to myself that it was fine and that it was healed. I also no longer referred to it as my “bad leg” and thought about it as my “healed leg” or my “leg that can take all the punishment and come back for more” or my “strong leg”. Only recently when I started doing pistol squats in the gym I found I could do more with my left leg than with my right – which still comes as a shock.

    I also found recently that trying to beat my foot on that leg in time to music and keep it up really got into all the muscles on my shin that still have a lot of scar tissue. Its an ongoing process – almost like a voyage of discovery.

    I hope you are feeling heaps better and also a little like an invincible Wolverine with an (adamant)titanium augmented skeleton…



  • alan

    Very useful blog, Jake. My tib/fib fractures and intramedullary nail insertion happened 8 years ago (football) in my late forties. Back then there was nothing like your blog on line to provide information and support. I kept a detailed ‘leg log’ myself for several months; so much happens; so many ‘firsts’ to record.
    I have no pain today, just the constant different ‘feel’ to the metallised leg, and an area of numbness around the knee.
    I have wrestled with the question of nail removal ever since. The consultant who inserted the nail advised removal after 18 months as part of the deal. A different consultant later advised leaving it in as no pain and ‘maybe get it done with your hip later in life’ (nice bit of black humour, cheers feller!). There is the lurking fear of impact injury – I remain active e.g. cycling, running. And the thought of having a ‘normal’, titanium-free leg again. But on the other hand, I can read from your blog that while many were pleased with the results, some were not.
    I will be interested to see the results of your survey, which I just completed. Especially with regard to nail removal. I’m glad for you and everyone else who made good recoveries, and wish the very best for those injured and still recovering now. Cheers, Alan.

  • Julia B

    This blog has helped me so much in my recovery process. I fell down the stairs and fractured my fibula/tibia right above my ankle. Since I have three little ones, the doc recommended the IM rod/screws to get me on my feet fast. It’s been almost 3 weeks and I am full weight bearing and using a cane with the walking cam boot. I seem to be healing well but it really hurts bad after I move about at home.
    Is this soreness normal? Also, have you experienced throbbing knee pain after bending it too quickly?
    My other question is psychological – I’ve noticed that I get bent a little sideways when my family teases me about “being a wimp” or “faking” the pain. Usually, I’m able to throw back some snide comment. It’s all playful banter but lately it just gets me down. Anyone else experiencing that unpleasant impatient/disappointed feeling?

    • Karen

      Oh yes, I am 6 weeks post op and have some real ups and downs this blog has been great but also challenging as so many people seem to progress much faster.
      Psychologically the inability to do so many things at the rate I used to has been hard and I do think once you start back to doing the cooking washing etc everyone thinks that’s it all back to normal and let’s you get on with it, despite how sore you may be. I have found some days good and can get plenty done but wiped out next day.
      I also seem to have arthritis in my knee which has been swelling up on a regular basis and just this week got over that and the ok to start using one crutch and free up a hand, when my back has truly packed in. Again I think this is from using the one crutch and despite intense concentration probably walking crookedly however today has been spent enforced sitting on hard chairs and packing hot water bottles round my back and thinking how this is holding me back now I finally got the go ahead to start exercising a bit. I would nearly venture the back pain is worse than the IM leg was post op. Hopefully a couple of days and I can start again with one crutch walking.

  • David

    Had my nail and screws taken out 1 week ago today, approx 20 months after the initial break. The op to remove the nail didn’t go as well as planned, and the 30 min planned op turned into over 2 hrs as they really struggled to get the thing out!! Still feeling really tender in the knee and ankle atm, but i can put all my weight on the leg, and hobble around without too much severe pain. Get the staples out next week……hoping the healing process goes well after this and I go from strength to strengh!!
    All the best to all 🙂

  • Cheymus McNulty

    Hey jake,

    You are right, I have been in hospital in South Korea for 5 days with my phone looking for some reasonable realistic storylines to follow and yours was by far the most detailed and personal. Thank-you very much for taking the time. I’m 4 days past surgery and have actually experienced very little pain so far which I am grateful for. I broke the tibia in one spot and the fibula in two in a motorcycle accident. Our IM nails look identical. So thanks again.

  • Christine

    I spiral fractured my tibia and fibula on Oct 27. 2014. Today is Dec 15 2014. I am 7 weeks post op with nail. I am 90 percent healed at fracture site. Amazing. I started physio 2 weeks post op which besides this blog has been my only guide to healing. I can walk without crutches. BUT physio recommends staying on one crutch to ensure less limping.
    When I left the hospital the day after surgery the Surgeon said weight bearing as tolerated so I put weight on when I could. When I got staples out 10 days later a different Dr said feather weight bearing. I found the two opinions frustrating. But was somewhere in the middle.
    I got a bike at home to work on rehabbing. I am doing 20 minutes of walking in doors 3 times a day. Stairs are tricky for me as I live in a bungalow so cant practice. How Jake did 7 flights with crutches and during recovery still amazes me.
    I have a baby who will turn 6 months next week and needing so much help to look after her for the first 4 weeks was so upsetting but I am so great full for everyone in my life. My 6 year olds only Christmas wish is for me to walk I am making that happen.

  • Weiwei

    Thanks for sharing. I broke my tibia/fabia bone on jan 11th 2015 with a spiral fracture. I had the rod inserted the next day. I am allowed to put weight on my bad leg 2 weeks after the surgery with a boot to protect my ankle. I have a fracture on my ankle as well. At 5 weeks I was allowed to not use my boot. In the Very beginning both my kneel and ankle r very stiff and felt sore with muscles. It slowly gets better and at week 7 i am able to walk around although with a limp and my ankle is still having limited range and felt sore when doing toe stand. I am doing PT right now. It does help me to bring the muscle back and reactive them. I was told whenever there is a trauma. The music shutdown automatically and rehab will help to get them back. My kneel also felt sore when I bent it all the way. Otherwise it is fine except felt a bit weak. Don’t know if I will have sustained knee pain in the future. It was said 75% of this surgery will result in long term kneel problem. I have confidence that it will get better day by day after reading all the posts here and hope everybody who has the surgery having a smooth recovery. Every one’s pain will be different but it will get better.

  • Amanda ratcliffe

    Hi , I was net rested to see that some people have had all the screws out but left the rod in place , my surgeon told me this was not possible as most of my pain comes from the large screw under my knee and trouble with a lower one rubbing on the post tibial tendon . I need to ask again .make sure you strengthen the posterior tibial tendon right away with toe raises as mine is giving me trouble 3 years on . Hope everyone keeps healing well and keep your spirits up you new starters , although my tendon is sore now I have had some great walking this last summer .

  • Sharmistha

    I had a similar fracture and underwent IM nailing in my tibia, I’d been told it would take a year to heal at max, but its been 2 years now and my leg still feels weird. For instance, a soft clicking sound and a strange feeling of something moving inside my leg, on plantar flexion of the ankle. They’re more annoying and remind me of a time I wish to forget, than painful or debilitating, so I try not to complain. Anyway, thanks for writing about your #, it was nice knowing that I’m not the only one 🙂

  • RobbieD

    One week post op IM Tibial nail – glad to have discovered this blog and can see some light at the end of the tunnel ……….but boy ,what a long tunnel it is eh? Thanks Jake and others for sharing. Speedy recovery everyone.

  • fgal

    Thanks a lot Jake for sharing your experience here. Last Sunday I had a trail running accident and broke my tibia and fibula, on Monday I had an IM nailing done. Reading your story gives me an idea of what I will be going through and a lot of hope. Thank you very much 🙂

    • Angela

      Thank you so much for your blog posts about the IM nail recovery Jake. I only wish I had found it sooner. I am 9 weeks post fall off my son’s pretend snowboard. At 40 I guess I should have know better, but I had been feeling fabulous so… anyway now not so much. Very little information given pre or post IM nail surgery. I was just in so much shock I was just like – fix me. Like someone else mentioned I had no idea how this would affect my life at the time. I immediately knew it was broken … the wiggly feeling at the end of my leg and just figured I’d have a cast in for 6 weeks or so. How wring I was. Anyway I feel like so far my recovery has been pretty textbook comparing my story to yours and based on what the surgeon and PT have been saying. 9 weeks out and I can walk unassisted, but tend to use at least one crutch because otherwise I limp too much. Trying to build up strength and flexibility now in physio. With my injury although they had sent me home from hospital initially without an air cast – they put one on 10 days post op when owner back to get the staples removed and they xrayed again and found out I also had an ankle fracture. So no weight bearing at all for 6 weeks. The past 3 I have seen a tremendous improvement and for that I am greatful. But a few weeks ago I could barely bend my knee at all or straighten it and now (with much pain and difficulty) I can bend it quite a bit. Curious to know about the screw removal and improvement to pain. How do you know if the crews are what is causing your pain?! My knee and ankle pain is not right on top of the screws but more nearby ish. My surgeon is if the opinion all hardware will stay in. It does make energies of reinjury. Thank you again for your humorous and inspirational blog. I look forward to further recovery over the next year.

  • Jon Hallett

    Hey Jake,
    Thanks very much for this write up. I’m currently 4 weeks post op, and I’m not going to lie, I’m a little more worried about this recovery now. I was really hoping for the 6 to 8 weeks and be back to normal. I didn’t get the cast off until 2 weeks post op and was still told no weight on the left leg (the bad one). I am very anxious to get back to work as I am part of a 3 man utility crew and I’m left feeling guilty that I’m not there for them. My injury cam from falling between ladder rungs doing my own home renovations the first day of vacation that I took.
    It has been nice the last couple of weeks being able to shower semi-normally with a chair in the shower stall and being able to have full range of my knee and be able to scratch my ankle if need be, but I thought I would be further along in my recovery than I am. I feel better about my progress after reading your story. I wasn’t really given any information from my surgeon post op, or if he had I was too messed up on the painkillers to recollect, and have yet to see him still. I’ll see him in about a week and a half from now and I now have many more questions for him than before I read your blog.
    Now it seems like I’m just rambling on but i’m now prepared to adjust the the fact that I’m going to be invested in this recovery for a lot longer than I thought I was going to be. Thanks again for this fabulous blog. Keep us updated on whether or not you have the hardware removed or not.


  • Erin Stephanie MacDonald

    Hi Jake, I just wanted to say thank you for sharing your story. I am 4 years post op – my leg looks very similar to yours! (although not hairy!!) I think you are a year ahead of me in recovery, but I’ve been following your posts since I broke my leg. I broke my leg in a soccer game in 2012 and had a compound fracture and needed an IM nail inserted. The only limitations that I find with my leg, is that I can’t kneel without stabbing pain (but this has gotten better over the years), and when it comes to long distance running, I also experience shin-splints, mostly in my ‘good leg’. Which I’ve determined means that I will never be a long distance runner – although, I was never really a fan of long distance runs. On the plus side!!! I am in better physical shape than I was before my accident. I’ve focused more on weight training. And I was back playing soccer 1 year after my accident! I couldn’t not give up soccer, it’s my sport! Again, I just want to thank you for all the support you’ve unknowingly provided me over the years – and I wish you all the best in the future. Please keep updating your site!! I am curious as to if you get the rod removed – myself, I am very hesitant – it would mean more surgery. My surgeon is also of the feeling that if its not bothering me – we can leave it in forever..Take care!

  • Mark “Jazmarc” W

    Hi Jake, Thanks for the blog. You’re right there’s not much out there for non-medical types recovering from IM nail surgery. I’m a 6′ 178lb 57yo male who went through the IM nail procedure in Fall 2009. Took me about 6 months to recover from the surgery. Prior to surgery I weight lifted and ran short distances. Post surgery I resumed weight lifting and couldn’t run without knee pain. Currently I can’t run and walking has become painful as shin and knee pain are intolerable without taking daily Tylenol. Wondering if there are other older folks suffering with similar issues. My surgeon recommended leaving my nail in. Hope you are well.

  • Kara

    Hi – I had some locking screws taken out in March. I’m still having issues and wondered if anyone has had the same issues. All I can describe this is as restless leg – or rather restless from the knees to the ankle. I cannot get any comfort. Nothing eases things. To move my leg eases the feeling of restlessness slightly but then when it stops moving things feel worse. Cocodamol was working and easing things, but even this has stopped working. I’m 9 months post op for the initial surgery and 2 months post op having the screws taken out. Thanks.

  • HB

    Thanks for sharing your recovery journey, I’ve just read through all of it. I’ve had a tibia and fibula fracture, and got an IM nail two weeks ago. It seems like such a long way to go, and with so many potential problems along the way, I’m having some difficulty keeping a cool head about it. My doctor said I cannot bear any weight on my leg for 6 weeks, which makes doing everything so much harder. I’ve been trying to continue to work from home, but it seems this will have such a long term impact on my life that it’s overwhelming at times.

  • sattersley

    Hi Everyone: I am 3 years+ since my tibia IM nail. This blog has been the best source of information. Thanks Jake and all who have contributed. My leg had been perfect since the surgery in April 2013, until last summer when during a post-workout stretch I felt a sharp pain where the upper locking screw goes thru the nail close to the knee. It stopped as soon as I relaxed. A few days later there was bruising in the area, and a few weeks later, that upper screw started backing out. Now it sticks out about 20 mm. I’ve just seen the surgeon and the screw will be removed – just in clinic under local anaesthetic. I am curious to hear if anyone else has had the top screw removed and if there were any problems experienced.

    • Peter Gaughran


      I had my bottom two screws removed under local as I don’t react well to general; it was a very strange experience! I must say it made all the difference though – well worth doing!

      I did get to see the screws afterwards too. They wouldn’t let me keep them, but the sight was enough for me…

  • Gary

    Hope everyone reading this is healing well and the best of wishes to you all! This article and the comments section has been the most informative information I’ve been able to find after trawling the web and landing on very vague NHS sites. I’m currently just after week two of a pretty extensive open fracture of the Fibula and multiple fractures/shattered Tibia. Mine was caused by a motorcycle accident out in Germany. I got hit by a black BMW and landed myself in to a barrier. Safe to say I’ve actually come out of this quite lucky. I had the Rod inserted and also my Fibula plated. After recieving German healthcare and a free helicopter ride which was all very stereotypical (quick, efficient and clean). My leg looks really good already. Some minor swelling along my kneecap and ankle although all the bruising has subsided and I have more little aches than actual pain. Something I have tried is the Hyberbaric oxygen chambers. Most of them seem to be charity run and relatively cheap. My local one which doubles up for an MS clinic costs just £10 a session. The idea is that you are put in to a sealed unit that is pressurised and fed pure oxygen which increases the amount of Oxygen and plasma in your system to promote bone growth and general recovery. I’m sure there is a more scientific definition but that is as far as my C grade science GCSE will get you. Importantly I have heard very good things with people claiming very good recovery times although I am always swayed to the more skeptical side. If anyone else is doing similar or are interested I will gladly keep up to date on this feed and let you know how I progress. After two weeks I am already happy with the progress although I am not sure if this is through Oxygen therapy or just the Germans doing a great job? P.S if you get a broken leg in Germany they actually give massages not just for injured areas, I had a neck massage in hospital!! Only advice is bring a packed lunch if you plan to hurt yourself abroad. The food is diabolical

  • Deborah

    Had my nail put in back in 2007. I was having pain for years where the screws were, so my dr just pulled them out a couple weeks ago. I haven’t felt this normal in years. Surgery took about 30 minutes, the screws had welded to the rod, but he was able to extract them without breaking them (or me). There was a good amount of bruising and it was a little difficult to get around for a few days, but no regrets. So glad to have had it done. Wouldn’t have tried if I hadn’t seen others posting about getting their nails removed, so thanks to everyone for the encouragement. I hope the ones just getting theirs find hope here, and know they’ll be getting back to normal in no time.

  • William Mark Woodland

    Had my nail removed from the right tibia on August 25th. (Initially broke the leg 2009) Has taken me about 6 weeks to fully recover though I was back to work limping a bit after a week. Only took narcotics for pain 3 days postop. Used gabapentin and tylenol for maybe a week beyond that. 6 week follow up visit the doc gave me a cortisone injection in the right knee for general pain issues. Knee feels wonderful! Pain associated with the nail is gone! Very pleased with the removal procedure and would encourage others who have had years of postop IM nail pain to consider getting the hardware removed. I’m in the US and had fulfilled my deductible for the current year, meaning the surgery bill was over 80% covered. Otherwise I couldn’t have afforded it. Interested in hearing others experiences. Wonderful site, Thanks Jake!

  • Tracy Grant

    Hi happy to have come upon this blog, thanks Jake. I broke my Tib Fib May 21 the 24 weekend..falling with ankle twisted in drain grate, open fracture, I had surgery the same night, placed IM nail with the 2 screws under knee, just like you, and 3 in ankle, well just had 3 screws out on the 18th 2 in knee and the locking screw. The surgeon said I could walk rite away, I have been trying but I still have to use crutches, just 1 but can’t seem to bend leg while walking…I have been keeping busy doing housework and such, but now the nail seems to be bothering me, and feel tightness , like I have a bungie cord around ankle where the other 2 screws are… I really hope I don’t have to go thru removal again, this has been quite the unexpected challenge ever, I feel for all and hope all get well… and sorry for the long post, feeling disappointed.

  • Louise

    Hi Jake
    I was knocked off my bike 3 years ago and have the im nail and screws in knee and ankle. I was just wondering how you were doing. When I was laid up in bed I found your blog and I can’t tell you how relieved I was to find someone else out there who had gone through what I was experiencing, without wanting to sound dramatic I found the whole thing life changing and was so low for a long time. Since my accident I have returned to cycling and now do long distance swimming and I am now training for a marathon!! Would be nice to hear how you are.

  • Lisa

    Hey I have had my IM nail in tibia now since 2011.

    I still have some pain when I run, it’s cold and/or when I’ve put on weight.

    Fundamentally I feel lucky that my leg works and I’m happy and healthy. The break has changed me. But I’ve come
    To terms with it.

    • Louise

      Hi Lisa

      Like you I get the aches and definitely feel the cold now! I found my break quite traumatic and it certainly changed my perspective on a lot of things.

      Running my first marathon in 3 weeks!!

      All the best

  • Audrey

    Thanks so much for the info Jake et al. It’s March 2017 and there is still very little other info out there. I’m 9 days post op after tib/fib fracture with IM nail in the tib. I can actually hobble about without my crutches but i’m sure i’m not doing something right and i expect i will suffer for it in due course. Glad to read it gets better but scared it seems to take so long. Ive got first appointment at fracture clinic tomorrow and hoping to get staples out. Extremely frustrated by this whole thing especially my instant lack of mobility and worried my age will count against me as i’m 50 and really overweight and unfit.

    • Louise

      Hi Audrey
      I broke both bones in my lower leg in July 2013 (age 39) and this blog of Jakes was a relief to find as I couldn’t find much out there. It will feel like its taking a long time because if you are like me you want to be up and about straight away. Have you got the sexy black boot on 🙂 I had that on for nearly two months until the September and started my physio not long after that. I was signed off from physio in the March. An important piece of advice I would give is do the exercises that you are given, I did mine religiously and I really felt that that helped.
      I started cycling again in March 14 (my leg was broken by someone knocking me off my bike) and quickly lost all the weight that I had put on over the previous months. I did lots of swimming and walking too and that helped. I am now training for my first marathon which is on 2nd April (3 weeks eeek!)
      Basically there is light at the end of the tunnel, and don’t forget age is just a number. I found my whole leg break experience quite traumatic, but the main thing that I took from it is that you only get one life, live it.
      I hope your recovery goes well
      Louise xx

  • Lee

    Hi Jake.

    Just wanted to thank you for the time and effort you put into this and the information you have provided.

    I broke tib and fib in May 2016 training Jiu-Jitsu and have just passed my first anniversary. During my recovery your blog provided insight and assurance in the absence of any other information.

    My leg seems to be like yours now, just niggles. However, I have been back training since December 16 and competed for the first time since my break and managed to win gold so the leg is performing well.

    All the best,

  • Caroline Smith

    Thankyou so much for keeping this up to date – there is so little info out there and when the consultants told me I wouldn’t be standing for 3 months let alone anything else, I panicked (11 weeks and I’m back at work being a dog walker so they couldn’t have been more wrong!). Anyway, it was so reassuring to know that eventually life would be ok! So thankyou again x

  • Neil

    Dear All

    As has been said many times above there is (still) very little information available about what to expect and what works so this blog remains a valuable resource years after its inception. Thank you.

    I’m a 59 year old very keen cyclist and broke my Tibia and Fibula when I fell off on the last lap of a cyclocross race in mid-July. The Tibial fracture was spiral and about a third of the way up from the ankle. I’m now 12 days post insertion of the I’m nail.

    Things I’ve noticed so far:

    I was told I was fully weight bearing as pain allows imediately post-op. It’s very intersting how advice on when to weight bear seems to vary.

    Indoors I walk (or hobble) without any assistance but if I go out I use crutches and don’t weight-bear. It feels like good exercise but is very tiring and really hurts my hands

    I have marked swelling which is better after a night in bed but quickly comes back once I get up. Elevating my leg ought to help but I find it makes the pain worse.

    The worst pain comes in bed at night. I’m using Ibuprofen and Paracetamol having tried one dose of Oromorph in hospital without any benefit.

    Prior to the accident I was quite flexible. Now my ankle is very stiff and I have odd sensations behind my knee when I try to fully extend my leg. I’m really trying to remobilise the ankle but don’t seem to be progressing which is a worry. I’ve not yet been offered any physio.

    Five days after the op I did ten minutes on the Turbo-trainer and have built up to 30 minutes a day. My broken leg is a “passenger” but it’s good for my other leg, my heart and my mental health!

    Most of my friends seem to think I’m overdoing it but who knows?

    I’ll try to update once I’ve had my OPA appointment at the end of August

    One final observation; my experience feels like a good example of chaos theory. One loss of traction between my tyre and the ground and my life is completely disrupted for weeks and months if not years.

    • Jake from Finland

      Hi Neil,

      Very sorry to hear your about your accident. I’m just over two years from my accident when my first feeling was that if I could turn back time 10 seconds to avoid this… Very much relating to your chaos theory thinking.

      Yes, unfortunately you are quite right this will likely take months or even years to recover but at the same time you could develop mental strength but I know that is not helping much at this stage of basically a great shock.

      My break was also spiral and also third proximal. I was told no weight bear for four weeks, then about half for next four weeks and then full after that but all the time with help of crutches. Just one four weeks sounded like eternity in the beginning but time will pass if you just let it to.

      Anyhow if you are now at 12 days, the worst is over, now its about to take it easy and let the bone get better and it will take time. One thing I would get rid of is the ibuprofen as it blocks the bodys internal inflammation which is part of the healing process. Biggest pains will likely ease in the coming days anyhow or if not ask for some other additional medicine.

      I was also early on trying to hobble with the crutches but I think that was just mental help in the end that I could somehow go out. As you are cyclist I would suggest to buy an indoor bike but take it very easy for the first many weeks: this should be not at all about the cardio or muscles but just rolling motion to keep your ankle and knee moving and that helping also to reduce the swelling process (which is the body’s natural casting process). The natural motion of the ankle is the pump for the internal fluids. When I said in my first 6 weeks check that I was doing this biking they said that definitely yet at this stage – let you bone heal… So I left it for few weeks a bit scared.

      Also this is not the time to get fit by using the broken leg, its all about getting that into good condition and it will happen, you are definitely not too old for that: the complete skeleton is fully replaced maybe every 5-10 years so if you let it heal it will be in about 18 months 99% same as it was before (you will not notice any difference anymore then).

      However the metalwork in your body will be different to what you had before the accident, please ready my post earlier in this thread when I had my HW removed in this January just 18 months after my accident to get my opinion on the fact. The sensation of stiff ankle and odd knee never went away with me as long as I had the nail and the screws: they are very much needed in the healing process but can be bothersome afterwards. At least I would very much encourage to take the screws out when ready.

      I did not do any guided physio but you should very much do some one your own and do try to listen to your body and understand and believe what it is telling you, so are you doing enough or too much.

      But as said don’t worry too much about the flexibility or muscles but just about the bone that you need to have in order. In addition to avoiding anti-immaflatory painkillers (ibuprofen) I used supplement of calcium, magnesium, zinc, C and D vitamin as well as K2 vitamin. These all are very inexpensive and maybe we get all that is needed from the food (except maybe K2) but I took those just in case. Also the best source of D vitamin is still available (sun) so take that during the mid-day if you can, I felt helped me mentally as well as this is quite difficult injury from the mental aspect as well.

      Take care and good recovery!


    • Mark Stangl

      Feb 2016 I was hit by a snowboarder after a full day of skiing. Spiral Fracture of my tib and fib. Got the IM rod and plate. It took an ultrasonic gadget to finalize healing of the large 10 mm gap in my tib. After 8 months it was on its way. I started cycling after 3 months with leg protection. At 10 months I started skiing, hiking, and racquet ball back up. Now at 17 months, I am beginning to feel some leg pain when the weather changes and headed for surgery to have a screw removed from the rod at the ankle due to irritation from kayaking straps. After 2 months I found one of the 2 screws near my knee had broken in the IM rod. I will be 65 in 2 days. My friends tell me my lymphatic system needs some help. Do what you can and remember that does not kill you makes you stronger.

  • Mark Stangl

    Feb 2016 I was hit by a snowboarder after a full day of skiing. Spiral Fracture of my tib and fib. Got the IM rod and plate. It took an ultrasonic gadget to finalize healing of the large 10 mm gap in my fib. After 8 months it was on its way. I started cycling after 3 months with leg protection. At 10 months I started skiing, hiking, and racquet ball back up. Now at 17 months, I am begging to feel some leg pain when the weather changes and headed for surgery to have a screw removed from the rod at the ankle due to irritation from kayaking straps. I will be 65 in 2 days.

  • Neil

    Dear Jake from Finland, thanks for your response and advice.

    Interesting information re the NSAI’s and their effect on bone union. I’m not sure I could manage without them at the moment as I’m not willing to take opiates but I’ll try to keep the dose as low as possible.

    Interesting too that your experience was that the stiffness didn’t resolve until screws were removed. I couldn’t find your previous “HW” post unfortunately. I’ll keep trying to mobilise my ankle; it’s early days yet but if it continues to deteriorate I’ll have to discuss what needs to be done.

    I had another thought. If this process we’re all going through feels traumatic then imagine what a similar injury sustained 100 years ago would have meant, or if we lived in less developed societies. Pain, disability, loss of income, amputation? We are so lucky to have access to such sophisticated treatments.

  • Karl Aylett

    I just wanted to say thank you I had a motorcycle accident 18 months ago and reading your blog really helped me,
    I broke tib and fib and have an im nail I was lucky had a good surgeon and a job that was supportive ,im now running again and for the most part don’t notice my leg … if this is just happening to you be brave stay positive and eventually things do get better ….. good luck new I’m nailers and thanks again

  • Fiona Watson

    Re my earlier comment – I too am self employed and am looking likely to go under very shortly – single parent and self employed childminder.

  • Renata Peret

    Dear Jake,

    I’m happy to hear that you feel better and better every time you PST something!
    Also thank youuuuuu for sharing!

    It’s such a shock event in your life!!!

    I had an accident 1month ago and broke also tibia fibula and ankle…

    So also have nail and some screws!

    Crutches are my best friend and can’t really put any weight on the leg still for at least another 4 weeks!!

    But getting there I hope!!!!

    Very happy to have read your memory and think you are a star!!!!!

    Many thanks!!!

    Renny xxx

    • Renata Peret

      Big thank you for everyone to share too!!!!
      Sorry I’m not great with blogs and didn’t notice everyone ‘s comments!!!!
      And thank you!

  • Steve

    I just hit my year anniversary. I’ve been back in the gym since May doing leg press and other exercises. So far no trouble putting up 400lbs. I still have symptoms of the injury but none that prevent normal day to day living. I don’t run much anymore. But probably could if I wanted to. Hardware still in for now. Knee is more problematic than the break area. Although if I push around three break area I’ll feel something. All in all, any nerve damage will take time..the area where they put through nail had some numbness which is still there but not noticeable unless touched.

  • Stuart Smith

    Hello Jake,
    Just a quick note to say how I enjoyed your blog. I just came across it agin after organising my bookmarks. I broke my pelvis/femur in a MTB accident while riding the South Downs above Brighton 3 years ago. I was riding solo and it took emergency services 1-1/2 hours to get to me, I’ll never forget the whole experience, the NHS were amazing and I’ve been back to the hospital ward on each anniversary to thank them. I remember coming across your blog while in recovery at home, thank you. I’m pain free except for an occasional minor niggle every couple months, just a friendly reminder telling me it’s still in there!
    I’m absolutely fine and have ridden thousands of miles since the accident!

  • Neil

    Dear all

    I posted some observations in July, two weeks after nail insertion for a distal spiral tibial fracture after falling from my cyclocross bike. I’m now over three months post-op so I’m posting an update. I expect someone else has reported similar experiences so please forgive any repetition!

    At five days I did ten minutes on a turbo-trainer in the garage and quickly built up to between half an hour and three quarters of an hour a day. I don’t know if it helped my physical recovery but it was good for my head!

    At two weeks I stopped using the crutches. My physio later said that it was important to try to walk with as normal a gait as possible so that may not have been wise.

    At four weeks I rode for 5 minutes on a quiet road on my proper bike and since then I’ve been riding five times a week. For a while I used a normal flat pedal on the broken side so that I didn’t need to twist my leg to put my foot down. I’m right handed and broke my right leg so I only put my bad foot down at the end of the ride. My biggest fear was of a dog chasing me and sinking its teeth into my calf! I haven’t had the courage to ride off-road yet.

    My physio has been very helpful in suggesting how to improve mobility in my ankle and knee. She seemed more concerned about the swelling though. At about eight weeks she decided to massage my leg to try to reduce the swelling. This caused the pain to be a lot worse for the following weeks and my daily hour dog walk became very difficult. Her suggestion of 10 minutes a day in a yoga position where your backside is against the wall with your legs vertically upward has been much more successful.

    At six weeks the X-ray showed no sign of healing. A friend did an ultrasound which showed some progress and at 12 weeks the next x-ray showed that it was “progressing to union”. Interestingly the ultrasound also showed that my patellar tendon on the “bad” side was twice as thick as the good one. I since learned that they cut through it to insert the nail. I hope it doesn’t cause the anterior knee pain (akp) that would be an issue for me as a cyclist. The good news is that akp goes away after 8 years!

    So now at 14 weeks I’m feeling okay. I can walk for two hours, walk on tip-toe, cycle for three hours and quite often suddenly notice that I haven’t thought about my leg for half an hour.

    One final thought; buying old man’s loose-topped socks was a good move. They don’t trap the fluid that leads to the swelling that then leads to pain. I’m more fashionable but much less comfortable in normal elastcated socks.

    Good luck to everyone for their own recovery.

  • JP

    Update one and a half years after my IM nail surgery. Had a motorcycle crash, and did a nasty spiral fracture of the tibia and fibula, also broke part of the bottom tibial joint (adding a couple more screws for good measure), and some bruising on the tendons on the back of my knee.
    I’m functioning pretty normally now, and do all sorts of sports, but still have some pain when running. Doc at the time said that it would be one year until I would walk normally, and two years until running normally. I thought I’d beat that easily, but despite training hard and being stubborn, seems like he was spot on on his prediction.
    All the hardware is still in, might remove the top screw at some point, as it sticks out quite a bit, the others I can’t even feel them.
    For everyone that is still recovering, good luck! It’s not easy but things will heal!

  • Mikey Turner

    Broke my tib and fib with a further 12 seperate fractures i think it was 4 years ago roughly. Worst experience of my life injury wise, operation and recovery, operation went well after 5 hours in surgery. Recovery i pretty much couldnt move out of bed for 3 weeks, didnt sleep much atall for the first week. I feel for anybody who has experienced this injury. 4 years down the line i get a fair bit of bother with my knee, just today i walked into the wheel barrow as i left it in a silly place, right on the screw below my knee, swollen and painfull now. I have been considering have the rod and screws for a while now but my dr says its not worth the recovery again. Very interested to see and read about recovery for this proces.

    • Mikey Turner

      Full recovery was 2 years fully healed break wise, getting back on my feet properly was 8 months i was able to walk without walking aids completly. Football injury, have played again since but id say about 5 games since the injury. I am able to run and play still but my leg is very sensitive not so much weak but just not even close to being how it used to be, something is just not quite the same

    • JP

      I had the screw near my knee removed, as it was the only one bothering me. It stuck out quite a bit, and I suspected it was linked to me having pain in my hamstrings. Still have 4 in other places. Won’t touch the nail.
      For just one screw removed the recovery was of course infinitely easier than the first surgery, although not as easy as I thought. It has been taking a while for the knee to heal and adapt to the changes in the area. The hamstring pain has improved a lot, but still not completely gone. I had some knee pain when running, which seems to have moved to another place in the knee but is still there. Things seems to still be improving, slowly.

  • Estelle

    I’ve been reading your blogs since the day after I broke my tib and fib 6 months ago, started in the few days was in hospital awaiting rods. It’s 6 months this week since my op so have been reading your 6 month blog…. wishing I’d written this be now. Well here’s my story…. broke mine changing the bed sheets! Dramatic I know lol. Spiral fracture , was in hospital 4 days before they operated and a further 2 weeks after, suffered DVT whilst in there too. Didn’t feel very confident with treatment but had nothing to compare it with. 2 days after discharge one of wounds on my ankle began opening this continued for months, eventually resulting in a hole where you could see the screw and bone also getting infected, was seeing nurse daily at this point. Ended up deciding to remove one of the screws in November going in through the open wound and attempting to close it again. Pain and infection continued so decision was taken to remove all metal work in December 3rd operation and another week in hospital. At this point my consultant retired so in January I met my new consultant. On my first visit to him he looked at my leg and X-rays and wounds and looked shocked! He ordered an emergency MRI results were back within a week and I’ve now been diagnosed with osteomyelitis and awaiting yet another operation at oxford bone infection unit to hopefully cure this. To say the last 6 months has been tough is putting it mildly. I did manage to return to work on a phased return last week but finding it hard going but determined to stick at it as financial situation requires it and aware of impending op and don’t yet know what that will entail as appointment is with 3 consultants an orthapaedic surgeon, bone infection consultant and plastic surgeon where they will decide together on treatment. Needless to say changing the bedsheets is now a ‘blue job’ in my household…… every cloud and all that lol

    • Michael

      Hi Estelle, I’m sorry to hear about your story. I hope you are feeling better now and recovering. I just got diagnosed with osteomyelitis too in the lower leg, two months after an IM nail surgery. I’m now due for another surgery in under two weeks to remove the infected tissues. How’s the recovery been for you recently?

  • Lynsey Ellis

    Fantastic blog Jake! My hubby did same thing in Jan this year, 2018, and also has been treated at st George’s! He too broke both bones, and has the rod, though has to have a second op which we are waiting for next! Great insight into what’s to come, hope u r well now

  • Gyana

    It is now 2018 and still your blog was the only relevant thing i could find! I broke my tib/fib 2 years ago and just had the nail removed 4 days ago. My physician in Germany presented the nail removal as the only sane option for someone still relatively young (32 y.o.) so i got it out. Can’t really say what i think about it. The leg is fairly painful 4 days post op. I Can hobble on it without crutches. Although i still use the crutches around the house as i walk quite stiff legged. I’m somehow disappointed that the recovery time seems to be quite involved. I had thought within a few days i will be walking normal with a few bandaids on the leg. But the reality is it will probably be several weeks like this and then again time to train the leg again.


    Great blog post Jake I came across it on the hunt for information post op. I’m 5 years post-op, and just now experiencing new pain. Looks like we experienced our tib-fib fractures in exactly the same spot…Do you still get pain near the original break site? I’ve been contemplating going to see my ortho. Hope you’re well!

  • Luciferxxx

    This is amazing i wish u all the best. Thank you for sharing this.

  • Steve Winmill

    WOW so similar I’m still in recovery 6 months on still not back to work (self-employed as well) but am due to have one of the screws removed from just below my knee as it protrudes about 1cm out. (you’ll know where I’m on about) mine was a work place accident though but the financial strain is a joke so was really helpful reading you’re posts as I fell like you represented the experience very well thank you

  • Audrey Gray

    Hi again folks.

    It’s now June 2018 and just over 15 months since I broke my tib/fib and became closely acquainted with an IM nail. It’s so disappointing to see that Jake’s blog (the best!) is still one of the very few sources of post-op information available.

    Everything is still in place and as I’ve more or less recovered pain-wise from my op, I’m not currently considering removal of any metalwork – I don’t want to tempt fate and end up worse off – especially as I had some pretty bad knee pain around 4-6 months post-op where they cut my patellar tendon to access the top of my tibia and I definitely don’t want to go through that again – tears to a glass eye!

    I still guard my leg on uneven or slippy ground and I’m scared of walking on ice or in the snow. I can’t kneel on that knee on any kind of hard surface, including carpet, but I can kneel on the mattress on my bed.

    I’m doing a 12.5 mile charity walk in Edinburgh in just under 4 weeks and I’ve starting doing long walks (up to 6 miles now) to build up to that distance. However, I’m starting get discomfort, sometimes turning to pain over the join of my ankle to my leg and guess where else? under my knee just to the inside of the knee. Is anybody walking 6 miles or more? Would some sort of knee support/brace/bandage help?

    Grateful for any thoughts/advice etc.

    And for those further behind in the recovery process – hang in there – it absolutely gets better but don’t expect to much too soon. My OH GP at work said it can take 18 months or more to fully recover from a nasty break with an IM nail – and I agree with that for me.

    Thanks again Jake for the updates – I don’t know what I would have done without them during what was a very scary time in my life.


    • Jarkko Elonen

      Hi Audrey,

      Just read your comment and I can totally relate to your feelings just over one year from accident. Anyhow I got all of my metalwork removed at 18 months, just because of the slight discomfort that I knew would last like for years to come. If you haven’t please read from earlier in this blog my feelings (JakeFinn) right after the removal. Now at three years of which 1.5y with and then 1.5y without metalwork I can say that my leg is now 99.5% what it used to be – I’m not avoiding or overly cautious of it anymore in any situation, I can kneel on it even on hard surface (like wood or tile), it does not feel “heavy” or somehow awkward at all. And I know all the metal that could release particles inside my body are away and gone. I don’t get _any_ discomfort on my knee or ankle anymore even after 20km of walking or exercise actually planning to do 100km hike in the autumn with backpacks over four days in wilderness (Finnish Lapland).

      My knee pain after removal was very minor compared to what it was originally (I did stretch my knee before second op knowing it would be displaced) so I would not worry that. The biggest pain was the stitches before removal at two weeks which are annoying but not major things as you know they will heal. None of us wants to have unnecessary operations but to my experience the removal was one of my best decisions related to my health and body and knowing the outcome, which I only hoped for in the beginning, I would do it in a heart beat again. Off course I don’t know how good I would feel at 3 years without the removal but I seriously doubt that I would be this good.

      Hope this helps at least a bit.

      Br, JakeFinn

  • Wendy Paine

    Hi all… great blog, and fab comments….
    I am 6 weeks post op, I have an IM nail in my right tibia, but also have a plated ankle/fibula for a displaced fracture on my left …

    I’ve been taking solace that this isn’t the end of the road… but wondering if anyone has done both before… I still cannot “hop” on crutches and the left in NWB currently and the right with the IMN cannot really cope..

    Would love to hear thoughts on Physio and rehab, currently I’m under NHS Physio but am thinking of going private as I have so far to go and need so much help…

    • H B

      I don’t have any silver bullets for you Wendy, but just want to say that although it seems like a long road, you’ll get to the end eventually. The worse is already gone by. I was told by my doctor that it would be 1 year until I would walk normally, and 2 years until I could run, and although I tried with all my might (I’m fit and stubborn), I could not beat his predictions. Slow and steady wins the race here.

  • Shiv

    Thanks so much for this blog Jake! I am 38 yrs old and currently ten days post IM insertion. Doing well considering everything but glad to read your story!

  • Cindy Smith

    3 years later I am in pain. Knee hurts, toes are numb. I just don’t know what to do. I appreciate your blog, not much out there.

  • Lily

    Hi, I’ve found your blog on your I’m nail so interesting and useful as I managed to break my tib, fib and 2 bones in my ankle about 8 weeks ago! I was in a cast for 6 weeks because of the ankle so have been walking about on crutches with a boot for about 2! Like you I’ve found very little info and wondered when you started putting more weight through your broken leg could you really feel a sharp but bearable pain in your shin and if so did you plough on through?

  • Laura

    Jake – I realize I am late to *your* party, but I am only 5 weeks into mine, having broken both my left tibia and left shoulder in a fall while hiking here in Canada. Your blog has been a great resource to me. I am still in quite a bit of pain, which is actually worsening this week around the lower screws in my tibia- I hope to get in to see the surgeon because after walking quite well on it the past couple of weeks I seem to have hit some kind of snag. But reading your blog gives me hope that it will all heal well in time, though perhaps more time than I had originally hoped!


  • Christine Jehlicka

    4 years ago I had a double spiral. Physiotherapist was the best ever for guide to healing. The massaged the scar over my knee at 14days post opp very gently to ensure scar didn’t attach to the knee. They challenged me every week to do more to heal. I needed to feel like I was doing something. This blog helped I read it over and over the first Two months. It was really hard I was walking carefully at just under two months but scared. I am healed. I kneel and play with my kids. My daughter was only 3 months when I broke my leg skating. Tomorrow I am getting my ankle screws out. Ail will never come out, but screws in the ankle are backing out themselves so I am still in this journey. There is light at the other side.

  • tomdstory

    Thanks forgot to tick below

  • onegracefulgirl


    I do not know if you are still active on this blog – but I wanted to say thank you for sharing your experiences! I broke my tib/fib in a very similar manner 2 weeks ago and reading of your recovery has encouraged me, and given me a laugh here and there that was much needed. There really is SO little information that is helpful!

    • Jackson

      Hope you’re doing OK Grace! (can I just call you that?)

      I broke my leg in 2016 as a 16 year old playing basketball and I am so sorry you’ve had to go through this experience, my thoughts are with you as you go about life and try to return to normality after this event.

      My words of wisdom to you are to just keep on pushing through, even when it seems so pointless because eventually, you will look back and say, “Wow, that happened, but look at how I was able to continue to go about life and persevere!”

      I also think it’s important to push yourself a bit so that you do enter into the uncomfortable stage where you can feel proud of your efforts (don’t go too crazy but try to test yourself here or there!). I think it was at about 3 months post op when I joined in my school 3km cross country running event, boot and all, and yes, some people may have said it was a bit stupid, which it probably was – I was 16 😛 – but I finished that race and I even beat several of the slower people. I was so proud of myself and that really boosted my confidence and my outlook on my situation.

      So I would highly recommend setting yourself goals (even if they’re small!) that some people may say aren’t attainable in your current state as you’re still in rehab, because you will feel so proud of your efforts and it’ll be extremely beneficial to your outlook!

      Keep on pushing! You’ve got all these people here in the same boat so if you ever have any questions just ask!

      Jackson 🙂

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