# Anyone come back from surgically repaired hip fracture?



## BarryG (Jul 5, 2004)

Would appreciate hearing from anyone else who went through this. Had surgery on a hip fracture 4 weeks ago with a pin/plate/screws inserted. Doing well, but can't flex my knee worth a darn (muscle tightness). Therapist & I work hard each session and get it just past 90 degrees and then it stiffens up again right after. My specific question to anyone who has gone through this - should I just wait another few weeks for the incision cut into the muscle to heal? Will the stiffness go away as part of the healing?

I'm hoping to get on the trainer soon using crank shorteners. Not sure if I should push it or just chill for a few weeks and let it heal more. The knee flexing muscles are just so tight and I really haven't noticed them getting any looser since the surgery.

Knowledgeable advice appreciated,
Barry


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## BikeRider (Aug 5, 2003)

BarryG said:


> Would appreciate hearing from anyone else who went through this. Had surgery on a hip fracture 4 weeks ago with a pin/plate/screws inserted. Doing well, but can't flex my knee worth a darn (muscle tightness). Therapist & I work hard each session and get it just past 90 degrees and then it stiffens up again right after. My specific question to anyone who has gone through this - should I just wait another few weeks for the incision cut into the muscle to heal? Will the stiffness go away as part of the healing?
> 
> I'm hoping to get on the trainer soon using crank shorteners. Not sure if I should push it or just chill for a few weeks and let it heal more. The knee flexing muscles are just so tight and I really haven't noticed them getting any looser since the surgery.
> 
> ...


Back in 1984 I was out riding and got caught in the rain. As I took a corner my bike fell out from under me and I landed hard on my side and broke my hip. I got a bolt, plate & screws to hold it all together. I was off my bike for a month but was then able to start riding again. I remember that my muscles wouldn't hardly work one day and then after I started using them they would come right back and start working again. I don't remember there being much stiffness but its been awhile now. I remember the first couple of rides I was a little wobbly but that went away pretty soon. I've done quite a bit of riding since then, the hip doesn't present any problems.

I'd give it time for your body to heal. And keep working those muscles to get them back in shape.


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## BarryG (Jul 5, 2004)

Thanks for the comments BR and glad you recovered so well. I've got all the leg muscles back working fairly well already. It's the extreme muscle stiffness in flexing the knee that has me concerned. Perhaps someone else will be able to comment specifically on that.

Barry


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## magnolialover (Jun 2, 2004)

*A friend of mine..*



BarryG said:


> Thanks for the comments BR and glad you recovered so well. I've got all the leg muscles back working fairly well already. It's the extreme muscle stiffness in flexing the knee that has me concerned. Perhaps someone else will be able to comment specifically on that.
> 
> Barry


OK, so this might sound like a friend of a friend story... But really, this guy is a very close friend of mine.

Anyway, he dumped it hard on his downhill bike at Mt. Snow, landed on his knee, which dislocated his hip, and shot the ball back through the back of his pelvis knocking a rather large hole in it. A couple of surgeries later on, he was still on crutches for about 2 months or so. Incident happened in September. By December, he was back riding regularly again with little or no pain. By October of the following year, he had gone from being a Cat. 5 racer to a Cat. 1, so his comeback was good. I believe he had the muscle stiffness that you had as well, but let it heal, and get better first. He didn't push it, and everything came back rather fast, but if you don't let it heal, you might run into problems later on. Talk to your therapist about it first.


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## alienator (Jun 11, 2004)

BarryG said:


> Would appreciate hearing from anyone else who went through this. Had surgery on a hip fracture 4 weeks ago with a pin/plate/screws inserted. Doing well, but can't flex my knee worth a darn (muscle tightness). Therapist & I work hard each session and get it just past 90 degrees and then it stiffens up again right after. My specific question to anyone who has gone through this - should I just wait another few weeks for the incision cut into the muscle to heal? Will the stiffness go away as part of the healing?
> 
> I'm hoping to get on the trainer soon using crank shorteners. Not sure if I should push it or just chill for a few weeks and let it heal more. The knee flexing muscles are just so tight and I really haven't noticed them getting any looser since the surgery.
> 
> ...


I busted my rt. hip in 2 different spots, at the end of April (repair pic here: http://forums.roadbikereview.com/showthread.php?t=31738 ). Surgical repair of the biggest of the fractures w/ a bolt, plate, and 4 screws. No repair done to second fracture since it's placement made surgical intervention sub-optimal. After 4 days in first hospital I was transferred to rehab hospital for 4 days. Got home on Friday, started PT on Monday. Did PT thru the end of July, 3 days a week for 2 hours. Three weeks after the injury, PT had me on a stationary bike. I started riding my road bike at at 5 weeks. I was released by doc at 6 weeks, with the big break completely healed and the other fracture starting to show some ghosting in the void.

The biggest issue for me...and probably you...was muscle pain. The repair required a fair bit of muscle dissection. If you're in shape, then the dissection is more involved, leading of course to more muscle pain. 

It takes alot of work to get your muscle recruitment (in the injured leg) back to normal. The quad essentially shuts down because of the surgery. This leads to other pains and difficulties: knee pain, funky walk, pain and difficulty like you described. Best advice would be to get your therapist to be as aggressive as possible. PT will verily suck, but the payoff will be worth it. Before every PT for the first 2 months, I took two Percodan. Being able to take the edge off the pain allows a person to get more out of therapy and work a bit harder. This isn't just my view, but the opinion of the doctors I've had. If your doctor is stingy with the pain meds, then bug him until you get more. The key is to be able to work very hard in PT.

I'm now done w/ PT. My second fracture is 75-80% healed, and I'm putting about 150-200 miles a week on my road bike.

Good luck.


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## Cory (Jan 29, 2004)

*friend of mine did it 2 years ago, says he's 100%*

A friend of mine (happens to be a physician) hooked wheels with another bike and fell two years ago right in front of a hospital. He snapped the femur at the neck, and did the whole screws-and-plates repair procedure. His recovery was slow (there were some vascular issues too, I think), but he says he's back to 100 percent now. I know he's done a couple of centuries this year in about five hours, and I'm going to ride one with him in a couple of weeks--not bad for a 52-year-old guy in the Sierra Nevada.
He's a former big-college basketball player, and he was in exceptional shape when he crashed, which may have helped. His biggest obstacles apparently were mental--he's always been able to overcome problems through hard work, but a broken bone is only going to heal so fast, and he went through a period of depression about it even though he knew the medical facts. He worked really hard at his PT, and said once you start to show progress there, it gets easier to deal with. Long haul, though.


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## BarryG (Jul 5, 2004)

Really helpful to read of other's experiences. PT/muscle advice much appreciated alienator.

Thanks,
Barry


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## Endless Goods (May 25, 2004)

*Yep...*

Floyd Landis I believe...

Best of luck in your recovery- I'm sure you'll do fine


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## alienator (Jun 11, 2004)

If you want inspiration, watch any TdF coverage of Chris Horner. He busticated his hip in March (I think it was March....maybe April) and then went on to ride a bang-up Tour. I don't know the extent of his fx, but whatever it was, coming back to ride and do well in the Tour is a gutsy thing.


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## High Gear (Mar 9, 2002)

A guy that used to ride in our club crashed and broke the hip socket. He was in traction for a long time. He came back very well from that injury. Good luck.


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## 4bykn (Jan 28, 2001)

I broke my acetabulum (the socket part of the pelvis) in a bike accident about six years ago. Spent 72 days in traction in the hospital. When I got out the knee on that leg had literally not been moved for ten weeks, and would not bend at all. It took many therapy sessions to get so I could even walk. The next year I managed only 800 miles on the bike, some of them quite painful. This year I'm on track for about 5000 miles, a personal best. 
There is a member here who goes by "Hipstrong" who has had a hip replacement, who may be able to give you some additional info, do a search on him.


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## Hipstrong (Oct 20, 2004)

*Here I am...*

Hip replacement is a different deal from fracture repair, but the surgical after-effects are probably pretty similar. 

I had a total hip replacement in March, 2004. By early April I was riding again (sort of). In September I rode a century in 4:40 or so, and could have gone faster had I not been babysitting a friend who cracked. 

My leg muscles were very jacked up for about three months, and my knee hurt on that side for almost nine months. The pain was from the nerves being manhandled during the surgery. There really wasn't anything wrong with my knee - the muscles had plenty wrong with them, having been dissected!

It is certainly possible to come back from an injury like this with no problems. The big fear is necrosis, since the blood flow to the top of the femur is easily disrupted. The bone can actually die if blood flow is reduced. But even that can be fixed. 

19 months later, I have no issues at all, and I'm riding 150 - 300 miles/week, at least 6 rides weekly. Speed is good, recovery is good, pain is minimal to non-existant. 

Good luck to you! It should all turn out fine. But it will take 6 months to start really feeling normal. Don't worry about the aches and pains - it's normal healing.


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## commuterguy2 (Feb 23, 2004)

*coworker did*

A coworker of mine had his front tire get caught in a crack in the road, did an endo, which broke his hip. Came back 100% (lots of therapy and had the benefit of being a top triathlete in his age group at time) but it took time and effort.


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## BigPiece (May 18, 2004)

*orthopaedic advice*

3 years into my orthopaedic residency at a very trauma heavy program and days away from being done w/ my total joint arthroplasty rotation. Bottom line is get on a stationary bike at a minimum. The longer you wait to get your range of motion back the harder it will be. If you baby a knee and don't move it, it will get stiff, contract and potentially take another surgery to get full ROM back or even manipulation under anesthesia. This does not mean kill yourself but you should be able to or be trying to spin on a stationary bike to keep this movement. I'm not sure what type of hip fracture you had (intertrochanteric? femoral neck? subtrochanteric?) The only one to worry about necrosis would be a femoral neck as the other are in a part of the bone w/ excellent blood supply. Rehab would be very similar to a total hip minus the dislocation precautions. A good study recently showing total hips do better than fixing femoral neck fractures but being younger you probably had an intertroch fracture or one closer to your feet in the metaphysis of the bone.
I am a little confused why your knee is struggling to flex. The muscle disection went through your outside quad muscle (vastus lateralis) and did not alter your flexors.
If you have pain meds use them for PT, at this point it would likely be ok to use high dose NSAIDS (iboprofen, aleve, mobic) but check w/ your orthopod first at some may want to have the hip 'healed' on XR prior to anti-inflammatories which still may take 2-4 weeks.
In summary, I hope I didn't confuse you. I would take some pain meds and get on the stationary bike as best you can. Ice that hip or knee down after and use the other modalities your physical therapist has to help stretch you out and recover from your sessions. I would not worry at all as almost 100% of motivated individuals will get great ROM and strength back after surgery. If it continues to give you problems make sure you see your orthopaedic surgeon to rule out any knee injuries you may have sustained in the accident such as meniscal tear, ligament injury, etc.


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## BarryG (Jul 5, 2004)

Thanks BP - I can definitely use all the good medical advice I can get.

The fracture was in the femoral neck. The knee is uninvolved. The problem seems to be with the muscular innervation, as a result of the surgery (7/24) or trauma (7/23). I've yet to get a clear explanation on exactly what the problem is.

Your ROM advice is easier said than done. For whatever reason, I seem to have lost some of the ROM the last few days and there has generally been more pain with use of the leg. Last week in therapy I was just able to ride a stationary bike gently for 10 minutes (after a lengthy knee flexing session). However, every upstroke was just too painful today to stay on the bike for more than a couple of minutes. This was after we just barely got 105 degrees of momentary flex as a result of a long flexing/stretching session.

I'll try and get in with the orthopedist tomorrow. The strategy of continually pushing the ROM for knee flex despite the pain seems to have run into a temporary roadblock. I can't help but wonder if something in the muscles/nerves needs to heal a bit more before this knee is going to free up a bit in flexure.

Thanks,
Barry


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## FastFred (Aug 12, 2003)

My heart goes out to you...good luck with a speedy recovery.
Let's all be careful out there - serious injuries can happen too easily!


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## alienator (Jun 11, 2004)

BarryG said:


> I'll try and get in with the orthopedist tomorrow. The strategy of continually pushing the ROM for knee flex despite the pain seems to have run into a temporary roadblock. I can't help but wonder if something in the muscles/nerves needs to heal a bit more before this knee is going to free up a bit in flexure.
> 
> Thanks,
> Barry


From experience, I gotta emphasize just how much the PT sucks and hurts. Even w/ narcotic analgesics on board, the PT freakin' hurt. How soon after surgery were you on your feet? The day after surgery....ok, 16 hours later.....the PTs and nurses piled into my room to get me out of bed and up onto my feet (albeit, w/ crutches.) For the first two days I was able to crutch, at most, about 100 feet.

Get thee to your orthopod and get things checked out, but be prepared for him to find that there's no other injury causing your problems. A busted hip is a tough injury, and the surgical repairs make it another order of magnitude tougher. 

You WANT to do the suffering now. If you don't regain the ROM, now, it'll be very difficult to regain it later, if not impossible.

Unfortunately, Barry, there is no easy path for someone with a broken hip. The nature of the beast is that it is maximally suckworthy.


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## BarryG (Jul 5, 2004)

alienator said:


> From experience, I gotta emphasize just how much the PT sucks and hurts. .


Thanks alienator. I think you're probably rightand the orthopedist will reinforce the message. With that being true, I really am going to need to get on some effective pain killers for the near future and will ask him about that. 

I'm not sure how you avoid the muscles stiffening up from the soreness resulting from of a painful stretching session (seems to be what's happening to me) and losing flexibility the next day or two.

They had me up on crutches either the same day or day after surgery. I was able to go pretty far, except I fainted during a few of the early outings (from the blood loss/standing, etc).

Thanks again for all the info/support - much appreciated,
Barry


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## mellionpaul (Sep 14, 2005)

HIpstrong, thanks for posting on this forum. 
I had my right hip 'replaced' in February 2005 with titanium and polyethylene from Depuy. The recovery was relatively OK, especially considering my life before was terrible. I am a long time rider, although much more of a tourer and enjoyer than a racer or gearhead, and have been riding throughout the summer. Everything is going pretty good, and I've just started to look for others to talk with about this. My doctors can't tell me much, they don't have much experience with my situation, which is I'm 49 years old and I'm riding about 4-6 hours a week, mostly on my road bike.

I'm just generally looking for others to talk with who've had some similar experience. I had to raise and re-angle the handlebar/stem on my bike to change the angle of my hip and torso, opening it up so I'm not so crunched down, that's the only thing the doctors are pretty adamant about, keeping that angle pretty open. I just did this this week, the hip was starting to get sore, so I'm adjusting the way I ride and maybe the amount, also, maybe keeping my rides to 60-80minutes. I'm trying things and feeling my way in the dark on this. 

If you know of anyone else who's gone through this I'm interested in talking........






Hipstrong said:


> Hip replacement is a different deal from fracture repair, but the surgical after-effects are probably pretty similar.
> 
> I had a total hip replacement in March, 2004. By early April I was riding again (sort of). In September I rode a century in 4:40 or so, and could have gone faster had I not been babysitting a friend who cracked.
> 
> ...


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## roaddog (Sep 17, 2002)

*Not Yet*



BarryG said:


> Would appreciate hearing from anyone else who went through this. Had surgery on a hip fracture 4 weeks ago with a pin/plate/screws inserted. Doing well, but can't flex my knee worth a darn (muscle tightness). Therapist & I work hard each session and get it just past 90 degrees and then it stiffens up again right after. My specific question to anyone who has gone through this - should I just wait another few weeks for the incision cut into the muscle to heal? Will the stiffness go away as part of the healing?
> 
> I'm hoping to get on the trainer soon using crank shorteners. Not sure if I should push it or just chill for a few weeks and let it heal more. The knee flexing muscles are just so tight and I really haven't noticed them getting any looser since the surgery.
> 
> ...


My broken hip was on June 25, 2005. I'm still on a cane. Stationary bike is very painful. I have the same knee stiffness you describe. I'm going back to ortho to see if he can tell me what is wrong. Perhaps the knee was also damaged in the fall and just now showing up. Another complication is my femoral neck was shortened considerably. There are a lot of ligaments around the hip capsule. There was a post earlier this year by Nova with a picture of the ball and femur. It appeared the neck was shortened in that pic. Not sure how much motion can be regained in that case (and mine). Also there is leg shortening. Do you have any of those symtoms?


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## BarryG (Jul 5, 2004)

Roaddog, sorry to hear about the tough rehab. I guess there are no rules with hip fx recovery - I've heard a number of stories since my posting. 

I hope you can work out your rehab issues and start making some progress soon. Hip fx is a bear of an injury.


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## alpharoad (Apr 10, 2011)

It's been now 4 weeks since surgery to my right neck femur fracture.
I got the srew+plate+pins. First 3 weeks with two forearms crutches and in the 4th only with one. 
I'll start pedaling the bike this week with the home trainer.
Still got to work more on my muscle quad flexibility.

Thanks


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## Barry in GA (Jan 19, 2009)

No hip fracture, but I have had both hips totally replaced. When I had the first replacement done in 1998, the protocol was "no weight bearing for 30 days". After 30 days, the muscle atrophy was pretty bad and that resulted in lots of rehab and and several months before I could walk without a noticeable limp. In 2008, the protocol had changed to "all the weight you can handle starting the day of surgery" and the recovery was remarkably quick (walking without aid after 1 week and traveling on business within a month).

Hip replacement surgery is worse than a fracture repair. For those who don't know, they basically slice your butt cheek open, disconnect everything, dislocate the hip and turn the leg around backwards, cut off the head of the femur with a circular saw (makes a hell of a racket), pound a metal rod in the femur with a big hammer, ream out the hip socket in the acetabulum and pound in a metal socket (another big hammer), put everything back where it belongs, re-attach all the ligaments and tendons and sew everything up.

BarryG, unless you damaged the hip joint, your recovery should be something in between my two hip replacements. You should benefit from immediate partial weight bearing and avoiding muscle atrophy, but you will be limited by the healing of the fracture which takes time. No reason that you should not be close to normal in a couple of months if you do the rehab. I will never forget the head rehab technician (cute as could be and looked about 16) saying "You're gonna cuss me!" She was right, but the results were worth the effort.


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## bikerjulio (Jan 19, 2010)

sounds like OP has this










I'm 60+ and fractured this coming off the bike in early Feb this year.

My recovery as follows:

4 weeks on crutches & painkillers.

at 5 weeks using a stick, and on an indoor trainer.

at 8 weeks back on the bike, daily since.

my main problem has been quad pain, especially when walking.

at 6 months now, I'm a lot better though still not quite 100%. Perhaps 98%.


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## alpharoad (Apr 10, 2011)

I'm in the 4th week now and i'm starting to leave the forearms crutches. 
Lot's of exercice an PT and walking.
No pain but still some quad stiffness, although the knee is pretty close of 90 degree angle.
Every day i try to push a little bit more.


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## Dinosaur (Jan 29, 2004)

This is an old post from August of 2005. I did not pay much attention to it at the time. By stroke of luck I fractured my right hip the following December. I was back on my bike within 3 months, thanks to an excellent surgeon. However it took a real long time to get that strength back in my right leg. Maybe a year, or more. I would not want to go through it again for sure.


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## bleckb (Jun 13, 2005)

In case anyone is reading this well after the original post, much has changed. Broke my hip in a CX race and had it replaced. They now go in from the front, leaving about a six-inch scar. It's been almost eight weeks since surgery and I'm on the trainer, soft pedaling.


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