Broken Femur / tips for recovery?

[Zackus]

2 weeks ago, I went for a quick ride in town to go pick up a 4pk of beer for Friday evening and decided to get a 45 min spin in in the process. I was making my way through Baltimore's inner harbor when I came to the cobblestones of Fell's point. Everything was going well when out of nowhere I went down.

There were a couple of bystander's that immediately came up to ask me if I was ok. I was stunned, but it was obvious I would need their help to collect myself and get up. After they helped me to the side of the road, I sat for a bit and it became clear I wasn't going anywhere so I called my wife to come and get me.

I'm not sure if I lost traction briefly or my wheels got stuck in the train tracks or what happened. I may have been slightly concussed, but I went down and my hip and head took almost all of the impact of the fall. Don't worry the bike is totally fine! Complete fracture of my femoral head. This fracture often results in them putting in an artificial hip, but they wanted to avoid that if possible since I'm in my 30s so they set it with 3 steel screws to hopefully avoid needing to replace the hip in 20 years if they had gone the replacement route.

Be safe out there and always wear a helmet! I would definitely be in worse shape if I also had received a severe head injury. I'm 2 weeks into recovery and pain is low and PT is going well but I'm still 4 weeks away from being able to put weight on my right leg. Who knows how long the whole recovery will take, but I'll at least miss a few months of running/biking/outdoors/fitness.

I'm interested if any experienced any other similar cycling injuries and what tips they have for staying productive/somewhat active/ maintaining weight while in recovery.

[NHAero]

Bummer, heal up quickly!
I took a fall a few years ago and also not sure exactly what happened, but it was near train tracks also. I was really lucky - just some abrasions but it was cold weather so I was wearing layers. Yanked the front wheel past the lawyer lips on the carbon fork!
I wonder if the hardware is 3/2.5 or 6/4 Ti? The latter is much faster...

[Turkle]

I recently destroyed my tibia in an accident. The most important advice I can give you is - make sure you get quality PT (preferably at a university sports medicine complex) and that you follow their directions. I credit the PT people at VCU for saving my athletic pursuits following my devastating injury.

I also built up a bike while I was recovering. It was a good project to keep me busy!

As far as fitness goes, I did as much exercise as the PT people said I could get away with. A lot of upper body stuff (seated, of course). I did all the exercises/movements the PT people prescribed, no matter how painful or just boring they were. I also was on a spin-bike style trainer as soon as I was able to do so.

There were some pretty dark days while I was recovering, please send a PM if you need to talk through anything or just want to let me know how things are going.

[duff_duffy]

I’ve seen/heard of more accidents caused by railroad tracks than any other situation. If it’s wet out they are like ice, when dry still can be slick. I’d bet they had something to do with it. We have a set of tracks up road by me and those took out two riders extremely hard…both guys are decent riders too, problem is they cut across road at an angle so you either should bunny hop them or cut into road and cross at 90 degree angle which is not safest move. Be careful going over them! Good luck with recovery.

[Spdntrxi]

my buddy had your Ti upgrade a couple years ago. He was in his mid 40s. I think he spent about 10 weeks off the bike. He's pretty normal now but claims to be down on peak power since.

[Black Dog]

If it’s any comfort to you a good friend of mine went down and ended up with the exact same fracture. He was in his late 30s at the time. They used screws for the same reasons as you. He made a complete recovery and was as fast and fit well within a year. No lingering issues 6 years later. I know that everyone is different and this is one data point. It’s just to let you know that it’s possible to make it out of this as good as new.

[mass_biker]

Also in Baltimore - know that area well (when I used to work downtown)- and the combo of cobblestones and train tracks is super dicey. I wish you well on your recovery.

+ 1 on the helmet AT ALL TIMES; could have been worse

Some thoughts

- it’s the dog days of summer here in MD…do you have access to a pool? If you’re near Harbor East/Downtown, I recall that the MAC had a great therapy pool for aqua jogging and the like
- fall is a time to rebuild…my best springs were based on actually little miles in the fall and a deliberate effort to start the new year of cycling more around Thanksgiving…i.e. don’t sweat it too much - the advice to get better first is good
- as far as non-weight bearing exercise - swimming (#1 above), rower (when you have range of motion and dr’s permission to do so), trainer (as other have mentioned)…have never done the elliptical with any focus except when I had foot injuries when running, and I actually found it was a good workout

Good luck - PM if you want to chat + I hope you heal up.

MB

[teleguy57]

Sorry to hear of your fall and fracture. You'll get lots of good advice here!

My go-to recommendation on recovery is Kelly Starrett's Surgery Series. Thoughtful recommendations based on his personal experience with total knee replacement (which more than a few of us here have undergone). Also very applicable to traumatic injuries and resulting surgery as well as planned stuff.

Some things may be a bit controversial; good to have things upon which to do additional research and draw your own conclusions.

Speedy healing -- and take the return to cycling at an appropriate pace.

[dgauthier]

Originally Posted by Zackus

(...) I'm interested if any experienced any other similar cycling injuries and what tips they have for staying productive/somewhat active/ maintaining weight while in recovery.

I remember reading sage advice in reference to self-coached training: "If you had a valuable race horse that could win the Kentucky Derby, would you run it to exhaustion every day?"

Treat your body the way you would treat a race horse that took a nasty spill on those same cobbles. You only have *one chance* to heal perfectly. Worrying about your fitness today isn't worth compromising the function of your hip for the rest of your life.

Keep your eye on the long game, follow your doctor's instructions to the letter, do your physical therapy when the time comes, and above all let yourself heal.

[Tickdoc]

Dangit, I came here looking for ti bike bits.

Man this sucks. Must be a weird feeling when you don’t know how you went down.

Thank goodness for the helmet and for having people around to help.

Future father in law fell off a roof a little over a month ago and suffered the same fracture, along with femur, ribs, back, and a finger. He’s twice your age but expected to make 100% recovery, but it will be with a lot of hard pt work and some luck.

Wishing you the best recovery and glad you are (relatively) ok.

[Zackus]

Thanks for all the support everyone! Yeah I know to be careful around tracks, but I guess I wasn't careful enough. I was on 33mm tires, and figured I was good, although the tracks are likely what cause me to go down. It's just funny because we've all had some slips and falls where you get a scrape and a little jersey tear and you get back up and you're fine, but just the wrong spot and it's a critical hit.

Also, after a little research, I must come clean, my screws are actually stainless steel, and not titanium. I'm sure you can imagine my disappointment. I've asked the doctor if it's Reynolds 953 or Columbus XCR but I haven't heard back yet.

In all seriousness, I'm hoping that by mid-September I get cleared for at least trainer riding. It's time for me to give zwift a go, and see if it's for me.

Originally Posted by Turkle

As far as fitness goes, I did as much exercise as the PT people said I could get away with. A lot of upper body stuff (seated, of course). I did all the exercises/movements the PT people prescribed, no matter how painful or just boring they were. I also was on a spin-bike style trainer as soon as I was able to do so.

There were some pretty dark days while I was recovering, please send a PM if you need to talk through anything or just want to let me know how things are going.

Really cool Lemond and glad you're recovered! I've got good support with my wife and a few friends but I appreciate the offer. I think I may get some Amazon adjustable weight bench so I can start doing more upper body stuff.

Originally Posted by mass_biker

Also in Baltimore - know that area well (when I used to work downtown)- and the combo of cobblestones and train tracks is super dicey. I wish you well on your recovery.

+ 1 on the helmet AT ALL TIMES; could have been worse

Some thoughts

- it’s the dog days of summer here in MD…do you have access to a pool? If you’re near Harbor East/Downtown, I recall that the MAC had a great therapy pool for aqua jogging and the like
- fall is a time to rebuild…my best springs were based on actually little miles in the fall and a deliberate effort to start the new year of cycling more around Thanksgiving…i.e. don’t sweat it too much - the advice to get better first is good
- as far as non-weight bearing exercise - swimming (#1 above), rower (when you have range of motion and dr’s permission to do so), trainer (as other have mentioned)…have never done the elliptical with any focus except when I had foot injuries when running, and I actually found it was a good workout

Good luck - PM if you want to chat + I hope you heal up.

MB

The Pool is a great idea and I hadn't considered that. I'll ask my PT when/if that is an option. I'll also be going to deep creek lake in 2 weeks, so hopefully will get some time in the water there if I get cleared for it. Just got staples out today so hopefully the wound is healed at that point. It was an "open" surgery due to the complexity of the fracture so it's about 9 inches long with steri-strips on it.

and yeah i'm hoping by late October I'll be back on the bike. Hoping for trainer sooner than that, but the cool weather should be good for getting some miles in.

[old fat man]

Do the PT with an experienced cyclist and sports PT. Be prepared to endure the pain during rehab. I shattered my elbow with an open fracture of the humerus in January. 3 plates, 16 screws and a not-great prognosis for recovering range of motion. My PT is a local cycling hard man who twisted and pulled my arm twice a week for 3 months. I've regained nearly all range of motion and strength. No limitations on the bike or with other activities.

Do the hard work, it'll be worth it

[Turkle]

Originally Posted by old fat man

Do the PT with an experienced cyclist and sports PT. Be prepared to endure the pain during rehab. I shattered my elbow with an open fracture of the humerus in January. 3 plates, 16 screws and a not-great prognosis for recovering range of motion. My PT is a local cycling hard man who twisted and pulled my arm twice a week for 3 months. I've regained nearly all range of motion and strength. No limitations on the bike or with other activities.

Do the hard work, it'll be worth it

I endorse the above without reservation. All the pain of PT - and it was painful - has showed up in my ability to get out there and ride. The work is worth it.

[steelbikerider]

Unfortunately, I've had 2 broken femurs, 1 right, 1 left.

Right side 35 years ago(29 years old), 7 screws and a steel plate, from a velodrome crash. I was young, did my own rehab, weights, lots of indoor trainer time and had hardware removed after 18 months, (recommended). I had a slight decrease in performance going from a field filler cat 2 to a field filler cat 3. Removing the hardware made a noticeable difference in lingering pain and recovery from long rides. I was on crutches for 5 months with partial weight bearing and on a trainer in 4 weeks.

Left side was 2 years ago(63years old), blindsided by a dog, 12 total days in a hospital, 8 of those in a rehab hospital learning to walk again. I have a titanium rod the length of my femur and a shorter rod from the ball joint to just under the skin. Walked out of the hospital with a walker and moved to a cane after 4 weeks. Started PT 3 times/week for 6 weeks after getting home and Zwifting 5 weeks after the break. Ditched the cane after 3 weeks. Did a second 6 week PT rehab stint a couple of months later.

I no longer walk with a limp unless i'm tired, walk a little slower and my left leg is back to pre crash strength but lost flexibility. The ortho and wife said no more road riding so I now Zwift and play pickleball. After 90 -120 minutes of P-Ball, I'm done.



Hit the rehab hard, my PT was surprised at how hard I could push myself and at my progress based on the severity of the break. Progress will be uneven and painful but the harder you work, the less long term effects you will have. Also remind yourself that you are improving, especially around the 6 week mark. Just remember that if you aren't better than the day before, then are you better than 2-3 days before.

I'm not a doctor but your break doesn't look as bad and hopefully you don't have much muscle damage from the surgery. Also do your exercises/trainer rides on days when you don't have PT and sometimes its OK to take a rest day. Feel free to PM me if you want more info/encouragement.

P.S. Might want to stay out of the lake until the incision is completely healed, check with your doctor.

[oldpotatoe]

So sorry to hear but glad you seem to have some good docs

BUT, am I the only one to see this irony?

I was making my way through Baltimore's inner harbor when I came to the cobblestones of Fell's point. Everything was going well when out of nowhere I went down.

Heal quick and well..