Twelve weeks ago I managed a distal fracture of my femur while snowboarding. I'm 30 years old and compared to the experiences I've read of others recovering from similar injuries, I've had it pretty easy. My pain levels have been minimal throughout, I regained full ROM in about 3weeks post-op, and in general have been feeling pretty good. I work as a snowboarding instructor and as such I was in great physical shape prior to the accident. My concern is that after talking with the doctor at my most recent checkup that I may be pushing my rehab too hard as he made it very clear that he wants me to exercise caution regarding what activities I choose to do. My regimen since week 6 has included 25min of minimal resistance stationary biking after receiving permission from the doc to do so, and walks around the neighborhood (crutch assisted) every other night or so since week 9ish. At the 6week check-up the doc said that I had good soft callus formation and that things were looking good. He even went so far as to say he figured that when he saw me at the 11 week mark I would likely be 'good to go'. However, it was obvious to me at the 11 week check up (last week) that my fracture still needed time. The callus material looked much more prevalent and more dense than it did at week 6, but all of the fractures were still essentially visible through the callus tissue. My doctor said that I was still healing and that I was ok to start swimming, but that I still needed to be on at least one crutch or a cane until further notice and that if I'm going to be doing longer walks that I needed to be using two crutches. I spoke with him today briefly to clarify what sort of time intervals we're talking about regarding exercise and he suggested that he wanted me to do no more than 1hr of weight-bearing exercise per day at this point. He said I that the callus still needs to fill in a lot of material and that I'm not "fully healed" which I knew, and that CAUTION was to be my plan.

I'm working without a PT since I don't have insurance; so all of this has been a bit of a guessing game until today when he gave very specific instructions regarding duration of exercise. The problem is that I am normally a very active person and have a hard time sitting still all day. The walks have been great, but there are days in the past few weeks where I have been on my feet A LOT crutching around shooting pictures of friends skateboarding and such. When I say A LOT, its intermittent, but probably approaches 2.5hrs-3.5hrs on my feet; but again, usually only once or twice a week, and again on crutches. After those "big days" I tend to be a bit sore for a day or two, so I rest, and pick up with walks or biking when my leg feels rested. On Wednesday this past week, I had a "big day", and felt a bit sore yesterday so I spent the day resting, but managed to get in a walk around the block in the evening and woke up feeling pretty good today. So today I walked around the block using one crutch while carrying the other with me to use as I fatigued. I did most of the walk on one crutch and got home feeling great, so I jumped on the stationary bike for 25mins with 10mins pedaling at one resistance level above the minimum and finished out my time pedaling on minimum resistance. That was probably a bad idea as I've been really pretty sore for most of the day today, and I worry that I may be setting myself up for a non-union fracture by doing too much.

I'm sorry this post is so wordy, but I wanted to give you as much info as I could regarding my situation. My femur is rodded with two screws near my hip and two screws just above my knee, and I'm wondering how much movement I can really impart to the fracture site given the rod. I've also included X-rays from pre and immediately post-op so you can have an idea of just how bad my fracture is. Unfortunately, I don't have the X-ray images from week 6, or week 11, so you'll just have to go on what I said. I have no problem backing off a bit, as I simply want to ensure this thing heals properly so that I can get back on the mountain next fall. Thank you so much for looking.

Here are the X-rays:

Pre-op view 1:


Pre-op view 2:



Immediately post-op 1:


Immediately post-op 2:
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