How to Get Back Into Running After a Tibial Plateau Fracture

Suffering a tibial plateau fracture can feel devastating for runners. The crack or break in the upper part of the shinbone near the knee joint leaves you unable to do what you love that is to hit the pavement and feel the freedom of a good run.

The recovery process is grueling, between surgery, immobilization, and physical therapy. Even after the fracture has healed, the thought of running again can seem daunting. Your strength has deteriorated, and the fear of re-injury looms large.

However, with patience, preparation, and care, returning to running after a tibial plateau fracture is absolutely achievable. By slowly rebuilding your fitness, correcting form flaws, and listening carefully to your body, you can confidently get back in the running game. Today’s post will walk you through the critical do’s and don’ts, step-by-step. Read on!

Consult Your Doctor

Before lacing up your running shoes and hitting the pavement again, it’s crucial to get clearance from your doctor. Schedule a follow-up appointment to discuss your recovery process and get feedback on your strength and range of motion. Your doctor can evaluate your progress and determine if you’re ready to start running again. 

Be sure to discuss realistic timelines and expectations for rebuilding your running fitness. While you may be eager to pick up where you left off, your body needs time to heal and regain strength. 

Don’t be discouraged if your doctor recommends waiting a few more weeks or starting with short run/walk intervals. Tibial plateau fractures can take many months to fully heal. Rushing back into intense running too soon often leads to overuse injuries or setbacks. 

Ask your doctor about any specific restrictions or precautions to take while running after fracturing your tibial plateau. For example, your doctor may recommend avoiding hills or inclines in the beginning and sticking to level surfaces. 

Downhill running places extra stress on the knees that could irritate your fracture recovery. Your doctor may also advise wearing a knee brace for extra support and stability when you return to running.

Start Slowly

Once you get the green light from your doctor, it’s time to start rebuilding your running fitness. But resist the urge to immediately pick up where you left off preinjury. Your body needs a slow and gradual running reintroduction to avoid setbacks. 

Begin by incorporating low-impact cardio like walking, swimming, or cycling into your routine. Focus on improving overall stamina and endurance without the high impact stress of running. Aim for 30-45 minutes of gentle cardio most days of the week. This will get your muscles, joints and cardiovascular system conditioned. 

When you feel ready, slowly ease into running by alternating between short running spurts and walking breaks. Run for 1 minute then walk for 2 minutes, repeating for 20-30 minutes. 

Gradually increase your run intervals while decreasing walking time. This run/walk method allows your body to adapt to running impact while building strength and resilience. In the beginning, don’t worry about distance, just focus on time spent moving. 

Start with what feels comfortable and progress conservatively from there. You may only be able to run for a few minutes at first. That’s normal – rebuild patience and consistency. Speed and distance will improve over the coming weeks and months. 

Proper running form is critical as you retrain your body. Consult a physical therapist or running coach to ensure correct posture, cadence, foot strike and mechanics. Avoid over-striding and focus on shorter, quicker steps. 

Landing on your midfoot rather than heel reduces impact on the knees. Increase your steps per minute to about 170-180. Core and hip exercises teach your body to run in proper alignment reducing strain on the knees and legs. 

A strong core helps balance each stride and maintain stability. Be patient relearning how to run smoothly and efficiently. It takes time to ingrain new muscle memory and movement patterns. 

Choose The Right Running Shoes

The right running shoes are crucial when returning to running post-injury. Shoes that provided sufficient cushion and support prior to your tibial plateau fracture may not meet your needs during rehabilitation. As your injury heals and strength improves, the amount of stability and cushioning you need will evolve. 

Visit your local specialty running store for a gait analysis to identify your current biomechanics. You may overpronate or underpronate, putting abnormal pressure on the knees. Look for shoes with midsole cushioning, stability features, and motion control if needed. Replace shoes frequently, as they lose shock absorption after 300-500 miles. 

If you used orthotics or inserts before your fracture, you may need an updated pair tailored to your changing needs. Custom orthotics promote proper foot alignment in motion, taking pressure off the knee. Speak with your doctor or physical therapist about inserting temporary wedge orthotics to reduce stress on your healing tibial plateau. 

Gradually transition to more minimalist shoes as you regain strength and progress through rehabilitation. Highly cushioned shoes encourage weaker foot muscles, so strengthen your feet with lower drop shoes once healed.

 Minimalist shoes also enhance running form by promoting a forefoot or midfoot strike. Be wary of racing flats or heavily worn shoes without enough support. As you return from injury, prioritize cushioning and stability in your shoe selection. 

Importance of Strength Training

Integrating regular strength training into your rehabilitation routine is critical for recovering full function after a tibial plateau fracture. Running places high demands on the muscles surrounding the knees and lower legs. 

Strength training helps rebuild muscle mass lost during recovery while also stabilizing and protecting the joint. Aim for 2-3 dedicated strength sessions per week in addition to your running. 

Target Muscle Groups

Focus exercises on the major muscle groups surrounding the knee joint: 

Quadriceps: As the main stabilizers and extensors of the knee, the quads support proper leg alignment and absorb impact during running. Strengthen them with squats, lunges, leg extensions and step-ups. 

Hamstrings: This group counterbalances the quadriceps behind the thighs. Strong hamstrings protect the knees from injury. Target them with leg curls, bridges and hamstring slides. 

Calves: As shock absorbers for running, sturdy calves keep pressure off the tibia and knees. Train calves with raises, jumps and hops. 

Glutes: Strong glutes stabilize the pelvis and hips for efficient running mechanics. Build them with bridges, clamshells, and monster walks. 

Core: A solid core enhances stability and posture. Do planks, crunches, and other abdominal exercises

Exercises After a Tibial Plateau Fracture

Bodyweight exercises are highly effective for knee and leg strength. Squats, lunges, calf raises, bridges and step-ups are excellent choices. Start with just body weight then progress to holding dumbbells for increased resistance. 

Avoid painful ranges of motion and modify exercises as needed. In addition to bodyweight moves, incorporate resistance bands into strength training. Loop bands around your thighs or ankles to increase intensity during squats, clamshells, monster walks and other moves. Bands add challenge throughout your progression. 

Schedule physical therapy appointments specifically focused on knee and leg strengthening. A PT can recommend specialized exercises targeting your unique weak points revealed during initial recovery. 

Gradually build the duration of strength training sessions and number of sets/reps of each exercise. Prioritize quality movement over heavy weight, progressing conservatively to avoid setbacks. With disciplined strength training your muscles will provide crucial support when you return to running.

Focus on Recovery

Recovery is a critical component of any running program, but especially important when returning from an injury like a tibial plateau fracture. After the trauma of a fracture and surgical repair, the tissues around your knee need ample time to heal properly. Rushing back into running too soon or overdoing it between runs can quickly lead to overuse injuries or complications. 

Resist the temptation to run multiple days back-to-back right away. While it’s tempting to make up for lost time during your recovery, consecutive days of pounding the pavement will fatigue your body. Plan at least one rest day between each run when first getting started. 

This gives your bones, joints, muscles, and connective tissues time to adapt to the impact of running. As you rebuild your fitness and gradually increase mileage, you may be able to add additional running days per week. But continuing to incorporate rest days into your program is key. 

Icing your knee after runs can help minimize inflammation and soreness. Apply a bag of ice wrapped in a towel to the knee for 15-20 minutes following each run. The cold constricts blood vessels, slowing circulation and reducing swelling. 

Be careful not to apply ice directly to the skin, as this can cause frost bite. Icing is most effective within the first 48 hours post-run. A knee compression sleeve worn after icing also helps limits inflammation. 

Getting sports massages helps improve circulation to aid recovery between runs. The increased blood flow enhances delivery of oxygen and nutrients to fatigued muscles. Massage also helps flush out metabolic waste products that accumulate after exercise. 

Target the muscles surrounding the knee like the quadriceps, IT band, hamstrings and calves which absorb impact during running. A licensed massage therapist can also perform techniques to encourage optimal alignment of the knee joint. 

Using a foam roller on muscle groups like the IT band, quads and calves can further accelerate recovery between runs. Slowly rolling tight areas applies deep pressure to release muscle knots or adhesions. Foam rolling restores muscle length, improves range of motion, and alleviates post-run soreness. Use caution rolling directly over the knee joint or any bruised areas.

Taping and Bracing

Before trying any type of knee taping or bracing, consult with your orthopedic doctor or physical therapist. They can advise if it is appropriate and necessary for your specific tibial plateau fracture recovery. 

There may be certain precautions or restrictions required after surgery that makes taping or bracing unsafe or ineffective. Your doctor will take into account the location and severity of your fracture, type of surgical repair, current stage of healing and your ongoing symptoms. Provide your doctor with a full picture so they can make an accurate recommendation about bracing.

Options for Knee Taping

If your doctor gives the go-ahead, knee taping provides flexible joint support and can be customized to your injury. Using rigid sports tape, a trained healthcare provider can tape the knee in ways that may: 

• Compress and stabilize the joint after injury 

• Improve alignment and tracking of the kneecap 

• Reduce pressure and irritation on fractured areas 

• Relieve pain by lifting pressure off the tibial plateau 

Rocktape and Kinesiotape are common brands used for sports taping. Tape may be applied in various patterns based on your needs. It can be worn during runs and other activities. Reapply new tape after a few days as it loses adhesiveness. Remove carefully to avoid skin irritation.

Over-the-Counter Knee Braces

For ongoing support, over-the-counter knee braces offer more rigid stabilization of the joint. They are made of flexible, breathable neoprene material with plastic or metal supports built in. These braces provide: 

• Added stability and shock absorption during impacts 

• Reduced side-to-side knee motion 

• Increased proprioception and awareness of knee positioning 

• Relief of pain by offloading the tibial plateau 

Brace sizing is important for correct fit. Measure the circumference of your leg 6 inches below the center of your kneecap. Braces with a dual strap system and Velcro closures can be easily adjusted. For running, open patella braces that avoid pressure on the kneecap tend to be most comfortable.

Nutrition and Hydration

Proper nutrition and hydration support injury recovery and fueling for runs. Focus on eating nutrient-dense whole foods to aid your body’s healing process. 

Consume plenty of fruits, vegetables, whole grains, beans, nuts, seeds, and lean proteins. The vitamins, minerals, antioxidants, and phytochemicals they contain help reduce inflammation and oxidative damage from running. Foods especially high in inflammation-fighting nutrients include leafy greens, berries, tomatoes, citrus fruits, broccoli, cherries, fatty fish, avocados, walnuts, and olive oil. 

Stay well hydrated before, during and after running. Carry water with you on runs and sip consistently. Dehydration can negatively impact joints, leading to pain and improper mechanics. Drink about 16-20 ounces of water 2-3 hours pre-run, 7-10 ounces every 20 minutes during longer runs, and another 20 ounces post-run. Listen to your thirst signals too. 

Time your protein intake strategically around runs to best support muscle recovery. Consume 20-25 grams of protein within 45 minutes after runs to replenish depleted glycogen stores and stimulate muscle repair. Include protein-rich foods like eggs, Greek yogurt, cottage cheese, protein shakes and chocolate milk. Aim to distribute protein evenly throughout the day as well. 

Consider supplements that may enhance recovery. Omega-3 fatty acids found in fish oil combat inflammation. Tart cherry juice provides antioxidant and anti-inflammatory benefits. Collagen supplements supports tissue repair. And vitamin D aids bone healing. Check with your doctor before taking any new supplements, especially with post-surgical medications. 

While nutritious whole foods should make up the bulk of your diet, don’t be afraid to enjoy the occasional treat. Satisfy cravings in moderation. Just don’t overdo empty calories right after intense runs when the body most needs recovery nutrients. Pay attention to how different foods impact your energy levels and running performance.

Listen to Your Body

Tuning into your body’s signals is key when returning to running post-injury. Don’t ignore any pain or try to push through it. Your body is trying to tell you something, so you need to listen. 

It can be tempting to keep running even if you start to feel some discomfort around your knee or leg. But sharp or aggravated pain should never be overlooked. It likely means you are doing too much too soon. Sudden increases in pain may indicate tissue inflammation, scar tissue buildup, improper healing, or compromised joint mechanics. 

At the first sign of sharp knee or leg pain during a run, stop running. Walk slowly for a few minutes to see if the pain subsides. If it does, consider calling it a day. The run may have overly stressed the tissues. If the pain continues persistently, get off your leg, ice the area, and make an appointment to see your doctor. 

Don’t just write the pain off as normal post-surgery soreness. You need to determine if it’s inflammatory pain that requires more rest or mechanical pain that means you need to adjust your form or stride. Track your symptoms closely so you can explain them clearly to your doctor. 

Be prepared to tweak your running program based on pain signals. You may need to back off on distance or intensity and rebuild more gradually. Or you may need to incorporate more cross-training and strength work to support the knee joint. Communicate openly with your PT so they can modify your program accordingly. 

Make sure you are fully recovered between each run. If you are still sore or fatigued from your last run, wait another day before going out again. Forcing yourself to run on residual tightness or inflammation will compromise your form and put you at risk of compensation injuries. 

Honor any lingering post-run pain by allowing proper rest before running again. Rushing back too quickly will inevitably backfire and prolong your recovery in the long run. Be patient, listen to your body, and only progress your running when you feel ready.

A Final Recap

So ultimately, how easily you get back into running after a tibial plateau break will come down to your own dedication. With patience and by progressively building your fitness and form, recovery from a tibial plateau fracture will allow you to successfully return to the running activities you love. Stick to the plan, listen to your body, and don’t give up hope. You’ll be back better than ever before you know it!

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