Injury to recovery. A broken pelvis to full recovery in 3 months. 

This year had started well. I was following my Ironman training plan I bought through Trainingpeaks.com from Phil Mosley: Training Plans with Coach Support | MyProCoach™ 

It is a really well put together plan that integrates perfectly into trainingpeaks and then into all my Garmin devices to be following out on the road on my bike, on my turbo trainer, on a treadmill or while running outside and it now works with scheduled workouts in the pool. 

In the weeks leading up to my injury I was swimming faster than I have ever consistently swum, running faster than I have ever consistently run and cycling faster than I have ever consistently cycled.  

But this all changed when we were on vacation in Athens and I headed out for my scheduled 24km run on the Tuesday, that I had built using the heatmaps of Athens on Garmin.  

It should have been a nice run following the metro and then a canal down to the waterfront and then along the waterfront. A flat course that had looked pretty solid based on the heat maps.  

I started well and was running along when I had to turn and cross a canal. I was moving from the road up the curb to the footpath and my trailing foot clipped the curb, knocking me off balance and causing me to fall. But if you know me, you know I didn’t just fall over sideways like most normal people, no, my front leg landed and then locked at the knee and all of my weight and momentum went onto my front leg and my femur went up into the hip socket like a battering ram and broke the socket in a few places. 

 

Now, I didn’t know this at the time. I was in a bit of pain and it took me a minute to pick myself up off the ground, at which point I noticed my watch was telling me that it had activated the emergency contact notification due to my accident. I thought I might get a call from Vanessa at some point as she is my emergency contact in Garmin, but that never came (turns out she was still asleep). I then hobbled over to a concrete bench to wait for the pain to lessen so I could continue my run, even if at a more sedate pace. While I was sitting here a man cleaning the park offered me some tissues to clean the blood off my knees. I had not even noticed that my knees were bleeding. 

After about 15 minutes I knew I was not really going to be able to continue, or even be able to walk back to the hotel, even though it was only 2.3km away. I saw a taxi and waved it down and after hobbling badly over to it I asked them to take me back to the apartment. 

Once I got back to the apartment, I had to go up a handful of stairs to get to the elevator to go back up to rest of the family who were all just starting their day and getting ready to go out for a day of sightseeing. I hobbled in and Vanessa right away saw that I was in pain but I brushed off her concern and said I would be fine. I just needed a shower and to rest a bit. So I hobbled into the shower, washed away the blood and dirt and then settled myself onto the sofa to recover. Vanessa was annoyed I was not going to be joining the family out that day but I think she recognised that I was maybe in more pain than I was letting on. 

While I was sitting on the sofa there was very little pain in my hip which gave me false confidence that I was going to be fine. The problem was that any time I moved it was pretty bad. It was when I got up to go to the toilet and I almost passed out with the pain that I knew I needed to get it seen to and that I had probably done something pretty stupid/bad. 

I started calling my insurance companies and doing some searching on the internet to see where I could be seen to in Athens and by the time the family came back from their day out sightseeing I was ready to go. 

We took a taxi to the Central Clinic of Athens Home - Central Clinic which is a private hospital in the city. I was seen to relatively quickly and sent for x-ray and an MRI of my knees and hip. After the X-rays we waited a little for the doctor to review it and then I was advised that I was going to be staying at the hospital for a bit and would get more x-rays and a CT scan the following day. 
  

I was moved into my room on a private ward and my leg was already placed in traction (splinted, bandaged and then a weight was attached to it hanging over the bed to pull it out of the socket and relieve the pressure on the pelvis). 


While the room was ok, the bed was a little too short for me and after not very long it became very uncomfortable. I also had the issue that sitting/lying for any length of time is uncomfortable for me as I have had issues since I broke my coccyx 7 years ago. But I had a TV and my book and I settled in for what would be a stay in hospital longer than I wanted. 

The following morning, I was put into an ambulance and sent out for CT scans. The theme of things being too small for me continued with my feet hanging over the end of the stretcher, feet being hit by the door of the ambulance when they shut it because they were hanging over the end and then when I got to the CT scanner my shoulders were pushed up tight against the side of the machine. 
 

After all of these scans the doctor came to see me and explain to me that I had a fracture in both anterior and posterior wall of my right acetabulum. Basically I had shattered the socket that the femur sits into. It was at this time that they informed me that I would need to have surgery to have pins and plates put into my hip to repair the damage. This would be an incredibly invasive surgery and would require me to stay in the hospital with them for 20 days after the surgery. 

After being told about the injury I understood that surgery was the right course of action, and they assured me that their doctor was a leading surgeon who was currently in the US presenting at a conference and would be back to do the surgery in a day or two. But for me, if I was going to be staying in the hospital to recover for such a long period of time, I wanted to be closer to my family and they were all going to be leaving Athens at the end of the week. Also, we had found out that day that kids were not allowed into the hospital there, so I was unable to see them at all anyway while I was there. 

I phone the REGA, which if you follow our family we used last year when Samantha was sick in Lithuania, and they took all my details and the information that I was being told at the hospital and said they would call me back after they make an assessment as to whether I can be transported back to Switzerland and what the process would be.  

REGA called me back and confirmed that they would indeed transport me back to Switzerland as their assessment of the injury, doctors and hospital was that I would be better off in Switzerland. All that was left was for me to wait until they made all the arrangements to come and get me. 

During this time I was looked after well in the hospital and got daily visits from Vanessa to keep me relatively sane while I watched a lot of TV and read my book with my leg constantly in the traction device hanging off the bed and me wriggling about trying to find a spot that was comfortable for more than 5 minutes at a time. 

It is now Friday and it is finally the day of my transfer and I needed for the first time that week to take a shit. Another thing that was too small for me, the bed pan. This was rather uncomfortable and rather undignified as I needed help from the nurses and Vanessa. After all of this and a sponge bath, I was seen by the doctors to fit a device around my hip to lock my hip and leg in position for transport.  

The team from Rega arrived and when the nurse walked in, Vanessa right away recognised her as the same intensive care nurse that had dealt with Samantha last year. Seeing her again made Vanessa break down in tears, a little  overwhelmed as she was by the whole situation, but also fully appreciative of the care that REGA take and how they were helping us again. They got me all prepped for transport and I was again placed onto a stretcher and wheeled down to the ambulance to transport to the jet they had sent to pick me up. 

We went through the private entrance at the airport and after a few checks we were at the plane. The pilot met me and I was taken up the ramp on my stretcher and moved to the bed on the plane. This was a surprisingly comfortable bed and probably the first time in the week that I had been truly comfortable. The doctor and nurse got me settled in, got me some food and a drink and then we settled in for the flight back to Geneva. I had a nice flight with a good window view out the window of the small jet and great care from the doctor and nurse on board. I also had a nice sleep (that was a little helped by the painkillers I received).
    
At Geneva I was transferred by ambulance to La Tour Hospital who had been told I was coming. But I was still left to wait for about 4 hours to be seen to, where I was sent for a new x-ray and CT scan. This time I fit into the machines. I was eventually moved to my room at around 10:30pm. Thankfully they still had some food waiting for me as it had been nearly an entire day and I had not yet eaten, other than the sandwich on the plane.  

The following morning, I was prepped for surgery with a bath and with the brace on my hip being removed. I was told I would be going into surgery any time now and was waiting patiently for what seemed like hours. 

Eventually the nurse came back to see me with lunch and told me that they had been informed that I would no longer be going in for surgery and that the doctors in Switzerland had reassessed my x-rays and scans and decided that I would recover 100% without the need for the invasive surgery that was proposed in Athens. I didn’t get to speak to the doctor but I challenged the nurse on the varying opinions and she passed messages between the doctor and myself. His assessment was that because there was no displacement and only small bone fragments, that I just needed to keep weight off my leg/hip until the bone had healed and to do rehab. 

That same day the physio came to see me with some crutches and I started walking around the hospital ward with my crutches getting used to moving around and keeping the weight off my leg. I was allowed a max 5kg on my leg which is really nothing. And any time I didn’t listen and put too much weight on it I instantly regretted it due to the pain. I was also given a Zimmer frame to help me get around the room and now had some freedom of movements. 

I was discharged from the hospital on the Sunday following my accident and had to make an appointment to see a hip specialist to get a further x-ray in 2 weeks and to arrange my rehab with a physiotherapist.  

I found that there was a good Physio living in the village near me who was the husband of my masseuse and so I got in touch with him to see if we could start my treatment. He was able to come to my house at first where I was set up to do a few exercises.  

Having full movement of my hip and only the limitation on the weight that was put on it meant that there was a lot of things we could still do. I started with doing step overs using a low bar. I also had to do some lateral leg lifts in a standing position and some twists of the leg to start getting all my movement back.  

I did these for the two weeks until I had been to the doctor and got my new x-rays. It was here that I was told specifically how lucky I was not to get the surgery in Athens. My doctor showed me the scans and the breaks and showed me how there was really no displacement and how small the bone fragments were. He also explained just how invasive the surgery would have been, taking all the muscle off my lower back, hip and upper leg to access the part of the hip that would have needed the pins and plate. He agreed fully with the other Swiss doctor that I didn’t need surgery and would make a full recovery. I was prescribed a lot more physio and time off work for recovery.  

The physio progressed with BFR bands being added to the process. This restricted the bloodflow to the legs while I was doing my workouts which made my muscles feel like I was listing heavy weights even though there was no weight added at all. This allowed me to keep movements and strength without going over the weight limit imposed by the doctor. Leg raisers and calf raisers were added to my workout and I was doing my rehab 3 times a day. Indoor cycling on my turbo trainer was also added back to my routine although it was hard at first to get onto the bike without extending my leg into a painful position or putting weight on the bad side.
 
My physio was moved to a gym and we started working out on some of the machines there, respecting the weight limit set by the doctor but getting me doing more movement exercises, different lifts in different positions, extensions where the weight limit allowed and also cardio exercises where possible like cycling and the cross country ski machine. These session were one hour each twice a week. Also with some massage sessions to help with the muscles that were now working after the injury.

6 weeks after my accident it was time for the next x-ray and doctor’s visit to see how my recovery was going. He was pretty happy with my progress and told me I could start walking again without my crutches and could also start driving again. This was a huge point in my recovery as it gave me back so much freedom to be able to move about again. I was still not allowed to run just yet and the next 2 weeks were still critical in the recovery process so I should avoid falling at all in that time and re-damaging it before it was fully healed. 

This meant that at the gym we could do more work with the weights and walking exercises. It felt very strange to be using my leg properly after all this time and thankfully all the exercises with the physio meant that I didn’t have too much readjustment to do. It felt good to be moving in the direction of being fully active again. But this process was still tough and slow continuing the twice a week sessions.

Now that my hip was recovering well we discovered that I had a groin strain from my accident as well and focused on stretching and exercises to help it recover and allow for full movements. This mostly consisted of opener stretches and lunges of types to move the groin in all direction. We also had some focused massage sessions to help releive the strain in the groin.

My physio progressed until we were doing running exercises over short distances and not very fast until I was actually running at normal speeds on the treadmill. Fast high knees, crossover steps, ladder runs were the common excercises. My physio was quite impressed with just how well the healing was going and how there were not really any obvious signs of injury any more.  

I went for my first run outdoors exactly 2 months after my injury. It was slow and I was a little stiff after. But the stiffness was all in my muscles. It felt like I had run a marathon the day before while I was running. But a few more outdoor runs and a few sessions at the physio where I was mostly running and getting some massage to get the last of the groin injury. 
 
Now it is 3 months after the injury and I have been given the all-clear from my doctor after a new x-ray. He confirmed they can still see the shadows where the bone is doing some final healing but that I no longer have any limits and can go back to my normal training and activities. There should be no further issues with my hip and the bone is healed smooth where it should be and the small fragments are not going to cause a problem. 

The hardest part now is getting back to the fitness levels I was at before I had the injury but I am already making good strides towards it.