Introduction by Jonathan Bell: Craig McLean is passionate skier and contacted me from Canada just after his fracture. I promised I would do everything I could to get him back skiing. The result of his surgery can be seen in the VIDEO where we both had the most amazing weekend of powder skiing. He kindly agreed to write this blog which may give hope to those just starting a similar journey.
My broken leg by Craig McLean: In April 2012 I headed off to Canada for a heli-ski trip of a lifetime to help me celebrate my 40th birthday. On morning one of the trip I skied into a snow bank while skiing through a cloud in white out conditions. I was skiing slowly due to the poor vis and compressed and twisted my knee with the binding not releasing in was up to my knee to make the ‘pop’. In the middle of the Carriboo mountains with the only means of travel being a helicopter luckily I had one hovering over head and the guides from CMH got me off the mountain with a minimal amount of fuss. Initially I thought I’d ‘popped’ my ACL but an X-ray in Banff the next day confirmed I’d cracked my tibial plateau – aka broken leg!
I finally made it back from Canada and went straight to Wimbledon Clinics for MRI and CT scans it was then the true extent of the damage was discovered. What looked like a fairly clean break on the X-ray at Banff hospital, turned out to be a fairly messy break. The only good news from the scans was the knee ligaments were intact. So I had a couple of days to get the swelling down from the flight for surgery in a few days.
Lying in a hospital bed with a puffy bruised leg picturing what was coming was not a place I’d like to be everyday. Terrifying stuff, but I had complete faith in Mr Jonathan Bell, and the team from Wimbledon Clinics. It was a long week from the time of injury to finally getting the operation underway. The operation went smoothly and after a bizarre night on morphine and coming to terms with general anesthetic, the physio team were keen to get me moving my knee from day one.
I was sent to the hydrotherapy pool 36 hours after the op and the aim was to get me moving ASAP. Immediately after the op I had 90 degrees movement of the knee which by week three was 120 degrees and week 7 was only a few degrees off normal. I was amazed at how quickly the movement had returned, especially as to how it felt from the beginning. The hydro therapy pool was great a increasing slowly the movement I’d lost, with the sensation of floating helping big time with the pain.
I luckily had no plaster and so swimming became a vital ingredient to my rehab. The first 4 weeks I pretty much did daily hydrotherapy and by week four I began swimming in the pool with a buoy between my legs. Aside from entering the pool via the disabled steps, swimming was the only thing that made me feel ‘normal’ as it was the only thing I could do which made me appear able bodied. Between week 4-8 I started ramping up the distances and one of the challenges I set was how far could I swim non-stop for an hour. My record was 3800m. Swimming, although mainly working my upper body, really helped keep the physiology ticking over helping circulation, weight management and sanity.
Bizarrely at the time of injury, I was not rolling around the snow screaming in agony, it actually hurt less that I would have imagined. As the time went by the pain was more from having a massively swollen leg than bone pain. Obviously initially, the first two weeks did feel like I’d had a drill taken to my tibia, but that thankfully this decreased as time went by. The other main issue was from being unable to weight-bear for 12 weeks, having your leg bent with crutches and for weeks, gives you a permanent hamstring cramp! Not fun.
At week 8, I had a good chat with Mr Bell and we decided stationary bike work was a good idea, I promised to stay seated and not push too hard through the left leg and this had a fantastic affect on the circulation of my leg. Within a week, I lost the purple leg that would appear whenever I stood for longer than 5 minutes. It didn’t take me long to build up to an hour of turbo trainer/ watt bike work and was able to build up a much needed sweat! At the 12 week review, I convinced my surgeon that road cycling would be OK. Although I wasn’t able to walk without crutches, I promised to behave myself and headed off to do laps of Richmond park.
After 3 months non weight bearing, I’d lost 5cm in thigh circumference and had a long road back to get the muscle that has disappeared from dis-use. A big thank you goes to James Vickers, ex-GB ski team physio who heads up the return forom injury ski clinic at the Wimbledon Clinics. We hit the gym and I worked hard with him once a week for 9 months. One unusual technique was called occlusion therapy which is essentially doing weights with a tourniquet. The aim of this is a muscle that has reduced bloodflow during activity can increase in size at a faster rate.
At the time of initial injury I knew that weight bearing was not an option. After the diagnosis was made and the surgery planned the prognosis was non weight bearing for 12 weeks. (gulp!) Looking back, this is how it went, 12 weeks of non weight bearing using two crutches, week 13 one crutch and week 14 onwards no crutches around home and for short walks but still one needed for longer outings.
6 months later
At my 6 month check up since surgery all was going well. There is still a crack in the tibial shelf and this means no running, jumping or plyometrics just yet (or skiing before Christmas). Healing takes time huh, especially when there is a 3mm chasm to fill in. So what can I do? I can do a few laps cycling in Richmond park. I can deep squat/split squat 80kg and leg press 200kg. I’ve taken my amazing chin up ability from 3 sets of 2 reps to 3 sets of 10 reps and some rowing ergo. Oh, and I’d booked a ski week at the end of March 2013 to jump straight back on that pony!
Ski trip Easter 2013 – putting the mental demons to bed.
Twelve months nearly to the day of the leg break I headed off to Val d’Isere, France to test the knee and to take the family for our first family ski week. I started conservatively with a few nervous moments and flashbacks to the previous year’s injury – initially I stayed on piste and enjoyed a different type of skiing which involved skiing on piste and stopping at some of the great mountain restaurants Val d’Isere had to offer. My confidence in the knee grew as the week went on and ended the week off piste and shredding some great pow
October 2014 – time to get the screws and plate out.
I decided to get the scaffold out of the knee in 2014 as it was bugging me while cycling, running and especially kneeling on the ground. Not a great thought to be opened up again but it was as promised by Mr Bell to be a fairly straight forward procedure. Amazingly I walked out of hospital 4 hours after I went under general anesthetic and after it took a week for the skin to knit back together I was back on the bike in a week. (racing 3 weeks later)
What can I do know? Pretty much everything as I once had – some things even better. I race ‘A’ Grade track cycling, and see below for the video of my most recent return to injury ski trip – perfect conditions. Click here for video.
Thanks to Phin my long suffering wife for helping me through this horrible injury, my kids for keeping me smiling, my surgeon Mr Bell, Wimbledon Clinics, James Vickers my physio, who have helped transform me to the fittest and strongest I’ve been in 20 years. Thanks everyone!
For more information about The Return from Injury Ski Day.