Broken Pubic Rami Bones
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15th Mar '10, 5:39pm
Hi,
Had a nasty fall off my bike resulting in breaks to both pubic rami bones on the left hand side, an annoying fractured rib, lots of soft tissue damage and a broken tooth. Spent an agonising week in hospital. Got very little guidance on how to rehabilitate... was so doped up on painkillers, the info wouldn't have registered anyway...
So any advice for a 42 year competing at elite level (up to 9 days ago)? I'm not concerned about the tooth or rib. A visit to the dentist and 6 weeks taking it easy will sort them out. The pelvis is the big concern. How long can I expect to be laid up? Take to the bed or work at limiting muscle loss?
Pubic ramus fracture
22nd Mar '10, 3:29pm
Your adductors attach to the pubic ramus. These muscles not only adduct the leg but also act as stabilizers in unilateral stance. You are in for a long rehab. road. Healing in this area is slow. Unfortunately, i have also had this injury. It was over a year before I was running well again (speed and hills). Don't get discouraged.
how bad was the fracture...
22nd Mar '10, 5:01pm
how bad was the fracture... hair line? multiple fragments?... any screws or fixation devices? Was it a fracture or the separation of the pubic symphysis (aka diastasis)?
1 )right off the bat... Calcium & vitamin D... to give the body what it needs to rebuilt the bones.
2) nice call on the adductors... don't forget the part of the hamstring attaches onto the the ischial tuberosity... proximity.
3) not knowing too much details... I'd imagine you're going back for followup xrays to see how the fractures are in 4-5 wks?... if bones look find... then it's just a matter of logically, and progressively getting "more" active.
4) Soft-tissue injuries... thing tissue flexibility (muscle, ligaments & tendons)... what they are suppose to do, and how to introduce "forces" back onto them without overloading them. Ever heard of "Active Release Technique" or "Graston technique"... both are fantastic with soft-tissue rehab... done by those doctors and/or trainers that are active individuals who want their bodies to performance just like you do
5) if it hurts to move, fire/twitch/flex muscles without moving the hip, just to get the muscles to do something. you're bound to go thru some atrophy, the littlest muscle activities will always help.
6) do everything else while you wait for the pelvis to get on the bike. ie upper body strength training... in the beginning... pain is your guide... anything that causes pain, you might want to avoid for the moment...
7) later on... as you feel better... and more encourage to do more... just remember, it's not able speed... that comes much later... at first, think tissue tolerance... just building your pain-free frequency with your activities.
8) does it hurt to do front planks or side planks? where does it hurt?