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Recovering from a femur fracture.

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Recovering from a femur fracture.

Old 12-15-22, 02:23 PM
  #1  
DangerousDanR
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Recovering from a femur fracture.

About two weeks ago I fell on a small patch of black ice. My non-drive side femur neck was broken at the ball and at the trocanter.

PT has been willing to be as aggressive as possible, and I am already climbing stairs and walking with a cane.

I have been told that in two weeks I should be able to ride a stationary bike. Mostly to get back to full range of motion. That should put me past Fat bike season.

Once I have good range of motion, the slow fight to regain strength will begin. That is where I am hoping for a little input.

The broken (non-drive) side is going to be a lot weaker than the side which was not broken. I'm wondering if now is the time to get a dual sided power measurement system?

The PT people and the surgeon are all in with me doing weight bearing exercises now and see no issues going forward.
I don't see any other way to be certain that I am working the injured leg as hard as possible. My plan is to do a mix of leg presses, stair climbing treadmill, and riding a bike.

If yes to power monitoring, dual sided pedals, crank arms, or a spider based sensor? My road bikes have Campagnolo 5 bolt spiders so a spider system likely means a new crank.

Any thoughts on how much benefit I will get from a balanced effort and power monitoring?

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Old 12-15-22, 04:06 PM
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I don't put much into trying to power balance your legs. To train one leg to get stronger is to not train the other leg to get as strong as it could so your over all power is lower. Your weaker leg will catch up to a reasonable balance fast enough. Talk to your PT person about it.

Bikes are real efficient in converting leg power into motion. And if you look hard you can see that bikes move in surges as each pedal stroke occurs. So I can't fathom why you'd need to have it surge equally with both legs. Though I can see where people get the false idea that a smoothing of the power is better. Admittedly I have not been interested to read in depth on the subject. So if any has a good rational I'm open enough to consider it.

However if that is your excuse to get a dual sided PM, then go for it. I'm trying to justify to myself getting the right side PM to go along with my left side PM.

I'm happy with the crank arm base PM's. They seem to be the less expensive right now. I think hub based PM are long gone. My PM is 4iiii. But others are out there too for way less than pedal based PM's.

Any thoughts on how much benefit I will get from a balanced effort and power monitoring?
You'll know if you been fibbing to yourself how much power you put out! <grin>

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Old 12-15-22, 04:10 PM
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Get the Garmin dual PM pedals and make your insurance company pay for it as part of rehabilitation. You might have to get the PT people on board, but it is worth a try.

More data can only help, but I am less clear what you can do about an asymmetry.

Did you get a surgically installed internal fixation?

If it were me (and it was, except drive-side ankle 10 years ago), I would rehab on an indoor trainer and use actual bikes 3 or 4 months from now when there is no danger from ice on the road.
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Old 12-15-22, 05:05 PM
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The neck of the femur was basically smashed, so I do have an implant.

I considered getting a power meter a few months ago, but decided that keeping track of heart rate and overall speed was enough to indicate level of effort. Wind is the big resistance here and my cycling app does include the weather information.

It is hard to compare ride to ride. What I did know was that on average I was as fast last year as the year before.

My leg press lift is limited by the machine at the gym I use, but I was doing about 400 pounds on each side.

PT wants me to just do stairs for now, getting on the stationary bike at a month after surgery, so that is what I will do.

The orthopedic surgeon indicated that at two months I should be good to go on a bike. I'm going to see him tomorrow and ask a bunch of questions. It would be nice to be able to ride to work.

And if there is a significant benefit I will pay for a PM out of pocket. I'm still working full time as an engineering team lead, so if it will help it is a done deal.

And Mrs. Dan has always said that since we only have one car I should spend what I want on bike stuff. Also, we are both inherently cheap, so she knows that if I spend money, I believe there is value in what I am buying.

The insurance ( United Healthcare... but they are all <illegitimate children> ) did refuse to pay for an inpatient rehab stay because... well, they are the bean counters and I had already climbed stairs in the hospital...

My real question was about strength balance. My DS knee was not as strong as the NDS, thanks to an injury 50 years ago. But when I lift I make sure that I keep the load and repetitions the same.

Doing that has made them pretty close. If there is benefit to having balanced power, monitoring is the only way I can think of to make it happen. If there is no benefit, then I won't worry about it.
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Old 12-15-22, 06:37 PM
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Originally Posted by DangerousDanR View Post
Once I have good range of motion, the slow fight to regain strength will begin. That is where I am hoping for a little input.
I have been in your boat, with my left trochanter broken into 4 pieces. The surgeon screwed the parts back together (no artificial joint).

By the time I could get onto a bike, the muscles on my left side were quite weak. But I didn't do anything in particular to get back my leg strength. I just rode a lot.

The strength came back just fine. Other than some reduced range of motion (which has never returned), I would never know there was a difference between legs.
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Old 12-15-22, 07:24 PM
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About 35 years ago, I snapped my left Achilles tendon, not a biking accident; my forefoot just slid off a tall step I was sort of jumping up onto. I had surgery and was in a cast for 8 weeks. So sort of the same thing. I rehabbed it both in the gym and on my rollers. On my rollers, I did quite a bit of one-legged pedaling. I did intervals of up to 2 minutes, same gear both sides, and to exhaustion both sides. That was an easy way to keep track of progress. In the gym, I did one-legged work where I could, like on the leg sled, back machine, single-leg deadlifts, one-legged calf raises, whatever I could think of. Today, that left calf is still smaller than the right, but it's just as strong. I still do some one-legged work in the gym and the one-legged pedaling.
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Old 12-16-22, 08:19 AM
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Originally Posted by Polaris OBark View Post
Get the Garmin dual PM pedals and make your insurance company pay for it as part of rehabilitation. You might have to get the PT people on board, but it is worth a try.
I'm not sure whether this is an abuse of the system, or just brilliant.

If OP does decide to try it, push to get it approved before the end of the year, while you're already covered by your out-of-pocket maximum for the year. Otherwise it'll just fall into your deductible bucket for 2024.
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Old 12-16-22, 04:56 PM
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Originally Posted by Polaris OBark View Post
Get the Garmin dual PM pedals and make your insurance company pay for it as part of rehabilitation. You might have to get the PT people on board, but it is worth a try.

More data can only help, but I am less clear what you can do about an asymmetry.

Did you get a surgically installed internal fixation?

If it were me (and it was, except drive-side ankle 10 years ago), I would rehab on an indoor trainer and use actual bikes 3 or 4 months from now when there is no danger from ice on the road.
Durable medical equipment is generally reimbursable only if it has no other use.

As others have said, I wouldnt worry too much about the inevitable asymmetry. It will improve on its own and it can be tested and addressed in the gym. I am aware of no data showing that symmetry is fast anyway.
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Old 12-16-22, 06:20 PM
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I went in for my 2 weeks checkup today. The surgeon was of the opinion that what I need to do now is get to the gym and on a stationary bike.

My training stand is too difficult to get on right now, and there is the "their house, their rules" factor. If I'm out in public I will work harder than if I'm at home. Not sure that is true for me, but they do have recumbent stationary bikes that are easier to get on and off.

He is also in the camp of not worrying about differential strength, but in another 6 weeks they will take detailed measurements and possibly fit me with an auxiliary insole to insure equal length of my legs.

Thanks for the opinions voiced here. Since I only want the power meter if it will help with my recovery, it is now off the table.

Last edited by DangerousDanR; 12-16-22 at 06:25 PM.
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