Broken leg, subsequent rehabilitation and a spa stay

How my rehabilitation went after breaking my leg. And how I dealt with the sudden change in what was possible.

The injury

At the end of the winter of 2016/2017 I went for a walk below the peaks of the Krkonoše mountains. As it goes, misfortune does not walk in the mountains but among people, and so it found me too. During that walk I slipped, fell awkwardly and broke my leg.

The journey

I was carried down the hill by the mountain rescue service, and I felt like Karel Havlíček Borovský being carted off into exile, because due to the lack of money for the mountain rescue service the servicing of their car had been postponed, so the service interval had probably been exceeded in the end and the "smart" electronics in the car kept switching the engine off. I was only dreading that we would end up driving without the engine running and therefore without the brake booster. Fortunately that did not happen.

I was then examined at the medical centre in Špindlerův Mlýn, X-rayed, my leg was set back into its original position and fixed. It was a severe fracture with torn ligaments around the ankle. So I had to have surgery. Since I was born in Jilemnice, it was decided that I would go to the hospital in Jilemnice for the operation. However, it was not clear how or by what means. I will not keep you in suspense for long — fortunately it was not by the proposed taxi. I ran into a good man, and we even knew each other from secondary school. He was a paramedic assistant who was heading the same way, so he gave me a lift to the hospital. The place where I was treated operates as an independent facility. They have no contracts with the health insurance companies, probably to make the point that the insurers sink money into things other than supporting the health of their clients. And so the procedures at this facility are not covered by insurance. That is why I was also charged before leaving.

The operation

I was operated on at the hospital in Jilemnice, specifically by young Dr. Myšík, a capable doctor who surely has a bright professional future ahead of him. First I had to decide whether I would be operated on under general anaesthesia or with only half of my body numbed. I chose the partial anaesthesia. All I remember from the operation is that I felt as if a carpenter was building a custom stool down at my feet.
In the early evening I was still under the narcotics. So when I answered the doctor that I felt fine, she just smiled. But at night I could not sleep because of the pain, so I started taking painkillers.

They upgraded my leg with two titanium screws. I spent the first few days lying in hospital and then I was transported home with difficulty, where I lay for several weeks and injected myself against blood clots.

While the operation went quickly, the healing was long and gloomy. When a person who is very active both professionally and privately, and on top of that an athlete who races, suddenly cannot walk from one day to the next, it is a shock. All of a sudden I had to think about whether I needed the toilet right now or later. Even taking care of that need while sitting was demanding.
Happier moments came once the pain eased and I managed to get at least a little sleep. And then when I learned to walk on forearm crutches and found out that you can move around the kitchen quite comfortably on a wheeled chair.

Walking on stairs, however, was still a problem, especially with forearm crutches. That is why I got large underarm crutches:

With those I could at least hobble outside once a day for fresh air and sunshine. I always prepared tea in a thermos, food and a book, put everything in a small backpack and set off on the descent.

Extraction of the 1st screw

As long as I had both screws in my leg, I was not allowed to put any weight on the operated leg. The ankle was immobile and apparently the screw could even have broken.
After many weeks I went in as an outpatient for surgery under local anaesthesia and they pulled the first screw out of my leg. (Removing the screw was no more painful/unpleasant than having a tooth pulled.) I stopped giving myself injections and the rehabilitation could begin.

Rehabilitation

The chance to rehabilitate had come, but given the minimal mobility and the pain in the leg it was still demanding to perform ordinary everyday tasks, let alone get to rehabilitation.
I regularly commuted to rehabilitation and above all rehabilitated intensively at home. For example, I used weights that could be strapped above the ankles:

At a time when I still could not walk properly, I at least strengthened my thigh muscle at home so that the leg would not weaken too much:

This way I could start loading the thigh muscle without being limited by my ankle injury.

Then, as soon as I was able to put at least a little weight on the injured leg, I started rehabilitation on the bike. The bicycle is in fact ideal rehabilitation for leg injuries, because you can load and unload the leg entirely individually. The only obstacle was hobbling down the stairs and getting on the bike. But once you had hobbled over to the bike and the crutches stayed by the fence, riding a bike even in such a state was no problem for an experienced racing cyclist. On top of that, the sudden feeling of being able to move and be free, when after many weeks you get further than the toilet and the surgery department, is amazing. As a result, at first glance the person rehabilitating gives the impression of someone in full health, but the eyes often deceive...

The main ways of rehabilitating:

• Walking
• Swimming
• Strengthening and stretching the leg muscles around the ankle
• Cycling
• Strengthening the arch of the foot:
  • Walking barefoot
  • Picking up objects with the toes
  • Inchworm walking with the foot
  • Walking and standing on pebbles

The spa

Since I had a severe fracture, a stay at a spa is suitable for intensive rehabilitation. That is why the doctors filled in a spa application for me, which I sent to my health insurance company.
So at the end of July I checked into the spa, where I completed a four-week rehabilitation stay. Specifically at the spa in the town of Lázně Bělohrad.

Rehabilitation at the spa

Let me describe my experience with the stay at the spa. Every weekday and even on Saturday I had treatment procedures. We were given an exact schedule according to which I went around the procedures:

The spa programme was very demanding. Typically the pensioners were so exhausted in the afternoon after the procedures that they then slept it off. And already on Thursday they were looking forward to the free time on Sunday when they would rest.

My procedures:

• The procedure typical of the spa in Lázně Bělohrad is a wrap in warm mud. Officially it is referred to as a moor mud (peat) wrap. The wrap lasts 30 minutes and then, after rinsing off, 15 minutes wrapped in a sheet.
• Neck massages of about 15 minutes.
• Group exercise in the pool. Ideal rehabilitation for those who have difficulty moving. For those pensioners who exercised conscientiously it was also very strenuous, because water can put up considerable resistance.
• Individual exercise is tailored to the patient and their injury or health problems. It lasted 15+15 min. In my case it was strengthening and stretching of the muscles mainly around the ankle. I did exercises on a balance board. With great effort I also tried exercises on one leg — the injured one. My physiotherapist Andrea did a very good job.
• Carbon dioxide bath. I squeezed into a bag, probably a waste bag, into which they let CO2 in. It sounded like a pub tap when the beer runs out. I stayed in the bag for about 20 minutes. The aim is better blood circulation in the limbs and on the surface of the body.
• Hydro-massage of the legs.
• A bath in pink sea salt, 15 min + 10 min wrap.
• Time in the whirlpool.
• Other types of baths: herbal, pearl
• Gym — again focused on strengthening the leg and mainly the muscles around the ankle. The local trainer and bodybuilder Jirka had a very proactive and individual approach. When he found out I was an athlete, he showed me several very demanding exercises, for example the hack squat, and showed me a new exercise for me where you do a squat on one leg with the other leg resting freely on a bench behind the body.
• Peat compress
• Laser
• Magnetotherapy

Magnetotherapy in action:

Facilities

I was accommodated in a small room in the Grand hotel.
Food is an important element in life and especially in rehabilitation. I was pleasantly surprised that the food was not hospital-like but even above average compared to ordinary restaurants. There was no problem getting a large portion for a big active man, also given my high level of activity, when I had an extreme energy expenditure.

For dessert I got, for example, a tasty cake like this:

Sometimes it happened that I had a procedure right after breakfast. Exercise in the pool with a full stomach, for instance, is not ideal, so in such cases I only picked at breakfast and took the rest with me for after the pool.

Other activities at the spa

There was not much free time. The afternoons depended on how many procedures there were that day and how they were arranged. Saturday afternoon was free and then Sunday. There was a while after dinner. I go to bed early and we had to get up early in the morning for the procedures, so I did not stay up late.

Weather station:

During my stay at the spa the MTB race Podkrkonošský Maraton took place, in which I took part this year only as a spectator. This time I therefore had different experiences than as a racer...

Video from the start of the Podkrkonošský Maraton 2017:

I also made use of the municipal outdoor gym next to the sports grounds:

I went to this gym occasionally in the morning before breakfast to warm up. I mostly strengthened my chest and abdominal muscles there.

Walking slowly, I went to visit Bažantice, where there is a spring of ferruginous water:

I often went to the park to read books, where there is also a restored summer pavilion/gazebo:

I was visited twice by my excellent friend, masseur and fitness trainer Martin Háze. Once again it turned out that for a capable person it is a piece of cake to fit a visit to a friend into their diary.

When the weather was really nice, I went to the water, where in my free time I could rehabilitate by swimming. I visited several swimming spots, some by bike and others by car.
The Dachova natural swimming pool:

The ride back from Dachova:

The swimming pool in Konecchlumí:

The swimming pool in Lanžov:

The ride to Lanžov:


I also visited the swimming pool in Miletín, but that one is more for children. The pool is not big, it is shallow and there were a lot of people. As a swimmer, it therefore did not suit me very much there.
I also went to several other swimming spots and one secret one... There are plenty more pools and ponds I did not manage to try.

When the weather was not right for swimming, I rehabilitated on the bike.
Word soon got around the spa that there was some guest who went cycling after every procedure. I do not know who it was. I only went cycling every afternoon with regular recovery breaks once a week ;-).
My racing specials, the road bike and the mountain bike, were often parked in front of the spa and so the bikes were often admired. That is how I got to know a lot of interesting people. Even a modest, kind photographer who used to photograph the cyclocross champion Šimůnek.

On the road bike I even got onto the racing circuit for road motorcycles:

More photos from the rehabilitation rides:

The chapel in Lanžov:

A view of the church and the swimming pool in Konecchlumí:

A view from Byšičky of the pond at sunset:

On the MTB bike Duratec Torein I also rode parts of the Podkrkonošský Maraton course in sections. On some sections of the course I got off the bike for reasons of lack of training and safety and walked that part down or around on foot.

On the last day of the stay, when all that remained was to check out, I finally had enough free time, so I planned and successfully completed an endurance training ride of 111 km. I rode via Nový Bydžov and Chlumec nad Cidlinou all the way to the motorway.


To finish off, in the early evening I went for a swim in the pool in Konecchlumí:

The transport home was done with a car for a tall driver, into which both bikes and all my things fitted beautifully:

Continuing the rehabilitation at home

The fact that the spa stay was over did not mean the need to rehabilitate was over.

For home I bought a balance board and a resistance band:


I also dusted off the dumbbells so that my skeletal muscles would gain strength again:

Balance board:

I also dusted off the magnetotherapy device:

Extraction of the 2nd screw

I rehabilitated very responsibly all summer and so autumn came, when it was time to remove the second screw. The procedure was performed on an outpatient basis, that is, without the need to stay in hospital. The removal took a long time, but in the end they pulled it out, including the washer. So there is nothing extra in me any more.

Non-rehabilitation activity

Being on sick leave is a very demanding period. When your health is not ideal, your mood gets worse too. What matters is how you approach it and how those around you do. It is important to take a good attitude and do things that make you happy!

Rehabilitation was of course the priority, but a workaholic needs his fix. That is why I used the remaining time on sick leave not only to keep my spirits up but also to improve my soft skills:

• I practised English using the duolingo app and watched English films with English subtitles.
• I read books.
• I read about AJAX, Erlang and other IT technologies.
• Rest is important, especially for healing, so rest came first for me.
• Especially at the beginning I kept my leg elevated, but later on I still had to take a lot of care of the leg in various ways
• No less important is nutrition. Given the demands of the rehabilitation I included a high-quality diet for athletes.
• I could not attend the Installfest conference, but thanks to the conveniences of today's modern age I followed the conference online.
• Online training could also be managed, with certain difficulties.
• The most necessary and urgent needs of others I resolved with expert advice over the phone.
• I was also able to think through and partly prepare a talk for the Open Alt 2017 conference

A video invitation to the Open Alt 2017 conference, which I shot shortly before it took place:

How to sleep with a broken ankle?

You get sleep the same way as any other sleep. You need fresh air, to get up with the sun and go to bed at dusk, to have enough movement during the day — that is, to rehabilitate — and to have peace and quiet in the evening. If pain is troubling you, then take something to relieve the pain before going to sleep.

Advice after two years

I get a lot of questions by email, so I summed up the information two years after the injury.

Conclusion

I can recommend a recuperative spa stay to everyone, even to people in full health. And above all, be careful and take preventive care of your health.
More health advice can be found on the Fitness poradce portal.