Pilon and tib/fib fracture effects on climbing

I recently suffered a pilon fracture as well as a broken tib/fib while snowboarding in Utah. Got surgery (ORIF) and am non weight bearing until the end of May. My question is; does anyone have experience (direct or indirect) with how this may affect my climbing? I'm assuming that bouldering will be off the table for awhile because of the possibility of aggravation/reinjury from a high/awkward fall. I'm trying to stay psyched about climbing in the fall and train my upper body and core as much as possible. Any advice or input would be greatly appreciated. Thanks!

I feel your pain, I suffered an open tib and fib fracture this past January, also in Utah(snowbird). I am nowhere near recovered and still have months to go before I put any type of shoe on my right foot, so I will be unable to give any insight on how to start up again. However, I have managed to keep the fire burning.
There are a lot of books worth reading that can help aid in fine tuning skills. I have some big wall aspirations so i've been absorbing as much as possible from the internet and the books I'm reading. Some Techniques can still be practiced and refined even if you cant get on the wall. For instance, I've been rigging hauling system simulations on the ground, familiarizing myself with it as much as possible (of course this is not near as valuable as practicing this on the rock but hell I'm in a fucking wheelchair). I'm also taking this time to read every trip report possible for some objectives I have on my list, this is a great time to review topos and learn from others success/mistakes.

Ive noticed my leg shrink significantly in size, atrophy acts fast. Keep in mind it weakens more than just the injured area, be careful once you're weight bearing. Dont push it too hard right outta the gate. I know a few friends that blew their knees or ankles out after a leg break the day they get cleared from the doc to exercise.

Do you plan on getting PT? I imagine your range of motion will be pretty limited after all this.

I don't know if this is the type of stuff you were looking for but I hope it helps.

Good luck with your recovery, I wish you a seamless transition back into everything.

LR

Pilon fractures vary a lot, so the experiences of others with this type of fracture may not predict your results very accurately.

A friend of mine had one (from a leader fall), and could ride his bike OK but had a very big limp while walking.
He was considering surgery to have the joint fused.
He was about 60 when the injury happened; that could be a factor although he's always been in excellent shape.

In general, it is wise to be conservative about what your goals are for recovery.
First is to become weight bearing. This may not happen as predicted, so be prepared for setbacks.
Next is being able to walk on it.
Hopefully those goals will be reached, and I would not worry about planning for climbing until you get to that point.
Try to keep it simple and enjoy increased mobility at any level.

Nothing wrong with upper body training as things heal up, of course.
My shoulders got a lot stronger from walking around with crutches while I
waited for my tib-fib fracture to heal.
It also took a long time to my Achilles to finally stretch back out.
I didn't have a Pilon fracture, though.

Solid advice, much appreciated. I do have permission from the doc to start PT this week. I'm assuming it will be limited to ROM exercises/stretches initially and will eventually begin to incorporate re-learning to walk and balance/strength rebuilding once I am weight bearing. I know that the road to a full recovery is a long one and I have no intentions of pushing it too hard...the last thing I want is a major set-back/re-injury. Slow and steady wins the race. LR, wishing you a steady, rapid recovery. Keep the fire burning!

First off, really sorry to hear. Pilot fractures are the absolute worst. I had an open pilon fracture a little over two years ago, coupled with fib/tib fractures as well. 21 days in the hospital and three surgeries later, I had my ORIF done. The recovery path was faster than expected, going from my last surgery in early March to starting 10% body-weight bearing in mid-May, and walking again by June. Only wearing sneakers until July, and PT all throughout until December (nine months). Even then, I still had uneven strength.

YMMV, but the biggest issue I had with going back to climbing was that another fall with all the hardware in would've been catastrophic. So, I waited a year, and I had the hardware removed. Two months later, I went back to the climbing gym for the first time. A little less than a year after that, and I'm about to embark on a 12-month climbing/mountaineering trip, and I'm climbing better than I was before the accident.

Some keys to recovery:
- Food and supplements: This is huge. Green leaves, bone broth, and the right calcium supplementation will make all the difference.
- PT: Most PTs are awful. I went through five different PTs until I found one that worked. The key thing is to get someone who understand you want to get back to an active lifestyle, and also who can work on your flexibility. Getting at least 5-10 degrees of dorsiflexion is critical and will require a bit of painful work (which a lot of PTs - for liability reasons - don't do).
- Meditation and keeping a positive attitude.

In any event, feel free to DM me if you want more info. I can't say I'm "glad" my fracture happened, but I have to say a lot of good came with the recovery period.

Here's to a quick and healthy recovery!

A quick update for anyone who is interested. At 10 weeks post-op I was able to begin bearing weight, made the transition from the walking boot to a heavy duty ankle brace in less than four weeks, but am currently still using a cane to walk occasionally. At five months post-op I have achieved about 18 degrees dorsiflexion. My ROM is "very good" according to my doc and therapist, granted I worked very hard to make sure this was the case. Strength in my right leg is probably close to 70%, better in my quad/hamstring, less in my calf/ankle. Biking and swimming have been my go-to sources of exercise, as well as core, pull and finger strength. I have climbed about five times in the gym (top rope only), managed to scramble up a few 10s...was climbing up to 12a pre-injury. Completely lost my right heel hook, but I'm certain that will come back with strength.

Still have a lot of progress to make, but I want to encourage anyone with this, or a similar injury, to stay positive and keep your head up. Attitude is EVERYTHING! I hope this post can provide some reassurance to those facing serious injury and long recovery periods. Never give up!!

... 2 years later. I really ‘enjoyed’ this thread. 21 days in the hospital WOW! I’m 2 months since pilon fracture after a leader fall at Seneca Rocks, WV. 2 surgeries later, I’m very concerned about my future in climbing and overall outdoor activity which is what powers my soul. I’m up again w insomnia worrying about this stuff.

My surgery site looks like the Eiffel Tower w the hardware inside the shin but it doesn’t hurt so bad. What does hurt are the nerves in the foot. Half my foot feels completely dead and some of the nerves inside the foot are constantly firing. When it intensifies, it feels like screws being tightened in to the ball of the foot. Might be effects of surgeries or from my leader fall. Will take time to know if it’s permanent but hasn’t stopped.

Anyway, if any of you have long term (2-year) updates, I’d love to hear how you’ve recovered over time. I realize all Pilon fractures vary in severity. Mine is probably average. I was really encouraged to hear about your return to walking... climbing!

Thanks!
Tommy H

Tom H wrote: ... 2 years later. I really ‘enjoyed’ this thread. 21 days in the hospital WOW! I’m 2 months since pilon fracture after a leader fall at Seneca Rocks, WV. 2 surgeries later, I’m very concerned about my future in climbing and overall outdoor activity which is what powers my soul. I’m up again w insomnia worrying about this stuff.

My surgery site looks like the Eiffel Tower w the hardware inside the shin but it doesn’t hurt so bad. What does hurt are the nerves in the foot. Half my foot feels completely dead and some of the nerves inside the foot are constantly firing. When it intensifies, it feels like screws being tightened in to the ball of the foot. Might be effects of surgeries or from my leader fall. Will take time to know if it’s permanent but hasn’t stopped.

Anyway, if any of you have long term (2-year) updates, I’d love to hear how you’ve recovered over time. I realize all Pilon fractures vary in severity. Mine is probably average. I was really encouraged to hear about your return to walking... climbing!

Thanks!
Tommy H

What about 22 years later? Still have the hardware in which causes some issues- more as the years go by. It took about 9 months to sort of walk again and to start climbing again. Mentally it was hard, really hard but you get through and it is awesome again. Your climbing does change - I loved bold but now less so but that varies too. Even though I have very limited flexibility in the ankle you adjust. I climbed mid 12 after the injury and for a long time. Right now I am recovering from serious injury number 3. Started leading again after 5 months off with an easy trad 10. So happy to be out again. Now just building up again but need to be careful of not pushing too hard. 6 months after the last incident I head to France for 7 weeks alpine climbing. That is 3 weeks away so nervous but psyched. In the early injury or recovery phase it is hard to see the light  but you get there, maybe not the same as before but you adjust.

Ps buy some walking poles for long approaches and distance travel - will save you lots of pain and wear and tear. Even if you think it is 100% healed the joint will likely be damaged with increased risk of osteoarthritis so minimise weight on the leg by sharing the load.
Best wishes