Recovering From A Serious Injury Or Ill-Health Is A Structured Work Of Art – Advice On Femoral Neck Fracture Rehabilitation For Luis, Please?

Images of fracture of the neck of the femur.

Click image for link to article.

Hi folks!

Painful as pain is, it’s here to protect us from ourselves. Just ask someone with leprosy. Post-surgical repair, that’s fine.

Picture of blood supply to the head of the femur.

It pays to understand the Biology of the region of injury, so study is good.

Today I received a tweet from a cyclist that I admire, Luis, asking for my thoughts on recovery from a subcapital hip fracture (broken neck of femur, where it enters the hip joint), but with no pain. Yep! He fell off of his bike – these things happen. The absence of pain is significant, and also dangerous in my opinion, as he may apply more pressure to the joint than is wise. So here, in a nutshell, is my advice:

  1. Do NOT put any stress on the joint until a physician says you may, and even then hesitate until you’re sure they are correct. My biggest worry would be damaging the blood supply to the femoral head. But then again, bones are much more alive and malleable than we tend to think.

    Stacey wearing a bone growth stimulator

    Stacey is recovering from spinal surgery, and she has a great attitude to the pain and discomfort – she’s wearing a bone growth stimulator, by the way.

  2. Make sure you have the best medical support you can find. The fact that you’re having gammagraphy makes me think your medical team is in touch with the latest methods – I know little or nothing about gammagraphy, I hasten to add.
  3. Understand the diagnosis, including the mechanics of the femoral neck, as this will determine your approach to rehabilitation down the road.
  4. Be patient, which is extremely difficult, as I know only too well. But don’t be patient with poor medical treatment or anything that could lead to a frozen hip joint.
  5. I suspect that gentle exercises in the pool, once the bone is stable (not yet!), would be the best place to start, but a good physical therapist (preferably from sports medicine) is critical for guidance through recovery.

    Luis on the podium

    I look forward to seeing you back on the podium, active and well. “Campeon vet III duatlon de sevilla

  6. Research the latest approaches to bone growth and repair – my friend was wearing a bone growth stimulator after her neck surgery, so things have obviously progressed since I was in veterinary clinical medicine back in the late 1960s. Whether this works for the femoral head I’ve no idea, but speedy bone repair is important.
  7. Then, when all that is over, you’ll need a careful plan for return to activity, for which I recommend that you start with the study of Feldenkrais, which is skeletally oriented.

Those are my initial thoughts on your condition. I cross my fingers for a good outcome on the gammagraphy, the location of the fracture, and it’s repair.

Image of Luis's hip repair.

Post-surgical image of Luis’s hip repair. Looks solid. How long ago, I wonder?

When I wrote all that I didn’t know Luis had completed a surgical repair. He just sent me the image, minutes ago. No pain at this stage is good. I recommend slow and steady physical therapy, but I’m interested in people’s experience out there, especially triathletes.

Being as fit as you are will most certainly help your return to normal life, Luis.

Oh! Yes!

Check out SlowTwitch for other’s experience.

Take care!

-k @FitOldDog



  1. You are right. The absence of pain is potentially lethal in many cases of trauma. I know you hate cotton wool but that joint sounds like injuries of men on ships that his a mine. They walk around help others, fight fires and then within days go into shock and die.
    Do not get back on that bike! Not yet. Keep it in mind. It is a horizon image and imagine all you are doing now is part of a journey to that horizon and it will get nearer every day.

  2. HIT a mine

  3. Hey Kevin this it´s the evolution. Kind regards
    Hip fracture in an triathlete 61 years old (anesthesiologist) after a bike fall


    If I can help someone I commented my process of recovery after hip fracture by fall of bike 2 weeks ago t

    incredible the encouragement and the support of so many friends that some even knew. This is critical to the long and hard process that I face
    In the absence of scientific evidence that should be in a process such as this, given the limited scientific data available, I have prepared a rehabilitation plan with the Group of professionals and friends that are treat me, based on a very active/aggressive and early rehabilitation in the belief that mobility is the basis of the recovery and the immobility it is the cause oh the failure
    This plan is far away of the conventional treatment of hip fracture and therefore nobody should follow it without an appropriate medical supervisión
    I tackle this period with the best of spirits and the highest positivity. Forgetting what happened.

    6. Very balanced and with a minimal restriction of food and proteins on which I do during training and supplemented with amino acids, vit D, calcium, Curcumin, omega-3, multivitamins and glucosamine
    7. from the 4th day of the operation walked with crutches with little support, I’m progressively, increasing today load 20 kg and walk with triple and double support alternative with crutches.
    8, Sessions of physiotherapy in the morning and evening including: 4 hours of magnetic therapy, muscle neuroestimulation, gymnastics of uncommitted muscles, therapy proprioceptive Fendenkrais, bike static progressive periods, today 20 min, and tomorrow I start swimming and aquarunning.
    The medical tests all OK: Rx split stable, densitometry above normal, correct bone metabolism and scan with good supply blood to the femoral head and good at breaking osteoblastic activity. Absence of pain.

    10. The inconvenience of a sprain of the acromioclavicular joint which I am not doing him much attention and also hurt me crutches. I’m just treating it with taping and massage and it is slowly improving

    According to my observations, I go with 1 month in advance on the usual recovery, I wish I can go on like this and reduce delays, something that is not my main objective, which is a complete recovery of the hip in the period that is necessary

    On 1-4-14

    1 I started to walk without crutches (with 2-3 months in advance)
    2 continuous intensive rehabilitation: proprioception (Fendenkrais exercises), swimming pool, bicycle static, elliptical and gym
    3 sessions of daily global gymnastics
    4 sessions of daily stretching
    daily magneto therapy sessions
    Feelings very positive and waiting for the RX for control of day 10, looking forward already to start running


    densitometry, metabolism of calcium, control RX are perfect

    1. Very good sensations. Intense rehabilitation program and the moral high

    2. The weight remained as the previous fracture. The same diet: much protein, calcium, vitamins and vitamin D, more Curcumin, omega 3 and 4 amino acids.

    3. Magnetic therapy daily

    4. Intensive muscle gym, pool, bike and elliptical maintenance program.

    I copy the “training” of these 2 last day

    Tuesday: morning: 30 km in 1:30 h MTB + stretching. Evening MTB 6 km + massage and stretching + MTB 6 km

    Wednesday: 5 km MTB + 30 min elliptical 5.5 km 118 fc) + 5 min in reverse + weights and focused general gymnastics in leg 45 min session + swimming 30 min + aqua running 30 min + MTB 5 km

    So very happy, shortening deadlines head with prudence but with decision, and without fear. Consistent with my idea of rehabilitation through movement.

    Today (april 10th) first exit in bike with the companions of the triatlón club to go to the site of the fall to scare away ghosts.

    Because the athletes we recover before

    We have the right weigh
    We eat properly
    We are motivated to be OK physically and mentally
    We are disciplined
    We know our body and its limits, we accept the pain and suffering as an integral part of the life
    Us after intense workouts or competitions, suffered numerous damages: muscle, joint, tendon, liver, heart, kidney etc, we submit to intense inflammatory problems and after these episodes the body begins its regenerative process to deal with the next competition. This makes our body (hormonal, metabolic etc) much more prepared for your feedback (such a wonderful process, like magic) than people who do strenuous exercise.

    That is why after an accident or illness, our body recovers more quickly than the rest of us that if provided that we do not change our attitude, mobility above all, immobility destroys us.

    Why always you’re in a situation of recovery explain to your orthopedic surgeon who you are, and what you want and what you are ready for an early recovery, is often that they do not know what you speak, they are commonly treat patients and non-athletes. Seek advice from sports physicians, licensed in physical training and physical therapists or rehabilitation specializing in sports medicine.

    Encouragement to all who are in a process of recovery from a severe injury, as am I.

    From full health you can get sick, from the perfect fit you can injure, but from disease or injury only it can be better.


    April 12th of 2014

    • Hi Luis, thanks for your story. I’ll put it up as a regular post in the next few days, so people get to see it. They sometimes overlook comment streams. Do you have a few pictures to go with it? That makes it all the more interesting – people love pictures. Kind Regards, Kevin

  4. Luis Torres says

    Dear Kevin, last friday new image control XR and MRI, the head of the hip it is in perfect condition similar that the other hio, with no symptoms of necrosis at all. The fracture is very well advanced in it´s consolidation. The soft tissue around the fracture it´s some swelling (this it is normal as a part of healing). I will put the image soon. The sensation are so good that probably I start some very light and short run in the beach near weak. I have some disconfort around the gluteus when I start walk. I´m treating fix next week with my phisioterapist, working in propioception and streathenig.

    • Hey, Luis,

      I’m so pleased to hear that you are doing well. Maybe I’ll visit my sister in Torrevieja next year and see you on the way?

      Gratuitous advice (with apologies): if you run on the sand, run barefoot, it feels great and the stress on your hips will be much reduced, in my opinion.

      Welcome back to health.


  5. Luis Torres says

    Thanks kevin, run barefoot it´s my option walk and run very slow. It will be a pleasure see you if finally you go to Torrevieja.
    How can I send to you the new hip images for the blog?

    • Hi Luis! How big are the files? You could use dropbox if they are large, or reduce image size in Photoshop, and send as smaller jpeg, which is how I have improved my load time. Smaller the file the better, as long as you don’t lose resolution. Keep up the good work. Cheers, Kevin

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Disclaimer: As a veterinarian, I do not provide medical advice for human animals. If you undertake or modify an exercise program, consult your medical advisors before doing so. Undertaking activities pursued by the author does not mean that he endorses your undertaking such activities, which is clearly your decision and responsibility. Be careful and sensible, please.