Skiing after Tibial Plateau fracture

[Ski Fanatic Mom]

I am looking for feedback from any one who has had the unfortunate experience of suffering a tibial plateau fracture.

With ski season only 5 months away, I am looking for reassurance that I will be able to ski again. I am 5 months into my recovery (no surgery), and presently in physical therapy 3 times a week.

Although my doctor and therapist assure me I "should" be able to do most things I did before, there are still days when I am doubtful.

I am 51 years old, this is my first injury ever! Prior to my fall (which was the result of slipping on ice while walking and falling HARD on my knee - followed by a fall while skiing the next day ) I had been very physically active for decades...skiing 5 times a week during the winter months, and biking and hiking off season.

I had no idea how long recovery would be! I am gaining strength and although walking any distance is still uncomfortable, I am able to ride my bike for 20 mile trips without any pain.

So, I guess the bottom line is, I am seeking reassurance that there is life after a tibial plateau fracture! Skiing is an addiction and obsession! The thought of not be able to ski is very hard to think about.

Thanks in advance for any feedback.

Bernadette

 

[Robyn]

I have no input on your injury other than to say I'm so sorry and hope that your recovery keeps progressing. Remember, 5 months is a long time and I'm guessing you have every chance to recover in time. Your level of fitness before the injury is certainly helping.

But, I wanted to say welcome to the forum! Feel free to ask if you have any questions.

 

[MaineSkiLady]

Welcome, Ski Fanatic Mom! Ah, sorry to read that your first post here had to be about an injury :(

Based on experience with my son's 2 ACL injuries, what made the difference for him was going to a really serious sports performance rehab facility. The place he went to for both ACL rehab testing (though most of the regulation PT was done closer to home) pretty much had him "wired for sound" when doing periodic performance testing (which was so brutal, I couldn't imagine myself doing it in the complete absence of an injury). This place rehabs and strengthens a lot of pro and high-level performance athletes (with "thanks" photos and posters all over the walls as testimony).

I would think that a similar type of performance center would be worth your while, re: the type of electrode/muscular output testing that takes place. Once those numbers are in, the PT/trainers are able to recommend more specific work-outs and exercises to strengthen what's weak. There would also be discussion as to what type, if any, support would benefit your particular injury.

Strengthening of the specific region around your injury, as well as some close-up looks at the actual site itself, would seem to be a prudent step for you at this point in time, especially if you are continuing to have walking pain 5 months post-injury.

For what it's worth, this particular facility had my son back in competitive condition less than 6 months after patella tendon graft ACL and meniscus resection. He wore a DonJoy carbon fiber brace for 14 months post-surgery with both knees but has weaned off now (per PT) and only uses them on "sore" days. (which do happen)

 

[cwmscm]

I fractured my tibial plateau in December 2007. I also partially tore my MCL. I was skiing cautiously but on steeps by Feb. 2008 and less cautiously in March 2008 (no jumps). By May 2008 I could do some jumps. I am doing lots of leg strengthening exercises and I can tell that the hurt knee performs less well than the other. The fracture is no problem but the soft tissue injury to the MCL is the problem. It won't hold me back from skiing though.

So depending how badly you fractured and how fast you heal, you will probably be able to ski. Let's just hope that there is snow to ski on.

 

[KatyPerrey]

Sorry to hear of your injury but not to worry!!!

I fractured my tibial plateau in 2 places and had grade 2 tears in the MCL back in March of 1996 and was playing tennis 8 weeks later. Skiing the following season was simple. I was lucky - didn't have surgery because the breaks did not displace. I was no weight for 5 weeks and then slowly added weight over the next 3. For me the MCL is what took so long to heal but if you follow/do what the PT says you should be good to go! Don't get frustrated!!!!
As a repeat offender and graduate of physical therapy :p all I can say is keep with it and you will be back on the slopes stronger than ever!!!

 

[Ski Fanatic Mom]

Thanks for the encouragement , Robyn. Most days are "good days" but it's those occasional bad ones that get me discouraged. I'm not anticipating any extreme skiing this season, but I just can't wait to be back out on the slopes again.
Bernadette

 

[skibum4ever]

I suffered a tibia plateau fracture on November 16, 2006 at Breckenridge. Was able to ski to the bottom but could not walk after removing the ski. Saw 3 surgeons in 3 weeks before finding the "right" one. It was displaced so surgery was required. Had surgery Dec. 4. Have a titanium plate and 4 screws in my leg.

I was 53 when I broke it.

About three weeks after surgery they removed the cast and the stitches. The next day I was riding the bike at the gym. Had to put the seat really high as my ROM wasn't very good. I worked really hard at non-weight bearing PT (per my surgeon) and weight-bearing PT (per my self-imposed schedule). Six weeks after surgery I was back on the slopes (mid January), skiing somewhat slowly and carefully, but skiing - to the horror of most of my friends. Used a brace all through 2007 and finally gave it up in January, 2008.

Bought a Skier's Edge and used it for low impact exercise throughout the summer and fall of 2007. Also did a lot of biking. Had no problem when I started skiing in October 2007.

Sounds to me like you're fitter than I was. Bike riding is a great exercise. I think that keeping the knee flexible and the muscles around it strong is very important. You will definitely ski this winter. A knee brace is probably a good idea for this coming season. You should not have any problem.

We just got back from 3 weeks in Chile. I realized that I have regained all my strength in the injured leg. I could ski every day and not have any problem. Skiing is an obsession for me as well. Good luck; it will be fine.

 

[Calamity Annie]

I suffered a tibia plateau fracture on November 16, 2006 at Breckenridge. Was able to ski to the bottom but could not walk after removing the ski. Saw 3 surgeons in 3 weeks before finding the "right" one. It was displaced so surgery was required. Had surgery Dec. 4. Have a titanium plate and 4 screws in my leg.

I was 53 when I broke it.

About three weeks after surgery they removed the cast and the stitches. The next day I was riding the bike at the gym. Had to put the seat really high as my ROM wasn't very good. I worked really hard at non-weight bearing PT (per my surgeon) and weight-bearing PT (per my self-imposed schedule). Six weeks after surgery I was back on the slopes (mid January), skiing somewhat slowly and carefully, but skiing - to the horror of most of my friends. Used a brace all through 2007 and finally gave it up in January, 2008.

Bought a Skier's Edge and used it for low impact exercise throughout the summer and fall of 2007. Also did a lot of biking. Had no problem when I started skiing in October 2007.

Sounds to me like you're fitter than I was. Bike riding is a great exercise. I think that keeping the knee flexible and the muscles around it strong is very important. You will definitely ski this winter. A knee brace is probably a good idea for this coming season. You should not have any problem.

We just got back from 3 weeks in Chile. I realized that I have regained all my strength in the injured leg. I could ski every day and not have any problem. Skiing is an obsession for me as well. Good luck; it will be fine.

I fell skiing with my kids the day after Christmas. I ended up going down backwards and well I fractured and bruised the tibial plateau. I also skied down. Loaded the car, drove my kids home and went to park. When I stuck my left let (injured one) out of the car to get out, I crashed to the ground. Opppps. I am 66 and never skied at all until I was 42. I have skied most years since then mostly east coast ice . The last three winters I have been at Crested Butte, CO. The skiing is incredible here and I have gotten so much better. I was really the best ever when I crashed this year. I had just started doing little jumps and bumps. I am old which is apparently a problem with HGH production. I take HRT already and work out at the gym 6 days a week. I lost about 130 pounds 4 years ago and don't want to gain it back. I am having a terrible time with the crutches. I have arthritis in my hands that makes the crutches unmanageable. I have fallen 6 times in 9 days because of the crutches. I have a brace too. I started at the gym immediately doing no weight bearing exercise. I have just about 99,9% maybe ROM and almost full strength when extended. The problem comes if I stick my leg to the side (not straight up) and try to put weight on it. That hurts. Otherwise it doesn't hurt except when I try to sleep.

The crack did not show up at all on the X RAY . Only on the MRI. There was no depression of the bone but bruising was there. I also have not had any menisci to speak of in 40 years,so I don't know if I miss them or not. I was told no damage to ligaments , that they are all intact. So have been sort of bad. I walk around my house carefully putting my leg straight up and down and only use the crutches outside. I don't think I am stressing the break since there is NO pain unless I get on the side. So maybe it will slow my recovery but another fall and I might need surgery. I did three hours in the gym today, non weight bearing. leg and butt and upper body and core. I did also 10 miles on an arm driven bike and 30 on a stationary bike. They are saying that skiing again this season is a "stretch" and giving me the most wimpy PT ever. I gave up on it. I did all the stuff they wanted me to do in 10 minutes. It was silly. So I am working with the gym lady who works with them a lot, she says it is because they don't know me that they are being so slow. I was hoping to be back up there with tape and a brace in 6 weeks. Is that wildly unrealistic?

 

[skibum4ever]

I fell skiing with my kids the day after Christmas. I ended up going down backwards and well I fractured and bruised the tibial plateau. I also skied down. Loaded the car, drove my kids home and went to park. When I stuck my left let (injured one) out of the car to get out, I crashed to the ground. Opppps. I am 66 and never skied at all until I was 42. I have skied most years since then mostly east coast ice . The last three winters I have been at Crested Butte, CO. The skiing is incredible here and I have gotten so much better. I was really the best ever when I crashed this year. I had just started doing little jumps and bumps. I am old which is apparently a problem with HGH production. I take HRT already and work out at the gym 6 days a week. I lost about 130 pounds 4 years ago and don't want to gain it back. I am having a terrible time with the crutches. I have arthritis in my hands that makes the crutches unmanageable. I have fallen 6 times in 9 days because of the crutches. I have a brace too. I started at the gym immediately doing no weight bearing exercise. I have just about 99,9% maybe ROM and almost full strength when extended. The problem comes if I stick my leg to the side (not straight up) and try to put weight on it. That hurts. Otherwise it doesn't hurt except when I try to sleep.

The crack did not show up at all on the X RAY . Only on the MRI. There was no depression of the bone but bruising was there. I also have not had any menisci to speak of in 40 years,so I don't know if I miss them or not. I was told no damage to ligaments , that they are all intact. So have been sort of bad. I walk around my house carefully putting my leg straight up and down and only use the crutches outside. I don't think I am stressing the break since there is NO pain unless I get on the side. So maybe it will slow my recovery but another fall and I might need surgery. I did three hours in the gym today, non weight bearing. leg and butt and upper body and core. I did also 10 miles on an arm driven bike and 30 on a stationary bike. They are saying that skiing again this season is a "stretch" and giving me the most wimpy PT ever. I gave up on it. I did all the stuff they wanted me to do in 10 minutes. It was silly. So I am working with the gym lady who works with them a lot, she says it is because they don't know me that they are being so slow. I was hoping to be back up there with tape and a brace in 6 weeks. Is that wildly unrealistic?

Hi, Calamity Jane, and welcome to the forum. Have you tried using a walker rather than crutches?

Yes, I was out skiing again 6 weeks after surgery. It was probably 9 or 10 weeks after the fracture, because I spent a long time going to surgeons I wasn't impressed by. But bear in mind that though it was healing after those 3 to 4 weeks, it was not healing straight and had to be rebroken before it could be fixed. Wear your brace and take a couple of short beginner runs. You'll know if it's time to become more aggressive, but please stay away from bumps and jumps. It sounds like you're already making tremendous progress. Please keep us posted and stick around, as there are a lot of nice and very knowledgeable women who hang around on Ski Diva.

 

[Calamity Annie]

Hi, Calamity Jane, and welcome to the forum. Have you tried using a walker rather than crutches?

Yes, I was out skiing again 6 weeks after surgery. It was probably 9 or 10 weeks after the fracture, because I spent a long time going to surgeons I wasn't impressed by. But bear in mind that though it was healing after those 3 to 4 weeks, it was not healing straight and had to be rebroken before it could be fixed. Wear your brace and take a couple of short beginner runs. You'll know if it's time to become more aggressive, but please stay away from bumps and jumps. It sounds like you're already making tremendous progress. Please keep us posted and stick around, as there are a lot of nice and very knowledgeable women who hang around on Ski Diva.

Thanks for replying so quickly. Most of the stuff I have read is bleak. I never did bumps or jumps until this year anyway, so no big loss--it was my goal for this year, but I guess now I would count if a goal-met if I just got back out there this year. I don't need surgery and since I don't have depressed bone--just bruising and good bone density in my knee +3.5 on my last DEXA I feel like I will get out at least a bit this year. I have had slow healing fractures before but I was in much worse shape overall, and ate a terrible diet. So thanks for the encouragement. I am using a cane in the house a walker would be too wide. We live in a really small place and getting to the bathroom would be really difficult. I guess I just have to be very careful and step as gingerly as I can.
Thanks Again, and Happy New Year--It dumped about 3 feet today. I guess Prince Harry was supposed to shovel my car out. haha. He didn't show up though. Oh well. I did my best.

 

[Calamity Annie]

Thanks for replying so quickly. Most of the stuff I have read is bleak. I never did bumps or jumps until this year anyway, so no big loss--it was my goal for this year, but I guess now I would count if a goal-met if I just got back out there this year. I don't need surgery and since I don't have depressed bone--just bruising and good bone density in my knee +3.5 on my last DEXA I feel like I will get out at least a bit this year. I have had slow healing fractures before but I was in much worse shape overall, and ate a terrible diet. So thanks for the encouragement. I am using a cane in the house a walker would be too wide. We live in a really small place and getting to the bathroom would be really difficult. I guess I just have to be very careful and step as gingerly as I can.
Thanks Again, and Happy New Year--It dumped about 3 feet today. I guess Prince Harry was supposed to shovel my car out. haha. He didn't show up though. Oh well. I did my best.

PS. will bumps ever be back in my skiing vocabulary?

 

[bounceswoosh]

@Calamity Annie , *hug* That sounds really difficult! I have also had experience (much more minor) with thing A interfering with the recovery of thing B. What a pain.

Have you tried the crutches that have a "C" shape around the arm as well as the grip? I don't know if they'd be better or worse for you ... certainly different than the typical crutches. Crutches are the pits.

 

[ski diva]

I have no advice, @Calamity Annie . Just wanted to chime in and say how sorry I am that this happened to you. Wishing you a fast and full recovery.

 

[COchick]

I fractured my tibial plateau in March of 2012 at Vail. (Wow has it really been that long?? Geez) FWIW, if you have to get hurt, Vail is the place to be. Haha!! From the time the first responder arrived slopeside to the time I was OUT of MRI was only 45 minutes. Crazy.

Anyway. In June of 2011 I tore my meniscus (slacklining of all things) and had surgery on that knee... they elected to repair it, so recovery was very slow. My first time out skiing after that was in January and I took it slow, but everything seemed fine, if a little more achy at the end of the day. So after the tibial plateau fracture, I was like F*****!!! When I got home (because I was on vacation when it happened), I saw the ortho that did the surgery on my meniscus the year before. He wanted to do surgery and put screws in. So I scheduled the surgery, but my BF was like wait... you should get a second opinion. I had a friend that was a radiologist for an ortho at a different location, so on the Friday before my surgery was scheduled, I went to see him. His advice was to let it heal naturally, and to not do surgery. I thought that sounded preferable, so cancelled my surgery (hospital was like whaaaa???) and did all the rehab required. Best decision I ever made! After rehab, that knee felt as strong as it ever had, and better than the surgery knee. In January of 2013 I went to Japan, which we already had scheduled when I had my accident, and I damn sure wasn't going to give up on that. But I was SO nervous. My first international ski trip and it was the first time out on skis since the fracture. Well I needn't have worried. I ended up being able to ski all day long, and while I had to (and still have to) ice down at the end of the day, it went better than I could have expected. I do always wear a brace on both knees now, though, as well as compression tights.

I think you'll be surprised at how good your knee will feel next time out on skis, providing you've been doing all the right rehab stuff. A fracture is by far a better situation than a ligament tear. Honestly the worst part about it all was the fear of falling and re-injuring the knee - either of them. It was REALLY hard to get over that, and to just get out of my own head, but thankfully Japan was so full of light fluffy snow that the one time I did fall it was like falling into a marshmallow. And that at least got me over my initial fear, like... I can still fall and be OK. In the end, I actually ended up a better and more confident skier.

Good luck!

 

[bounceswoosh]

rehab rehab rehab rehab

 

[Calamity Annie]

@Calamity Annie , *hug* That sounds really difficult! I have also had experience (much more minor) with thing A interfering with the recovery of thing B. What a pain.

Have you tried the crutches that have a "C" shape around the arm as well as the grip? I don't know if they'd be better or worse for you ... certainly different than the typical crutches. Crutches are the pits.

Thanks so much. I am going to ask for another MRI after two weeks, which will be in a few days. There is so much snow now, I am not going anywhere really. <y friend got permission to weight bear after two weeks. Maybe I will too? If not I am going to ask for other crutches with the arm thing for sure. Thank you.

 

[Calamity Annie]

I have no advice, @Calamity Annie . Just wanted to chime in and say how sorry I am that this happened to you. Wishing you a fast and full recovery.

Thank you. I am hopeful. The snow is dumping and it doesn't hurt. I rode the ex bike 10 miles today on 2 resistance and I have 100 % range of motion.

 

[Calamity Annie]

I fractured my tibial plateau in March of 2012 at Vail. (Wow has it really been that long?? Geez) FWIW, if you have to get hurt, Vail is the place to be. Haha!! From the time the first responder arrived slopeside to the time I was OUT of MRI was only 45 minutes. Crazy.

Anyway. In June of 2011 I tore my meniscus (slacklining of all things) and had surgery on that knee... they elected to repair it, so recovery was very slow. My first time out skiing after that was in January and I took it slow, but everything seemed fine, if a little more achy at the end of the day. So after the tibial plateau fracture, I was like F*****!!! When I got home (because I was on vacation when it happened), I saw the ortho that did the surgery on my meniscus the year before. He wanted to do surgery and put screws in. So I scheduled the surgery, but my BF was like wait... you should get a second opinion. I had a friend that was a radiologist for an ortho at a different location, so on the Friday before my surgery was scheduled, I went to see him. His advice was to let it heal naturally, and to not do surgery. I thought that sounded preferable, so cancelled my surgery (hospital was like whaaaa???) and did all the rehab required. Best decision I ever made! After rehab, that knee felt as strong as it ever had, and better than the surgery knee. In January of 2013 I went to Japan, which we already had scheduled when I had my accident, and I damn sure wasn't going to give up on that. But I was SO nervous. My first international ski trip and it was the first time out on skis since the fracture. Well I needn't have worried. I ended up being able to ski all day long, and while I had to (and still have to) ice down at the end of the day, it went better than I could have expected. I do always wear a brace on both knees now, though, as well as compression tights.

I think you'll be surprised at how good your knee will feel next time out on skis, providing you've been doing all the right rehab stuff. A fracture is by far a better situation than a ligament tear. Honestly the worst part about it all was the fear of falling and re-injuring the knee - either of them. It was REALLY hard to get over that, and to just get out of my own head, but thankfully Japan was so full of light fluffy snow that the one time I did fall it was like falling into a marshmallow. And that at least got me over my initial fear, like... I can still fall and be OK. In the end, I actually ended up a better and more confident skier.

Good luck!

Thanks that was so helpful. I don't have menisci (medial ) in either knee. Not for 30-40 years maybe now. I am not worried about that part. I am as you say worried about rein jury, I am older (66) and I am not sure at all about how it will heal without much HGH. Only exercise supposedly helps your body make it when you are older So, anyway, I am pretty hopeful, as I have zero pain, full ROM and strength in the leg at 11 days out. I am wondering if it really is fractured. The MRI was the only thing that showed it and the doc kept saying, it looks like a fracture. maybe it isn't. There was no compression or depression on the bone just bruising supposedly. She is also a former Olympic team surgeon, with a great rep, but I am really wondering if there is a mistake. No swelling either. I have some pain in both knees all the time and did before the accident. But I am hoping either it is a mistake or that it is so minor I will be fine with a brace in 6-8 weeks.

 

[Calamity Annie]

I fractured my tibial plateau in March of 2012 at Vail. (Wow has it really been that long?? Geez) FWIW, if you have to get hurt, Vail is the place to be. Haha!! From the time the first responder arrived slopeside to the time I was OUT of MRI was only 45 minutes. Crazy.

Anyway. In June of 2011 I tore my meniscus (slacklining of all things) and had surgery on that knee... they elected to repair it, so recovery was very slow. My first time out skiing after that was in January and I took it slow, but everything seemed fine, if a little more achy at the end of the day. So after the tibial plateau fracture, I was like F*****!!! When I got home (because I was on vacation when it happened), I saw the ortho that did the surgery on my meniscus the year before. He wanted to do surgery and put screws in. So I scheduled the surgery, but my BF was like wait... you should get a second opinion. I had a friend that was a radiologist for an ortho at a different location, so on the Friday before my surgery was scheduled, I went to see him. His advice was to let it heal naturally, and to not do surgery. I thought that sounded preferable, so cancelled my surgery (hospital was like whaaaa???) and did all the rehab required. Best decision I ever made! After rehab, that knee felt as strong as it ever had, and better than the surgery knee. In January of 2013 I went to Japan, which we already had scheduled when I had my accident, and I damn sure wasn't going to give up on that. But I was SO nervous. My first international ski trip and it was the first time out on skis since the fracture. Well I needn't have worried. I ended up being able to ski all day long, and while I had to (and still have to) ice down at the end of the day, it went better than I could have expected. I do always wear a brace on both knees now, though, as well as compression tights.

I think you'll be surprised at how good your knee will feel next time out on skis, providing you've been doing all the right rehab stuff. A fracture is by far a better situation than a ligament tear. Honestly the worst part about it all was the fear of falling and re-injuring the knee - either of them. It was REALLY hard to get over that, and to just get out of my own head, but thankfully Japan was so full of light fluffy snow that the one time I did fall it was like falling into a marshmallow. And that at least got me over my initial fear, like... I can still fall and be OK. In the end, I actually ended up a better and more confident skier.

Good luck!

You know, this is weird. But mine stopped really hurting after a few days--then it sort of stopped hurting at all. Finally after 16 days I went and had a second opinion as well. It turns out have all sorts of old injuries in my knee but my tibial plateau is NOT fractured. I have no menisci--but that was known already. I also apparently have a loose MCL (also old) and a large baker's cyst--none of which was relayed to me by the super surgeon. I skied for the first time yesterday , after 20+ days of not skiing or really using my left leg--trying no to be weight bearing. I did continue to work out the whole time with the rest of my body. But I was so sore (all over) when I woke up today. I am so shocked at how much strength I lost i three weeks--but I did. It is undeniable. My knee was a bit achy, but I iced it last night and it feels okay this morning. This whole experience has really made me question the methods used by orthopedic doctors. On another tibial plateau site, I saw a man whose doctor made him get off the crutches at two weeks and by all accounts he had an incredible recovery. I have a friend , a personal friend, who also had this same experience. Off crutches at two weeks and heavy duty pushing hard rehab and exercise program. Wow. I am starting to think that much of the problems people face are from the "rest" advice . Maybe resting is not as beneficial as it was assumed to be. I don't know about the "truth" of my knee. But I skied for two hours yesterday with no ill effects. The snow was heavy (we are in Crested Butte during 2017 Snowmageddon). But I am very glad that I at least kept up a heavy exercise routine even when I was not WB on my left leg. My left leg has atrophied, but I can see it could have been way worse. Also second opinions, are seeming like a "must do".

 

[Obrules15]

You know, this is weird. But mine stopped really hurting after a few days--then it sort of stopped hurting at all. Finally after 16 days I went and had a second opinion as well. It turns out have all sorts of old injuries in my knee but my tibial plateau is NOT fractured. I have no menisci--but that was known already. I also apparently have a loose MCL (also old) and a large baker's cyst--none of which was relayed to me by the super surgeon. I skied for the first time yesterday , after 20+ days of not skiing or really using my left leg--trying no to be weight bearing. I did continue to work out the whole time with the rest of my body. But I was so sore (all over) when I woke up today. I am so shocked at how much strength I lost i three weeks--but I did. It is undeniable. My knee was a bit achy, but I iced it last night and it feels okay this morning. This whole experience has really made me question the methods used by orthopedic doctors. On another tibial plateau site, I saw a man whose doctor made him get off the crutches at two weeks and by all accounts he had an incredible recovery. I have a friend , a personal friend, who also had this same experience. Off crutches at two weeks and heavy duty pushing hard rehab and exercise program. Wow. I am starting to think that much of the problems people face are from the "rest" advice . Maybe resting is not as beneficial as it was assumed to be. I don't know about the "truth" of my knee. But I skied for two hours yesterday with no ill effects. The snow was heavy (we are in Crested Butte during 2017 Snowmageddon). But I am very glad that I at least kept up a heavy exercise routine even when I was not WB on my left leg. My left leg has atrophied, but I can see it could have been way worse. Also second opinions, are seeming like a "must do".

Four weeks of complete bedrest will cause a healthy active 30 yo to lose the ability to walk. More and more in medicine we are decreasing the amount of rest recommended. These days people are "forced" (at least that's what they are whining about when you talk to them later) out of bed the evening after c/s and abdominal gyn surgeries because it decreases the rate of complications.

The only people I would trust to tell me who a good surgeon is are the actual hospital nurses who are unaffiliated with the practice and have no skin in the game. Individuals can have great results with mediocre physicians. There are also specific things people are good at, so your super sugeon may have his reputation from ACLs but have much less experience with tibial plateaus especially if everyone sends him their ACL repairs.

I like to break things up. I'm taking my aunt to Emory University for diagnosis and recommendations for her parathyroid gland but we're going to a parathyroid specialty surgical center if she needs surgery. I don't want the surgeons to decide if she needs surgery because of the old but true adage that says if your only tool is a hammer everything becomes a nail. Cutters (surgeons) cut, druggers (internal medicine) drug , etc.

Yes, second opinions are key as long as you aren't in the middle of a life threatening problem. Academic Medical Centers are the best, even if it doesn't feel that way, for problem solving, diagnoses, and weird stuff (not routine surgeries as they tend to not do a lot-they spend too much time thinking or doing weird cases). It freaks people out to see residents and medical students but you get hours more attention and the the attending physicians are torturing the learners about your case when you can't see them. Surgeons with high volume for routine type cases. Those are the rules I force my family to follow.

I should say in terms of the activity v. rest, there are some things that if you don't rest them they predispose you to other injuries so still be mindful.