If you are fortunate (???) enough to have the joy of wearing an Ilizarov fixator, much of your normal, mobile life may have changed. This is mostly true for people wearing the frame for bone growth treatment or those with foot plates/rings. The latter impedes walking mostly because the pins through the foot are probably (In my opinion and experience) the most uncomfortable of the lot.

However, even though walking about will not be the most comfortable experience, exercise is still most important, especially as research has revealed that bone growth is stimulated by the application of pressure on the uniting bones.
You will have, most probably, been given a schedule of exercise and physiotherapy by your surgeon / doctor / hospital physio. It is imperative for your recovery that you follow this regime. [NB Check out the Downloads page for physio info.]
Two of the most important exercises for wearers of Tibial fixators are shown in the images below. The description beside each animation explains the reasons for each exercise.

Animated upper leg exercise

In this exercise, the aim is to stop contraction of the muscles and shortening of the tendons which can occur with a tibial frame. This normally happens because it is more comfortable to sit or lie with the leg bent than it is to keep it straight.
However keeping the leg as straight as possible is extremely important to ensure that the leg does not retain a permanent bend at the knee which would make walking, once the frame is off, very difficult.
With the leg straight out infront of you, the foot is placed on a pillow such that it is slightly raised. The thigh muscle should then be tightened such that the knee is pushed downward. This position should be held for a few moments and then gently released. The exercise should then be repeated several times. How often you do this exercise each day is up to you, but if you find you're doing it almost subconciously whenever your leg is straight then thats a good move!

Animated toe exercise

In this exercise strips of rubber band (Called Theraband in the UK) are formed into loops around the frame such that they can be hooked over the toes with enough force to encourage the toes to bend upward whilst not, of course, causing pain.
The toes can then be made to curl downward against the bands. This exercises the toes and also ensures that, as far as practicable, you are unlikely to suffer from claw toe. This is a problem especially if the frame is being used to lengthen a damaged bone. Since soft tissue and muscle does not naturally stretch too easily, without suitable exercise, the toes would end up clawed, making walking extremely painful and difficult, possible resulting in the need for further surgery to sever the tendons and allow the toes to straighten again.
A similar exercise can be carried out with a large strip or loop to enable ankle movement if you do not have the ankle fixed by the frame [See the photos of Dale Bondie in Frames people wear ]

Of course, if your lucky enough to have a local gym that is suitable equipped, then just because one bit of the body doesn't work, it doesn't mean that you can't go and exercise the rest.
My local council runs what are called 'Fresh start' sessions for people who have diabilities or who are recovering from illness or disease. The gym is highly accomodating and has supervision at all times to ensure that correct exercise is carried out.
With their permission and agreement, as well as normal upper body exercises, I have managed to use some of the equipment, with slight adaption, to help keep my upper leg and thigh muscles in some sort of half reasonable condition.

Close up of leather strap and caribina clasp

 Part view of me, the leg & the machine

The machine I use is an adjustable curl machine where the pully is adjustable in height as is the load which can be placed on the system.
I have used a large, thick leather dog collar which I can fit around my leg just above the knee. This can be seen in the left hand picture. which also shows how the strap is clipped to the operating cable of the machine.
The right hand shot shows me, in a seated position. The height of the pulley is adjusted such that my leg is held off the ground by the weight load placed on the machine. The exercise is to push the leg downward, whilst keeping it as straight as possible. This position is held for a time and the leg is then allowed, in a controlled manner to raise back to the starting position.


The exercises can be varied from seated on a chair to seated on the floor or in standing positions. If in any doubt at all, ensure that there is somebody in attendance whilst you exercise. Above all DON'T OVER DO IT !
You'll be surprised how quickly the muscles will start to improve.

Back to the contents page.