Pain guide · Knee pain

Tibial plateau fracture: weight-bearing limits, rehab and the long-term outlook

A tibial plateau fracture is a break of the top of the shin bone (tibia), where it forms the lower half of the knee joint. It happens in high-energy injuries such as crashes, falls from a height and sport, and in falls from standing height in older people with weaker bones. Many need an operation with plates and screws; breaks that haven't moved can heal in a brace.

Recovery is long. Weight on the leg is often limited for weeks, set by your surgeon and varying a lot between hospitals, and then strength comes back over months. This guide explains the treatment, what one small trial and pooled studies show about putting weight on earlier, the warning signs, staged exercises with a 3D demo of each, and honest figures on work, sport and later arthritis. Your surgeon's and fracture clinic's plan comes first.

4-stage exercise plan When to get help 35 sourcesUpdated 21 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E after an injury if the leg is twisted or bent, a bone is sticking out, there's a bad cut or wound, or there are signs of shock: cold, sweaty skin, a fast or weak pulse, fast or shallow breathing, or blue, grey, pale or blotchy skin or lips. While you wait, don't move the leg or put weight on it, and don't eat or drink in case you need surgery.
Call 999 or go to A&E after a high-energy injury, such as a car crash, a fall from a height or a heavy tackle, if the knee looks deformed or felt as if it came out of joint, the foot is cold, pale or numb, or you can't lift your foot or toes. The knee may have dislocated, which can damage the artery and nerve behind it, even when a pulse can still be felt. Don't drive yourself.
Go to A&E: in the days after the injury or an operation, pain far worse than the injury seems to explain, a tight, full-feeling calf, pain that gets worse when you move your toes or foot, and tingling or burning. These are signs of acute compartment syndrome, a medical emergency; a tight cast or bandage can cause it, so if you have a cast, contact the hospital straight away.
Same day (NHS 111): after an injury, the leg is very painful or the pain is getting worse, there's a lot of swelling or bruising, it hurts to put weight on it, or it's very stiff or hard to move.
You hurt your knee and cannot take 4 steps, or you are 55 or over and hurt it in a fall: get it checked the same day for a broken bone.
Same day (NHS 111), while you're recovering: the pain gets worse; a very high temperature, or feeling hot, cold or shivery; the leg, foot or toes feel numb or burning, or look swollen, blue or white; the cast, splint or brace rubs or feels too tight or too loose; or there's a bad smell or it feels wet under the cast.
After surgery: changes in feeling, severe pain or swelling, a change of colour, or oozing from the wound. Tell the ward team, or once you're home, your GP or NHS 111.
Call 999: calf or leg pain or swelling with breathlessness or chest pain. It could be a clot that has reached the lungs. Do not drive yourself to A&E.
Same day (GP or NHS 111): throbbing pain and swelling in one leg, usually the calf or thigh, with red, blue or darkened skin or swollen veins. This can be a deep vein thrombosis (DVT). It is more likely after surgery, a hospital stay, 3 or more days in bed, or time with the leg in a cast.

See a doctor or physiotherapist if

The knee isn't bending or straightening as your team expected at each stage, or swelling keeps rising after exercise: tell your physiotherapist.
Once you're walking, the knee gives way, catches or locks: ligament or meniscus injuries often come with these fractures, so ask for a review.
In a brace: skin redness that doesn't fade after 15 to 20 minutes, a marked increase in swelling, sores or blisters, or pain, irritation or rubbing. Contact the physiotherapy team as soon as possible.
Pins and needles or numbness down the leg, or pain anywhere other than the knee: tell the fracture clinic or your physiotherapist.
Pain, stiffness or swelling that builds months or years later: see your GP. Arthritis after a plateau fracture is common, and treatment and a specialist review can help.

Understand it

What it is

The top of the shin bone widens to form the lower half of the knee joint; its upper surface, the tibial plateau, is made of softer, spongy bone. In most plateau fractures, the end of the thigh bone is driven into it, leaving part of the joint surface pushed down and sunken. That can upset the knee's alignment and, over time, add to pain, arthritis, instability and stiffness.

The skin, muscles, nerves, blood vessels and ligaments around the knee can be injured at the same time. Breaks on both sides of the plateau are the most complex.

Sources 1, 2, 3

Who gets itEmerging evidence

In a population of about 576,000 people, about 10 per 100,000 broke a tibial plateau each year, at an average age of 53. Men under 50 had higher rates than women, while rates rose sharply in women over 50. In German hospitals (2019 to 2022), the rate was 22 to 25 per 100,000 and 62% were women.

Younger people usually break it in a high-energy injury, such as a fall from a height, sport or a road crash; older people with weaker bones, in a fall from standing.

Sources 4, 5, 1

How it's recognised

Pain that's worse when you put weight on the leg, swelling around the knee and limited bending, sometimes with a knee that looks out of place. A pale or cool foot suggests a problem with the blood supply, and numbness or pins and needles around the foot a nerve injury or dangerous swelling.

X-rays come first: NICE (the National Institute for Health and Care Excellence) asks clinicians to use the Ottawa knee rules to decide who needs one. A CT (computed tomography) scan usually follows, to show the extent of the break and plan surgery. MRI (magnetic resonance imaging) isn't routine, but it's used to look for soft-tissue injuries, or for a hidden fracture when the X-ray is normal but the story fits.

Sources 1, 6

What a scan finding does and doesn't meanEmerging evidence

Torn menisci (the knee's cartilage shock absorbers) and ligament injuries often come with plateau fractures: across 17 studies (1,348 people), a tear of the outer meniscus went with about 5 mm more sinking of the outer plateau.

But meniscus tears are also common in people without knee problems. In 991 people aged 50 to 90 from the general population, tears were found in 19% of women aged 50 to 59 and 56% of men aged 70 to 90, and 61% of people with a tear had had no knee pain, aching or stiffness in the previous month. A tear seen after a fracture may be new or old; your surgeon decides whether it matters.

Sources 7, 8

Healing, work and sportEmerging evidence

In one cohort followed after surgery, the bone joined at about 4.7 months on average in people under 65 and 5.3 months in those 65 and over, with similar function at a year.

In 39 people who had surgery, the median time off work was 120 days: 90 in light jobs and 180 in heavy ones, and 10% cut their working hours. In 105 people, everyone in work before surgery went back, after an average of 11 weeks. Across 27 studies (920 people), 70% returned to sport, and 60% after open surgery with plates and screws. Return took a median of 6.9 months in one study and a mean of 22 weeks in another, often with a switch to lower-impact sport.

Sources 9, 10, 11, 12

The longer viewEmerging evidence

In 1,101 people from several hospitals, about 6 years after the injury, those treated without surgery scored about 5% below people of the same age for symptoms, pain and daily activities, and 68% were back at their peers' level. Those who'd had surgery scored 14% lower, and 36% lower for sport and quality of life, with only 30% at their peers' level for sport; their breaks were usually worse. In an Australian group 5 to 10 years on, knee scores and quality of life were lower than in a matched population, and people said they wished physiotherapy had been arranged routinely.

Of 114 people X-rayed a mean of 10 years after the fracture, half had arthritis (34% in the injured knee only, 16% in both knees), more often after breaks of the inner side or both sides. In Ontario, 7.3% of 8,426 people who'd had surgery had a knee replacement within 10 years, against 1.8% of matched people from the general population; older people and those with more severe breaks were more likely to need one.

Sources 13, 14, 15, 16

Older adultsEmerging evidence

In 47 people aged 65 and over operated on at one centre over 20 years, frailty strongly predicted death, 57% of the fixed breaks healed out of position, and 15% later had a knee replacement. The 5 who had a knee replacement straight away were the only ones allowed full weight at once, and they had fewer further operations. Another cohort found people aged 65 and over did as well as younger people after fixation. These are small studies.

Sources 3, 9

What helps, and how strong the evidence is

Brace or surgery: chosen by the breakStrong evidence

Health New Zealand says a break in a good position needs a brace or cast and crutches, and one that isn't in a good position, is unstable or involves the joint surface needs an operation. US orthopaedic surgeons (the American Academy of Orthopaedic Surgeons) say surgery to restore the joint is often right for an active person, while for others, medical problems may make surgery of limited benefit.

Operations use plates and screws, sometimes with bone graft or a substitute to fill the gap left when the sunken surface is lifted, or an external frame, which can be temporary while the skin and muscles recover. We found no trial comparing surgery with a brace for the same fracture. In the 1,101-person cohort, people treated without surgery ended closer to their peers, but their breaks were less severe, so this doesn't show that surgery made anyone worse.

Sources 17, 1, 2, 13

How long without full weight: practice variesEmerging evidence

As your surgeon allows. Your weight-bearing status is decided by your surgeon and written on your plan. UK hospitals describe it as non-weight-bearing, limited or unrestricted, and the British Orthopaedic Association (BOA) asks for the reason and how long it lasts to be written down too.

US orthopaedic surgeons say full weight usually waits until some healing has occurred, which may take 3 months or more. Traditional aftercare after surgery is 10 to 12 weeks of no or limited weight, but practice varies widely: of 111 Dutch surgeons, 72% started weight earlier than that, and of 151 surgeons worldwide asked about the same cases, most restricted weight, for anything from 2 to 12 weeks, and 45% said their plan was based on 'gut feeling'.

Sources 18, 2, 1, 19, 20

Putting weight on earlier: one small trial and low-quality pooled dataEmerging evidence

As your surgeon allows. In one small randomised trial, 54 people with simpler, one-sided plateau fractures fixed by surgery were allotted to walking on the leg as much as was comfortable straight away, or to no weight for 6 weeks, with the same exercises; 45 finished. At 6 months the immediate group had better pain, walking and knee movement scores, with no difference on X-ray or CT, and the joint surface sank in 1 person against 3.

Pooled studies (10 studies, 940 adults, mostly lower quality) found that early weight-bearing didn't increase pain, slow healing or non-union, and a review of 9 studies called it safe in selected cases. In older people, a matched study found similar knee scores but more widening of the plateau on X-ray with early weight.

This isn't standard practice yet, and hospitals differ. Complex or two-sided breaks are usually protected for longer, and your surgeon decides when you can put weight on the leg.

Sources 21, 22, 23, 24

Compartment syndrome and blood clotsStrong evidence

Compartment syndrome is a dangerous build-up of pressure in the leg muscles. In 766 plateau fractures at one centre, 14 (1.8%) developed it, mostly when they first arrived and mostly in younger men; with prompt surgery to release the pressure, function at a year matched that of people without it. A review calls the risk high after high-energy plateau fractures.

UK standards list pain out of proportion to the injury, and pain when the muscles are passively stretched, as the key signs, and ask for surgery immediately once it's diagnosed. NICE says blood-thinning injections may be considered while the leg is immobilised, if the risk of a clot outweighs the risk of bleeding.

Sources 25, 26, 27, 28, 29

Exercise after a plateau fracture: practice-basedEmerging evidence

Apart from the timing of weight-bearing, we found no trials of rehabilitation programmes. NHS physiotherapy leaflets start ankle pumps (10 every hour), thigh tightening, heel slides, straight-leg raises, knee straightening in a chair, hip movements and a calf stretch, 10 of each, 3 times a day, within any brace limits, often with a range-of-movement brace for about 6 weeks.

Another NHS knee fracture leaflet expects normal daily activities in 6 to 12 weeks, apart from high-impact tasks, and no sport for at least 12 weeks. People interviewed 5 to 10 years later asked for physiotherapy to be arranged routinely. The later stages and milestones here are editorial.

Sources 2, 31, 30, 14

Arthritis and knee replacement: a real risk, not a certaintyEmerging evidence

Half of people had arthritis on X-ray about 10 years after the fracture, with higher odds after breaks of the inner side or both sides, and those with arthritis scored lower for pain and function. In a large matched study, 7.3% had a knee replacement within 10 years of surgery, about 5 times the rate in similar people without the injury; older age and more severe breaks raised the risk.

So most people didn't need a replacement, but the risk is real. Keeping the thigh strong is a sensible way to look after the knee, though no trial has tested it after a plateau fracture (our suggestion).

Sources 15, 16

How much pain is OK while you exercise?

Your weight limit first; then an ache that settlesEmerging evidence

Your weight-bearing instruction overrides any pain rule. Pain isn't a reliable guide to how much weight a healing plateau can take, so don't add weight because it doesn't hurt; ask your surgeon or physiotherapist.

Time painkillers with your exercises, as NHS leaflets suggest. An NHS knee fracture leaflet's rule: aching, discomfort or stretching after exercise is normal; if pain lasts more than about 30 minutes or gets stronger, do the exercise less forcefully or less often, and talk to your physiotherapist if that doesn't help. Short, frequent sessions (5 to 10 minutes, 4 times a day) suit better than one long one.

Once full weight is allowed, the rule from our other knee guides can be borrowed: rate the pain 0 to 10; 0 to 2 is safe, up to 5 acceptable, above 5 too much, and back to your usual level by the next morning. A knee that swells more after a session has done too much (our suggestion).

Pain far worse than expected with a tight calf, a knee that gives way or locks, or pain that keeps rising week on week isn't a pain-rule question: get it checked.

Sources 18, 20, 2, 30

The exercise plan: 4 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Protect the joint: weight as your plan says (the first 6 to 12 weeks, as your surgeon allows)

As your surgeon allows. Your weight-bearing status (non-weight-bearing, limited or unrestricted, with the reason and how long) is on your plan; use your crutches or frame exactly as taught, including on stairs (steps in the notes below). If you have a range-of-movement brace, don't change its settings; it's often worn for about 6 weeks. Rest with the leg raised, the ankle higher than the hip and the knee straight, and use ice for 10 to 15 minutes if there's no cast or heavy dressing. Do each exercise 10 times, 3 times a day, within any brace limits, timing painkillers to suit. You may be given blood-thinning injections.

Ankle circles demonstrated on the 3D figure

3D demoAnkle circlesBeginner · No equipment

Ankle pumps: 10 every hour. Then turn the sole in and out · A King's College Hospital NHS leaflet's dose

Harder: Ankle CARs (controlled articular rotations)

Quad set (static quads) demonstrated on the 3D figure

3D demoQuad set (static quads)Beginner · No equipment

Push the knee into the bed, toes pulled towards you: hold 5 to 10 s, 10 times, 3 times a day · A King's College Hospital NHS leaflet's dose

Harder: Straight-leg raise

Supine heel slide demonstrated on the 3D figure

3D demoSupine heel slideBeginner · No equipment

Bend the knee within your brace limit, then straighten: 10 times, 3 times a day · A King's College Hospital NHS leaflet's dose. Stay inside the range your team allows

Harder: Hip windshield wipers

Straight-leg raise demonstrated on the 3D figure

3D demoStraight-leg raiseBeginner · No equipment

Knee locked straight, lift the foot 10 cm and hold 5 s: 10 times, 3 times a day · A King's College Hospital NHS leaflet's dose

Easier: Quad set (static quads) · Harder: Leg extension

Seated knee extension (chair) demonstrated on the 3D figure

3D demoSeated knee extension (chair)Beginner · A bench or box + Something with weight

Sitting, straighten the knee, then lower slowly: 10 times, 3 times a day, no weight · A King's College Hospital NHS leaflet's dose, within your limits

Easier: Quad set (static quads) · Harder: Leg extension

Seated calf stretch with a towel demonstrated on the 3D figure

3D demoSeated calf stretch with a towelBeginner · Other / check instructions

Towel round the foot, knee straight: hold 30 s · A King's College Hospital NHS leaflet's dose

Harder: Wall calf stretch (gastrocnemius)

Move on when: Your surgeon increases your weight-bearing status, commonly between 6 and 12 weeks, sooner in some. Hospitals differ, so wait for yours.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Weight back on: walking again (typically weeks 6 to 16, as your surgeon allows)

As your surgeon allows. Build up weight exactly as instructed and wean off the crutches; you may still need them at times. Work towards walking without a limp, getting the knee bending fully, and simple balance and strength work. An NHS knee fracture leaflet expects daily activities to return over about 6 to 12 weeks, but not high-impact tasks. On days you can't stand for long, chair exercises help.

Slow calf raise demonstrated on the 3D figure

3D demoSlow calf raiseBeginner · A wall

Both feet, holding a worktop: up for a count of 3, down for 5, 10 to 20 times · The Otago strength and balance programme's dose

Easier: Seated bent-knee calf raise (soleus raise) · Harder: Standing dumbbell calf raise

Sit to stand from a chair demonstrated on the 3D figure

3D demoSit to stand from a chairBeginner · A bench or box

Up to 10, sitting down slowly, using your hands at first · The Otago programme's dose. Clear it with your surgeon first after recent knee surgery

Easier: Sit to stand, pushing on the thighs · Harder: Bodyweight squat

Recumbent exercise bike demonstrated on the 3D figure

3D demoRecumbent exercise bikeBeginner · Cardio machine

10 to 20 minutes at a moderate effort, building towards 30 · The move page's dose, once the knee bends far enough to pedal round and your team agrees

Harder: Stationary cycling

Single-leg stand demonstrated on the 3D figure

3D demoSingle-leg standBeginner · A wall

Fingertips on a wall: hold 5 to 10 s, 3 times each side; build to 30 s · The first dose is the NHS balance exercises'; the build is editorial. Once full weight is allowed

Easier: Tandem stance and heel-to-toe walk · Harder: Single-leg reach matrix

Side-stepping (sideways walking) demonstrated on the 3D figure

3D demoSide-stepping (sideways walking)Beginner · A wall

10 steps each way along a worktop · The move page's dose, from the NHS balance exercises

Harder: Lateral band walk

Treadmill walking demonstrated on the 3D figure

3D demoTreadmill walkingBeginner · Cardio machine

Walking, building gradually from 10 minutes · Editorial dose. Walking outside counts

Harder: Treadmill jogging

Move on when: You walk without aids or a limp, the knee bends nearly fully, and you can stand on the injured leg for 30 s.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Strength (typically months 3 to 6, as your team allows)

As your team allows. Single-leg strength 2 to 3 times a week while the bone finishes healing, which took about 5 months on average in one cohort. Doses are editorial unless a source is named.

3D demoStep-upBeginner · A step

3 sets of 8 to 10 each leg · Editorial dose

Easier: Low step-up · Harder: Dumbbell step-up

3D demoLeg pressBeginner · Strength machine

3 sets of 10 to 12, within the depth your team allows · Editorial dose

Harder: Bodyweight squat

Split squat demonstrated on the 3D figure

3D demoSplit squatIntermediate · No equipment

3 sets of 8 each leg · Editorial dose. Pad the back knee

Easier: Bodyweight squat · Harder: Reverse lunge

Patrick step-down demonstrated on the 3D figure

3D demoPatrick step-downIntermediate · A step

2 to 3 sets of 8 each leg, the knee tracking over the foot · Editorial dose

Easier: Bodyweight squat · Harder: Skater squat

Glute bridge demonstrated on the 3D figure

3D demoGlute bridgeBeginner · No equipment

3 sets of 10 to 12; then single-leg bridges · Editorial dose

Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge

Elliptical trainer demonstrated on the 3D figure

3D demoElliptical trainerBeginner · Cardio machine

10 to 20 minutes at a moderate effort · The move page's dose

Harder: Stair-stepper machine

Move on when: Your team confirms the fracture has healed, you can walk briskly for 30 minutes without pain, and step-downs are controlled.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 4

Back to running and sport (often from 6 to 12 months, once your team clears you)

As your team allows. About 70% of people return to sport, often lower-impact; return took a median of about 7 months in one study and a mean of 22 weeks in another, and an NHS leaflet keeps sport out for at least 12 weeks. Ask your team before impact or contact sport, then bring impact back in small steps, straight lines before turns.

Treadmill jogging demonstrated on the 3D figure

3D demoTreadmill joggingIntermediate · Cardio machine

The NHS walk-jog programme, every other day, once 30 minutes of fast walking is pain-free · An Oxford NHS return-to-running leaflet, used here as a guide; the weeks are in the notes below

Easier: Treadmill walking · Harder: Sprint intervals

3D demoPogo hopsIntermediate · No equipment

Short sets of 10 to 20 · Editorial dose

Easier: Ankle bounces (mini pogo) · Harder: Single-leg pogo hops

Snapdown to athletic landing demonstrated on the 3D figure

3D demoSnapdown to athletic landingBeginner · No equipment

2 to 3 sets of 5, freezing each landing · Editorial dose

Harder: Box drop landing

Single-leg hop and stick demonstrated on the 3D figure

3D demoSingle-leg hop and stickIntermediate · No equipment

3 sets of 5 each leg, small hops first · Editorial dose. Only once your team clears you

Easier: Standing broad jump with stuck landing · Harder: Alternate-leg bounding

Shuttle runs demonstrated on the 3D figure

3D demoShuttle runsAdvanced · No equipment

Short sets, with wide, unhurried turns first · Editorial dose

Easier: Treadmill jogging

Get up and down from the floor demonstrated on the 3D figure

3D demoGet up and down from the floorBeginner · No equipment

5 to 8 slow cycles, kneeling on a cushion, changing the leading leg · The move page's dose; also a test of kneeling

Easier: Sit to stand from a chair · Harder: Bodyweight get-up

Move on when: You can train fully with no pain, swelling or giving way the next day. Keep two strength sessions a week for good (our suggestion).

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Stairs on crutches (written steps)

King's College Hospital NHS's technique. Your physiotherapist will check it with you before you go home.

1. Use a stair rail or banister if you can, with your crutch or stick in the other hand.
2. Going up: the good leg first, then the injured leg, then the crutch or stick.
3. Going down: the crutch or stick first, then the injured leg, then the good leg.
4. If you have weight limits, your physiotherapist will teach you the technique before you go home.

Source 2

Inner-range thigh work and lying hip movements (written steps)

NHS leaflets add these to the stage 1 exercises. They have no 3D demo. For the hip: lying on your back, gently slide the leg out to the side and slowly back to the middle, 10 times, 3 times a day, within your limits.

1. Only within the range your team allows, and only once they've shown you.
2. Lie or sit with the leg resting over a rolled-up towel or pillow under the knee.
3. Pull your toes towards you, then lift your foot until the knee is straight, keeping the back of the knee on the towel.
4. Hold for 5 to 10 seconds, then lower slowly.
5. Repeat 5 to 10 times (Royal Berkshire NHS) or 10 times (King's College Hospital NHS), 3 times a day.

Sources 2, 31

The walk-jog programme (written steps)

From an Oxford NHS leaflet written for coming back from any injury lay-off. We use it here as a guide, once your team clears you for running.

1. Start once 30 minutes of fast walking is pain-free, and your team is happy for you to run.
2. Week 1: jog 1 minute, walk 1 minute, for 30 minutes. Do each week's session every other day.
3. Week 2: jog 2 minutes, walk 1 minute, for 30 minutes.
4. Week 3: jog 4 minutes, walk 1 minute, for 30 minutes.
5. Week 4: jog 9 minutes, walk 1 minute, for 30 minutes.
6. Week 5: jog 15 minutes, walk 1 minute.
7. Week 6: jog 30 minutes without stopping.
8. Move up a level after a week without pain, and down a level if it hurts. From week 7, add no more than 10% a week.

Source 32

Brace care

Don't change the brace settings. Check the skin under it regularly, and keep the leg supported and the knee straight while you wash, then put the brace back on as soon as the skin is dry. Redness that doesn't fade after 15 to 20 minutes, sores, blisters or rubbing need the physiotherapy team.

Sources 2, 31

Positions to swap, and why

Habit or position	Why it matters	Instead
More weight than your plan allows because it doesn't hurt	Weight limits protect the repaired joint surface and are set for your fixation; pain isn't a reliable guide.	Follow your written status, and ask why and for how long if it isn't clear.
Changing the brace settings yourself	An NHS leaflet says don't change them.	Ask your physiotherapist.
A pillow under the knee	NHS leaflets ask you to rest with the knee straight.	Raise the leg with the ankle above the hip and the knee straight, and tighten the thigh.Try: Quad set (static quads)
Sitting with the leg down for long spells early on	It adds to the swelling; NHS leaflets raise the ankle above the hip.	Raise the leg and do ankle pumps every hour.Try: Ankle circles
Deep squats under load before your team agrees	Deep bending under load stresses the repaired joint surface (our reasoning).	Leg press or step-ups within the depth your team allows.Try: Leg press
Running, jumping or pivoting before you're cleared	The joint surface needs to heal first, and return to sport took months in studies.	A recumbent bike, then an elliptical trainer.Try: Recumbent exercise bike
Ignoring a tight, very painful calf or a numb foot	Compartment syndrome is an emergency.	A&E, or contact the hospital at once if you have a cast or brace.
Stopping exercise when physiotherapy ends	Sport and quality of life often stay below other people's years later, and people asked for more physiotherapy.	Two strength sessions a week, for good.Try: Step-up
Smoking	US surgeons say it may affect how well the bone heals.	NHS stop-smoking support.

Routines to follow

Low-impact leg workout (no jumping)

A gentle leg strength routine with no jumping: sit-to-stands, step-ups, wall sits, bridges and calf raises.

20 minBeginner7 movesA bench or box, A step

Knee strengthening workout: from first steps to full range

A 25-minute session for knees that don't currently hurt: thigh and hamstring strength, single-leg control, then an optional full-range block with knees over toes.

25 minBeginner13 movesA bench or box, A wall

Chair exercises for seniors: a seated workout

A 20-minute seated workout for older adults who cannot stand for long: marching, leg and arm strength, posture, and sit-to-stands that lead back to standing.

20 minBeginner11 movesA bench or box, Something with weight

Knee control warm-up

A 20-minute warm-up that trains your knees to track over your toes: side-hip strength, squats and lunges with alignment practice, balance and quiet landings.

20 minBeginner10 movesA wall, A band

More moves for this area

Questions people ask

What is a tibial plateau fracture?

A break of the top of the shin bone where it forms the knee joint, often pushing part of the joint surface down. It can come with damage to the cartilage, ligaments and menisci around the knee.

Do I need surgery?

If the bones are in a good position, a brace or cast and crutches may be enough. If the break has moved, is unstable or has stepped the joint surface, an operation with plates and screws is usual.

How long can't I put weight on my leg?

As your surgeon allows: it depends on the break and the fixation. US surgeons say full weight may wait 3 months or more, traditional aftercare is 10 to 12 weeks of no or limited weight, and surgeons vary from 2 to 12 weeks. Your plan should say what you can do and for how long.

Is putting weight on it early safe?

In one small trial after surgery for simpler breaks, walking on the leg as much as was comfortable straight away gave better function at 6 months and no more sinking of the joint surface, and pooled lower-quality studies found no more non-union. It isn't right for every break, and practice varies, so your surgeon decides.

What exercises can I do with a tibial plateau fracture?

NHS leaflets start ankle pumps every hour, thigh tightening, heel slides, straight-leg raises and knee straightening in a chair, 10 of each, 3 times a day, within any brace limits. Strength, balance and then impact come in stages, as your team allows.

How long until I can walk normally?

Usually not until you're allowed full weight, often around 3 months, and losing the limp can take longer. In one cohort the bone took about 5 months on average to join.

When can I go back to work?

In one small study, people took a median of 4 months off, and 6 in heavy jobs. In another, everyone in work before surgery went back, after about 11 weeks on average. Light or adapted duties can help.

Will I be able to run or play sport again?

About 70% of people return to sport, often lower-impact, after a median of about 7 months in one study and an average of 22 weeks in another. In a large cohort, people who'd had surgery scored well below their peers for sport years later.

Will I get arthritis in my knee?

Half of people had arthritis on X-ray about 10 years later in one study, more after breaks on the inner side or both sides. About 7% had a knee replacement within 10 years of surgery, against about 2% of similar people without the injury.

What is compartment syndrome?

A dangerous build-up of pressure in the leg muscles after an injury or operation: pain far worse than expected, a tight calf, pain when you move your toes or foot, and tingling. It followed about 2% of plateau fractures at one centre, and it's an emergency: go to A&E.

Why did my MRI show a meniscus tear?

Meniscus tears often come with plateau fractures, especially when the joint surface is pushed down further. But tears are also common in knees that don't hurt, so a tear on a scan may be old. Your surgeon decides whether it matters.

Is it treated differently in older people?

It's often a lower-energy fall onto weaker bone. Results after surgery were similar to younger people's in one cohort, though frailty raises the risks, and some surgeons offer a knee replacement straight away so you can walk on the leg at once.

Related exercise guides

Knee joint guide

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.