General: Can improvement be expected after one year?
Of course it depends on what needs to be improved.
- Bone.If the bone isn't healed after a year you may have a nonunion. Nonunions can be treated to obtain bone healing.
- Weakness. If your muscles haven't recovered full strength a year after the injury but everything else is OK you have an excellent chance of improving with a steady graduated exercise program. The biggest single problem with exercise is to think of the program as static - so many repetitions, so much resistance etc. Once you have found you can do the program "easily" you need to increase the load. Doing the same set of exercises week after week will never increase strength.
- Stiffness. This is more difficult. If everything has stuck together and hasn't been moved for a year you may have difficulty in improving the range of motion without help. At the very least you need PT and you may need manipulation under anaesthesia or surgery to release the adhesions if that is what is stopping the movement. However, you lose nothing by trying to stretch everything out and once you start to gain movement you may be surprised at how well you recover.
- Pain. Unless the pain is from some other complication such as adhesions, RSD or post traumatic arthritis, it should be possible to manage the pain and reduce its impact. (If it is from a complication you may need to have that complication treated) Chronic pain management is a huge topic that most OS are inexpert in (myself included). The trick is to accept the difference between hurt and harm. Many of the things that hurt don't actually damage you. In fact, once you have healed the bone it takes a lot to do you damage. Once you have identified the things which you can do, even though they are sore, you can steadily increase the amount that you do. After a time you discover that it still hurts but you are able to do so much more than you started with. Comments and personal experiences from the group would be very useful on this issue.
Can improvement be expected after one year?
You refer to pain managment by an OS's. Is it normal for an OS not to give any pain medications? How long do patients generally take pain meds?
Re: Stiffness - I believe that Movement is the key; at least, it has been the key for me! I made the most gains in ROM (bending) when I began using a stationary bike 2-3 times a day. I also recently began going to my indoor swimming pool and doing bicycle movements in about 4.5 foot deep water, which seems to help as well. Movement on a constant or near constant basis seems to loosen everything up and make the joint more fluid in my case.
Something else that may help: taking the supplements Glucosamine, Chondroitin, and MSM. Many MBLers have used these supplements in varying degrees and have had success in managing pain as well as increasing joint flexibility. There are also studies out to support their abilities to help prevent Osteoarthritus and to manage pain. It seems to be working for me as well, as I do not have to take anything stronger than over-the-counter strength meds (ibupropen and acetamenophen) most of the time.
Hope this helps!