Daily Archives: April 19, 2011

Arm Update Eleventeen

Hellohello. I hope you enjoyed the 5 Exercises For Runners post! I think I will have to make that a series of some sort. So many exercises, so little time ;)

Today I’m going to share with you some of the exercises I’ve been doing to rehabilitate my arm and get my level of fitness back.

For starters, I met with my new surgeon again today. If you’re new and want to know what the hell I’m talking about, here’s some background reading!

The accident & surgery
Recovery after surgery
Just being honest
Getting the cast off
Dealing with chronic pain
New surgeon & injury details 

So today was my second meeting with my new surgeon. He’s not the same one who operated on my arm. But I needed an orthopaedic surgeon to regularly follow up with when I moved to Moncton. You can read about my first meeting with him here.

Last time, I got the impression that he thought the reconstruction in my elbow was going to fall apart and that another surgery was inevitable. Well the good news is that it hasn’t fallen apart yet! Yay!

But it wasn’t all good…
 
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I shattered my radial head, a nubbin of a bone that connects my forearm to the top part of the elbow joint. It’s also responsible for wrist rotation (yes, it’s your elbow that twists when you rotate your wrist!).

The bad part is that some of the bone is disappearing. In the above photo I have an arrow pointing to a spot where some of it is visibly missing. The circle refers to a spot where there is a hole in the bone.

Having undergone a five hour surgery to reconstruct this piece means the bone was detached from its blood supply for a loooong time. Chances of a dead bone coming back to life and healing are slim!

Now, the more good news is that the current state of the bone in theory should not hinder getting mobility back. I should be able to mostly straighten and flex my arm in its current state. The screws that we thought may have to come out don’t seem to be in the way as much as we thought. So getting them out may not have to happen!

On the flipside, both my surgeons and physiotherapist are quite worried about my wrist rotation. You see, when I flex and extend my arm, the joint has a little bit of “give.” Meaning it’s always possible to push it a little bit further until I start screaming in pain.

My wrist however, when trying to rotate it towards the ceiling, just “stops” halfway. There is no give to it. It’s what my physio calls a “fixed end point.” It’s worrisome because in my current state, the rotation may not come back at all. It does not fall within the range of liveable motion and is not acceptable when other options are available, basically.

My surgeon told me today that he wants to see me again in five weeks. If I haven’t made much progress with my wrist rotation by then, he thinks there won’t be a chance of it getting any better. Thus, another surgery will be needed to fix it.

He wants to go in and just remove the whole radial head. Because I didn’t damage any ligaments or forearm, I could theoretically be perfectly fine without that piece of bone. He said I could even do push-ups again without it!

I’ve already decided that I want to go back to Ottawa for any further surgeries. My original surgeon is an upper-extremity specialist and knows my situation inside and out. I’ve been whining and whining about this whole “waiting it out thing.” And now that I have a timeline of five weeks I’m kinda freaking out a little. I don’t wanna be on an operating table in five weeks time!!

That’s why these next five weeks are going to be AAAALLLLL about rehabilitation. I’ll be working on rotating my wrist in my sleep!!

I’ve been taking photos of my arm to visually track the progress I’ve been making. I’m so happy I started doing this. Most days I just feel so stiff and frustrated with my arm, but these really show how far I’ve come!

Flexion on March 14 (after getting cast off):

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Flexion on March 28:

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Flexion on April 18:

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Definite progress here after not seeing much the first two weeks! Oddly, I haven’t been working on this direction that much. But everyone tells me that once you start to make progress with one direction, it automatically comes with the other. Biggest things I notice with this are that I can reach my mouth now with my left hand (makes eating easier!) and I can just barely hold my hair in a ponytail with it.

Extension March 14:

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Extension March 28:

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Extension April 18:

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Definite progress here! This is the direction I’ve been working harder on at physio. She pushes my hand down while I pull up resisting it. That flexes my biceps for 5 seconds. Then she releases and pulls my arm down for 5 painful seconds. She’ll also put a weight around my wrist to pull my hand toward the floor and just let my arm stretch out for 5 minutes. This direction is all about relaxing my bicep, which you can see inadvertently bulging in that photo.

Wrist rotation March 14:

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Wrist rotation March 28:

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Wrist rotation April 18:

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I love this photo because it shows my I can make progress on my wrist!!! Three weeks ago I couldn’t twist it 90 degrees without help from my other hand. Now I can twist it to neutral all on its own :) The goal is to get it facing the ceiling. Just 90 degrees left to go!

For my wrist exercises we do something similar where I have to push and resist in the opposite direction, then relax it into a twist.

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I also have to grab a long object that’s top heavy. No, not that, more like a channel changer with batteries. With the weight at the top, I let it drop to the side and pull my wrist towards the ceiling.

I’ve been doing physio three times a week, and these exercises three times a day. When not sitting down and consciously going through the motions, I am alwaysalways just trying to move my left elbow back and forth and twisting my wrist.

In Toronto, my physiotherapist did acupuncture to ease the swelling. Thankfully, it doesn’t get that swollen anymore. Now we use heat to relax the muscles into letting the joint move. My favourite part being the warm whirlpool tank that I put my arm in for 15 minutes at the start of every physio session. I’ll often start moving my arm in the shower too while the hot water is falling on it.

One final thing I’ve noticed, as I’ve mentioned before, is significant muscle loss. Especially in my left shoulder on the injured side. When I first went to my physio she could see the muscle loss just by looking at the difference between my two shoulders.

In the gym, I’ve been doing a lot of cardio (trying to lose weight after all!). I’ve been doing all the lower body and ab stuff I can think of that challenge me without requiring my arms. But I’ve also been doing basic weightlifting shoulder and back movements using no weight at all. My left shoulder had to hold on to a cast in front of my body for four weeks, then work to protect my injured arm for the weeks following that. Needless to say, just moving it in new directions feels like enough work.

Then of course there’s always TONS of stretching. Like, 20 minutes of stretching at the end of each workout. My posture has already dramatically improved and I like to think my muscles aren’t quite as tense. Perhaps being back at the gym has led to the significant improvement over the last three weeks!

Anyways, that is enough rambling about my arm for today. Sorry if this is all horribly dull for you. But to be honest, I need to get it all out. So thanks for being my bouncing board today :)

Question of the Day: I haven’t asked this yet and I really want to know, what kind of injuries have you had? How did you recover from them?

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