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.

IMG_6877

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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Posted on April 19, 2011, in Injury. Bookmark the permalink. 24 Comments.

  1. I love reading these updates – I’m enjoying your progress – keep posting!

  2. I’m pretty sure a wine glass counts as long and top heavy. ;) You could fill it with beer if that made you happier.

  3. I love seeing your progress. I will be rooting for proper wrist rotation! Goooo wristy!

  4. I know this is a kind of happy post as your arm is slowly getting better, but I am still feeling chills…bc I know that there were sooo many instances when I could have fallen in a bad way and ended up seriously injuring myself. And you don’t usually think of these things, but one little break can cause months of healing and rehabilitation. I think you’re a trooper for enduring all this with grace. Thanks for updating us! :-)

  5. This sounds so grueling Susan. Also I am realizing more and more how I take advantage of the things my body CAN do. I never knew your elbow moved when you rotated your wrist! Or that you could do push-ups without a radial head? Very odd. Makes me want to learn more about kinesiology. I think it’s great to have the progress pics. I actually bent my arm as I looked at the pictures, so I could get a visual of what you’re dealing with.

    I’m with Leah on the wine glasses! ;) As for injuries, I just recently stopped going to physical therapy for runner’s knee and plantar fasciitis. The pain is more managable more and I’m grateful for that. It sucks living with pain however! I don’t think either injury will ever really go away. Physical therapy was a godsend though and taught me so much about my body. I now know a ton of good exercises for prevention! Heat & ice are my BFFS.

    • If there’s one thing I’ve learned through this process, an injury may never go away, but that doesn’t mean it’s impossible to live with. Humans are SO adaptable! Even when getting used to chronic pain…

  6. So glad to see that things are moving along nicely with your arm/hand and I hope they continue to do so. I think the wine glass (or a big tall beer mug) is a great idea. Every time you rotate it and lift it to your mouth, you could take a sip. Nothing like a little motivation to get you going ;)

    Other than the usual minor injuries (e.g. sprained ankles), I also fell through a ceiling (yes, you read that right) which I did physio for, I cracked three ribs on a serving tray (yes, you also read that right) which I healed with a lot of pain killers and moving as little as possible, and I sliced my pinky finger open on a meat slicer (I swear, I’m not actually that clumsy) which couldn’t be stiched up so I became very adept at onehanding all the restaurant machines.

  7. Wow Susan, those pictures show really apparent recovery especially with the arm flexation.

    I just had minor stress fractures in my heels, I have never had anything to bad. I did get shoulder surgery for swimming junior year of high school because of overworking though. That took a really long time to recovery but only really hindered swimming not actual daily life things. I had to do a lot of PT and let the muscle regrow.

  8. Yeah I’ve had some really bad sprained ankles, and of course once you do it once just keeps happening.

    Only other serious injury is a bit lame. Playing cricket I caught a ball badly and broke my left pinky. Had a pin in it for a month and a splint covering it. Worst part was it was xmas, summer and I couldn’t submerge it in water. Going to the beach with a bag taped over your hand is not a good look.

    Great work with the recovery. Hope it’s good news in 5 weeks.

  9. Susan so sorry that you are in this waiting game and limbo. You are a very strong woman and I am amazed at your poise and upbeat attitude about it all. You are such an inspiration!

    Injuries…oh, tons. I posted recently that I fell running and 2.5 weeks later, my hands are still a MESS. Tore up, holes and chunks of skin missing…a mess. They will heal, but it’s slow.

    Have had many surgeries in life, such as knees. Rehab is so painful and challenging but you are right for sticking with it b/c you only have one shot, so to speak, to get things on track!

  10. So sorry to hear you may have to go in for another surgery. But great that you are so confident and determined to get it on track so you can avoid it! You are so strong and doing amazing with this whole ordeal- I think- no, I KNOW- you can do it!

    xo

  11. Once when I was a kid, I jumped off a roof in the midst of some sort of chasing game, and ended up falling onto a rusty metal sheet. The disinfecting from that hurt like a biatch, and it’s my biggest scar. It’s on my leg. But thankfully, it didn’t get infected and I fell onto muscle rather than joint.

    I also broke my left arm twice in the same place (once when I had fallen on ice). I remember the muscle loss when the cast comes off – not fun!

  12. I honestly think sometimes sheer will and determination can make us overcome so many things. You are doing AMAZING so far in your recovering and having a positive attitude (I am not so sure I’d be as positive as you are) :) I will be thinking of you and sending positive vibes that you do not have to get another surgery.

    xoxo,

    Danica

  13. my injuries are all still haunting me … because I didn’t do what the doctors / physiotherapists recommended … and the moral of that story is, maybe you should head on over to ottawa to see your surgeon and see what he thinks … another operation will suck, but take some meditation time and think about what you really want for yourself when you’re 30, and 40, and 50 and 80! To get personal here – I often worry (like really worry) about how I’m going to have / raise children with my bending and squatting abilities being so limited and causing me so much daily pain :(

    • Yesyes, my current surgeon is actually getting in touch with my Ottawa surgeon today. And I’ll definitely be seeking the Ottawa guy to get a second opinion. I’m a little scared going 5 whole weeks without checking in with him (I’ve been doing bi-weekly since my surgery). But if things falls apart, I will definitely know and feel it!!!

      Also, the longevity of this injury has REALLY been sinking in with me over the past few days. I started thinking about not being able to rotate my wrist when I’m 60. And same deal, what if I can only ever lift 5 lbs with my arm? How will I have kids? Moreover, it superduper sucks that I’ve FINALLY found the job/career I lovelovelove and I can’t do it. It kills me.

      Heart you Morgan!

  14. Yay for progress. And it sounds like your prognosis is pretty positive, or a least you have options. I know it can be a dangerous road to go down when we start to think of “what if…”, and I’ve been there myself. But the truth is that our body’s healing capabilities are amazing, and even when they aren’t we are able to adapt to circumstances in the most wonderful ways. Just shooting some extra postivity your way girl!

  15. I got a little woozy reading that but I made it through the whole thing! Haha. Thanks for the update, I still admire your strength through this challenge! Blah, recovery sucks and what sucks more is when it’s an injury like this, you are never quite the same. Not being mean, just being honest. It’s something I deal with every time I exercise and it’s been over 4 years! UGH. Anyway, sorry about the downer comment haha, I am such a bitch ;) I love yoU!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    • Nono, THANK YOU for your honesty!! Everyone (except for my doctors) keeps assuming I’ll be back in tiptop shape when this is all “over.” But as each day passes, I become less and less sure of that. The window for getting movement back is getting smaller by the day and I can still only straighten my arm to 45 degrees (0 degrees being straight) and 30 degrees is considered the “functional” range. Even if they don’t operate again, I know I’ll need to get used to just having limited use of my left arm forever!

  16. Hi Susan,
    I’ve been reading your blog for some time now, but this post made me come out of the shadows because I feel like my whole life for the past year has been about injuries and doctors and adaptability!

    Up until February 2010, I had boundless strength and flexibility…I was a dancer, yogi, runner, etc. Last winter I started experiencing major pain in my hip. Stopped running, went to various professionals (massage therapists, sports med docs, podiatrists, PTs) who didn’t quite understand the extent of the injury. I did 2.5 months of PT before getting the REAL diagnosis in July after an MRI w/contrast: a torn hip labrum!! I saw an orthopedic surgeon, one of the few in the nation who does arthroscopic surgeries on the hip, but I was not sold on the surgery. “Scoping” the hip is a relatively new procedure with little long-term data available. Also, I just did not like the surgeon’s attitude. So I have opted to forego any surgery, and after yet another round of PT (specifically for the REAL diagnosis), the condition is bearable, although I have had to adjust almost every aspect of my physical life. I absolutely can no longer run, and even walking long distances is sometimes painful. I can do yoga, but I can’t go near Pigeon pose or anything that torques the hip (I can’t even sit cross-legged anymore!). I can only ride my bike on flat surfaces, and I can’t use any cardio machines that are jarring for the hip socket, meaning no elliptical or StairMaster!

    At first the adjustment to this “new” me was very, very hard. I admire your courage, because I basically fell off the face of the earth when I found out the real deal. I was depressed and had to take anxiety meds as needed just to get to sleep. I didn’t have my blog at the time, but I probably would’ve abandoned it. I think it’s great you continue to write through all of these life-altering circumstances.

    I’ve now been living with this injury for over a year, and I still experience twangs of jealousy or frustration when others do what I used to but cannot now. I used to be that girl in yoga class who could do the splits, the straddles, every “Gumby” pose in the book, but it’s a whole new me now, and I’ve had to adjust my attitude significantly, which is one of the reasons I started blogging!

    I look forward to reading about your transitions and triumphs with this injury, and I sincerely hope you can one day return to your old job because you will have such a wonderful perspective on how it IS possible to change your body, mind, and spirit. You will be one hell of a trainer when you return!

    • Thank you so much Jennifer!! Hearing accounts from others who’ve suffered bad injuries helps SO much. And thank you for being honest about your struggle afterward. I’m nowhere close to always being positive, and actually have to constantly try not to get depressed about it. If it wasn’t for my blog to keep me going, I know I’d be in a lot worse shape. I got most of my confidence from being able to do things like excel in a yoga class (like you!), so having that suddenly disappear has been a huge hit. I know so many people who’ve been injured and bounced back so quickly and I feel like I should be able to do the same. But I am just physically and emotionally not there yet. I guess we just alwaysalways need to be reminding ourselves of the things we CAN do!! ;) Thanks again xo

  17. keep your chin up girl – we are ALL rooting for you!! hugs and love.

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