Week 14

March 30. Another day at the PT factory. I found out that I only have three more weeks of PT, since my insurance won't cover more. Luckily, today the work went better. I have only pain in the deltoids when raising my arm straight standing up, or from horizontal to vertical while laying on my side. All the other exercises are just stretching or regular muscle fatigue. It's simply amazing how fast some muscles have recovered, and how slow others have been. In fact, some exercises that I do in parallel motion with left and right arm are tougher for the right arm. Today the arm bike was easier. I kept an average of 90 rpms for six minutes, and I could have continued; the blood flow felt great. 

Today was the first time I tried my bike outside. It was pretty demanding on both arms since I have a road bike with a forward-leaning set up of the handlebar and saddle. But it felt good and gave life a bit excitement. 

March 31. Three months check-up with the doc. He was very pleased. I just want to see me one more time, and he said that I would see progress in PT fairly soon. I asked him what I've been thinking about for quite a while: "What about steroids?" The answer was no, the side effects are to risky. Natural healing is the best. I agree in principle, but why are there steroids if they never can be used? I didn't ask him that.

I'm now allowed to do anything except for contact sports, or ice skating... He believed that much would happen in terms muscle strength and range of motion during the next couple of weeks.

The mid x-ray above illustrates what he said during last visit: The body compensates the angle and adds more bone to the concave side and removes it from the convex (it's the osteoclast – osteoblast thing). In a year, there will be no angle, just perhaps a small bend. The bone during remodeling is recycled and I don't have to worry about calcium deficiency. I peeked in his notes from last time, and they were as positive as his words directly to me. I wouldn't have liked being lied to. 

April 1. Today I remembered to take an Ibuprofen before PT. That helped a lot, because it was a tough day. My PT added an extra pound to a few arm lifting exercises that were heavy enough with two pounds, and with the leverage of the long arm with the extra weight, the power increases significantly on the deltoid. 

He also wanted to perform simple straight-arm-raising exercises with no weights while standing, but make it static., holding the arm up for as long as possible. That's hard on my good arm too, especially after two minutes.

April 4. The straight-arm lifts while standing have worked wonders, although they're quite painful. I can go above 90 degrees. Although I'm beyond 135 degrees while lying down, the muscle strength is not sufficient to actively lift the arm that high. But it's getting better.

It struck me that the benefit of having a non-physical job that allowed me to work from home the first four weeks with no monetary loss, is now a problem. All kinds of physical activity feels good now: running, biking, garden work, but most of my time I have to spend in front of the computer and that stiffens the muscles.

Week 13

March 23. Another assessment day at the PT's. My passive abduction lying down was 133 degrees, but I certainly can't lift my arm that high standing up.

I don't get a sense of immense progress. It still hurts lifting the arm high--I can hardly lift it beyond 90 degrees while standing--but I can do 8 pounds with biceps curls. I can actually feel that there is a muscle now, and triceps has been noticeable for quite a while.  The annoying this is that I can live without biceps strength right now, but not raising my arm above my head.

March 26. Today my PT reiterated the statement that he could probably bring my arm straight 180 without destroying and muscles or tendons, but that I would probably pass out. For a second I was tempted: a couple of days of severe pain for a gigantic gain of extension. But I passed. And it wasn't really an offer.

He also thought that I had the muscle strength to lift the arm all the way up, but that the joints and competing muscles are preventing this motion. It's very annoying. But the rubber band work at home really helps. The red colored one feels too easy already.

Week 12

March 16. My regular PT was back. He must have read the notes from last week since he offered me a large number of new exercises with or without weights. The best ones were the "bungy chords," different colored rubber chords anchored to the wall to be pulled in different ways. The resistance felt nice on the yellow, the lightest one. Then I worked on stationary bike for the arm: a crankshaft in chest level with settings just like a bike. That stimulated my speed and blood circulation (and I burned 15 calories).

Hardest is raising the straight arm to 90 degrees forward and sideways. It's still almost unbearable, even with just the 1-pound rod. That's the most central exercise now, it in two directions each standing, laying on my side, and laying on my back, thus working different muscle groups against gravity. 

March 18. This was the toughest day in the PT gym thus far. Every exercise had weights now. The snow angel exercise, for example, that I really struggled with only a week ago felt much better even with a one-pound weight. He even let me do some bicepts life with 5-pound bars. That's very easy, and irrelevant at this point. But I'm certainly sore. 

For Friday he warned me, strength is not the issue, range of motion is, especially lifting the arm above 90 degrees, "take some Ibuprophen before you come." Ouch, that's gonna hurt at night.

March 20. He was right, it did hurt. But he liked my joke about the torture chamber of the Spanish Inquisition. I would have confessed everything even with 200mg of Ibuprohen. He extended my range of motion quite a bit, which really evident when I used the pulley to raise my arm. It certainly not going 180 degrees up, but far above 90. This was great torture. The 5-pound bench press also feels good now. So there is hope.

Week 11

March 9. The exercises went much better today. But no time to enjoy any victories, as my PT introduced new ones: laying on my back with my arm straight and parallel to my body I was raising it straight up. That hurts a great deal just below the shoulder joint. Another tough one was "Snow angel," moving the arm parallel to the floor while laying down. I'm also performing the wood rod exercise standing up in three ways now: forward lifting with straight arms holding the rod overhand as well as underhand. Underhand is significantly harder and hurts a lot, but I have done it several times since I came home and it's getting easier. Instead of doing 10 reps of each morning and night, I'm doing 5 every hour, or so. I'm also holding the rod behind my back and stretch back with straight arms. This is very easy, and there's no significant difference between my left and right arm. It's striking how some muscles cambe back to normal fairly, while others are very slow to recover.

I looked through the exercises on my Wii Fit game. Not much to benefit recovery: it was either too hard (as the yoga ones; the tree pose doesn't work if you can't life your arm straight up) or not engaging the arm at all (as skiing), but the jogging game is fine, and so was boxing from Wii Sports.

March 12. I've learned from "doogiedoc's" remarkable recovery that changing PT once in a while could be very beneficial. My regular one was away, so I got a colleague of his. She stated out very soft with a stretching massage that hardly extended my reach--I thought it was going to be a waste of time--but then she introduced a few more exercises and, above all, added weights. It was a whole new world that opened up. I did five pounds bench press, and it wasn't that hard. The weight made it easier to extend the reach over my head (I'm just about at 90 degrees). 

Just a pound's weight made it also easier to stretch the arm forward, when I was laying on my stomach. She ended the session by icing the shoulder. I'm not sure how beneficial that was, but it certainly felt nice.

She also made me aware of my insurance limit: I only have 30 visits, and I've spent 16 already, including occupational therapy. She recommended that cut it down to once or twice a week after my next evaluation on March 23, that way I'll have some extra visits after my March 31 orthopedic visit, if needed (and I have no doubts that it will be needed).

March 13. Another 90-minute session with the alternative PT. She pointed out the obvious: I'm compensating too much, some of which I knew about, after a few lifts I start leaning my body to raise the arm, but others were more subtle. She brought me to the mirror and let me life the 2 pound rod on straight arms forward, and I could see that my left should followed along quite a bit. I had been too focused on the angle, rather than exercising the right muscles. I need strength in my trapezius and rotator cuff. 

Another exercise she introduced, but didn't demand that I do is the "police hold": arm behind the back holding on to a towel and pull it over my right shoulder. This resulted in an intense stretch feeling, although I could only lift it an inch or so. It was very painful.

Today I also brought my violin to show the OT what an intensely complex instrument it is to play. It's completely non-ergonomical to hold and takes lots of different kinds of motions and rotations, particularly of the hand. She was amazed how the shoulder worked (I guess I was compensating a bit to keep the instrument up, but it didn't feel different than before the accident). Indeed, many musicians ought to work with a physical therapist to avoid many problems that occur sometimes early in the career. 

Week 10

March 3. The bone has improved a lot since the last visit. This 45 degree angle corresponds

to this one, only three weeks ago. Some of the difference could probably be attributed to the brace worn in the earlier picture. The doc said that the body compensates for the lack of bone on one side. I don't completely get it, since it is obvious on the x-ray which bone is new and which is old, and I can't see any balancing act going on. But the difference between these two images explains why my doc was not concerned about the non-straight angle. The body takes care of such imperfections, and even if there is an angle, the elbow joint is extremely flexible and can deal with it.

From the front view the new bone is clearly visible. Again, doc pointed out that the x-ray is two weeks behind what's inside.

I asked him how much it would take to break it again. The answer was "let's not find out." But he told me it would take quite a bit of force. He still thinks I should wear the brace if it's slippery out, but spring is here, so I'll burn my old friend, or perhaps turn it into a piece of art. I've not been wearing the brace while at home for several weeks and not outside for a week. But I'm not sure that the outside is the most dangerous place. There are lots of traps at home: the children's toys and the stairs (I almost fell the other day), not to speak of the shower.

March 5: Encouraged by the good orthopedic news my PT brought the heavy artillery: I can now do two pounds in bench press. Using a bar bell wasn't that hard, worse was doing it only with my left arm holding a one-pound weight. The real weight work will begin when I can raise my arm above 90 degrees. As the doctor said two days earlier, "you and I are not that strongly built," what he meant was: you were weak even before the accident and the recovery would be faster for a body builder. Although, after having just discovered this site, I'm not so sure. Even the bodybuilders seem to come out of a cast or brace with very weak muscle strength and limited joint mobility.

The OT believed my hand and underarm would be fine. I was 4 degrees from stretching it to the same angle as my right arm (175, I think). Active bending of the elbow won't be a problem, she thought, although it's 20 degrees from the right arm's ability right now. I have started to do small easy, but quite effective, tasks: brushing my teeth with my left hand, holding my left hand on the steering wheel in the car, even if I don't have to, holding the phone with my left hand, etc. And best of all, sleep without the brace. I kept using it at night until this week due to fear of night time "events" (not completely unfounded since I've done a few weird things in my sleep).

March 6: another day at the PT gym. The PT thought he saw some biceps growth, but it was just the bone callus. I'm fine with weak biceps and triceps, I rather have more deltoid strength. I'm dying to start swimming again, and if I could stretch out my arm, it would take care of many issues, I think. I'm just waiting for his words: whenever he tells me to exercise my biceps and triceps, I'll go full throttle. I still have my gym membership.