Monday, March 9, 2009

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. 

10 comments:

Anonymous said...

Hi bro, you have become my idol, jajaja. Your experience is great, is the closest to mine, the closest I have found on internet, probably tomorrow I am getting my brace, in what position should I keep my arm, is it important? (of course I know you are not a doctor, but you could give me some advices). How long should I use the sling? isn't it really important my bones moving inside (though now much less than before) sometimes you can feel it. Today I had a hard day at my university, I had two exams so I had to write, it hurted some. By the way, the doctor sent me to another place to get my brace made, they took my measures and they'll call to pick it up but the doctor said nothing about me coming back, he mentioned something like that some days before but he didn't make the medical order to get back for control, so, should I get my brace to the doctor so he puts it on me or let them do it in the new place, anyway I think I should get back to the same doctor, the one who has been watching over me, I think he forgot, what should I do man? Ps: I like wii, but more ps2.
See you bro, hope you get stronger everyday.

Per said...

Thanks for your kind words!

I'm amazed that they're making a brace especially for you. My doc just took one off the shelf. It was adjustable, of course, but certainly tailor-made for me. Occasionally, my skin got bruised, or even torn, especially around the elbow and armpit.

So we seem to be on different brace time tables. Take a look at the aofoundation site, http://http://www.aofoundation.org , click on the skeleton to your left and select your type of fracture. In my case it said:

"Brace care
As soon as comfort permits, the patient must be instructed in donning and removing the brace, and caring for the underlying skin.

By letting the arm hang straight down, the patient stabilizes the unbraced fracture with the force of gravity, and regains elbow extension. In this position he is able to shower, wash the arm, and replace the stocking with a clean one, usually daily."

This stage happened to me after four weeks of wearing the brace. But two weeks before then I was able to remove the underarm from the sling and move my underarm up and down, but absolutely not outwards. As the aofoundation writes,

"Beginning functional use
Simultaneous isometric contraction of flexors and extensors is important, as it stimulates fracture healing, improves support of the fracture inside the brace, and corrects fracture distraction produced by the weight of the distal arm. This can begin quite soon."

But only the doctor knows when "quite soon" is. The aofoundation does not give any time tables, except for how often to take x-rays.

Let me know how it goes.

Unknown said...

I suffered a proximal humerus fracture to my left arm 4 days ago. It was a stupid accident. I was coming back inside after doing yard work, tripped on a step leading up to the back porch, and smacked my shoulder on a post going down. After an hour of excruciating pain, I finally asked my neighbor to drive me to the ER. They took an X-ray. It looks like a clean break just below the shoulder joint. They put me in a sling and gave me a prescription for Percocet. I don't have insurance, savings, or even a real job--just some occasional part-time work--so I don't know how I'm going to pay for all this. I can use my fingers and hand now, which I couldn't at first. Sleeping on my back, even up against pillows, makes my back hurt. Aside from the ungodly horrible pain, the worst thing is not being able to shower or change clothes. I feel disgustingly icky. How long will it be before I can take off the sling and shower and wash my hair? I live alone and have no one to help me.

Unknown said...

How do you change your handle here? "Unknown" is NOT the handle I chose. I don't know why the stupid system changed it.

Anonymous said...

Mommapatricia
I broke my humerus at the ball joint also three weeks and three days ago. I am using a sling until I go n fr X-rays again on August 12 and hopefully it will have healed enough to go into pt. I broke the fifth metatarsal on the left foot as well but it seems ok now, just a side of foot bruise pain now. I am fortunate @77 that I sleep soundly and I have a caretaker husband who helps me with showers etc. the pain has subsided somewhat and I am ding small hand and finger exercises. I am able with the right hand to move the lower arm up almost to the shoulder several times a day, but now I am getting muscle pain near the outer armpit I hope from the exercises. So I am icing this area and resting for a day before returning to my little exercises. I take naproxen up to four 250 mg a day along with acetamiacen in conjunction as needed. I have the narcotic pills, but have not taken them. I also take 5000 units of Vit D. Daily. I use plain Greek yoghurt and soy milk eat lots of fruit and vegies, beans and oatmeal. I hope you are getting a bit more help from your friends. Some communities have visiting nurses services. It is a painful break but we are both lucky that our break was a single break and not mutiple or shattered! Each day is getting better but boy does it make you tired just doing little things. Good luck in your healing! Mommapatricia

Kim said...

I am now in week 9 of a spiral mid shaft fracture. Boy, there is nothing fun about any of it since I broke my writing hand and was only to be out of work for 6 days since I don't qualify for disability yet. Last week the doctor did not see enough bone growth to allow me to progress to no brace and PT. I take heart from all of the posts of people who also have a slower recovery like me. Thanks for all of the sharing. I check in a couple of times a week for inspiration. Sure is making the summer suck!

Unknown said...

I am in week 40 of recovery, and the tendonitis is still hanging around. I continue to stretch and use my arm like I used to (it seems like so long ago). Although it is sore, I continue to stretch it (I hope I am doing the right things).

Kim - hang in there. My brace didn't come off until week 12 and I didn't start PT for 2 weeks. I wish you a speedy recovery.

robyn said...

hi i am in week 27 with a nasty break to my left humerus i was in a plaster caste for 2 weeks then a brace for 6 weeks started physo at 6 weeks just gentle streching once the brace came off the hard work and pain started at times i was so depressed with pain and not being able to do anything but it does improve i can now do almost every thing with caution i excrise 3 times a day do all the house hold chores and am starting to feel good about myself again i am a 65 year old lady so dont give up hope its a long slow healing

Kim said...

Thanks, Pam and Robyn! Brace is off but the bone is still healing. The woman at PT is really helping and I can finally take out and put in my contacts every day. It's the little things that get accomplished that mean the most. Eating again with the right hand was accomplished two weeks ago. I am trying to be patient. Good luck to everyone else also in recovery!

Unknown said...

Nice post. Jhansi Orthopaedic Hospital is renowed name for being the best fracture healing hospital in Jhansi at affordable price. For any query visit website.