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.
16 comments:
Hi,
I have been looking for someone who can relate to my injury.I broke my humerus bone in 2 places in January,while running.The greater tuberosity, which fragmented and the surgical neck.In other words the ball and the area where the shaft meets the ball. I am also in phy. therapy. I am constantly in pain but I just hate taking the oxy codone. I am not allowed to take over the counter pain killers as they inhibit bone growth.
I've had an occassional vodka and soda to help me out.I have been told to be patient with the progress, I cannot raise my arm higher than my waist and my shoulder is so stiff it feels like it is breaking again during therapy.It hurts like crazy but I can now tie my shoes ,slowly.
I had surgery to put the plate and 10 pins in, it aches most of the time.I was hoping someone was out there with the same injury to give me a little hope.I too started the bike machine in therapy it is soooo hard but after a few min. it starts to loosen up and I feel a sense of accomplishment.Supposedly I am right "on track". My fingers are still numb and so is the inside of my forearm. Nerve damage I'm told. That should be returning soon.
Looking forward to running again or riding MY bike.......seems like quite a stretch!!-
Thanks for your story! I'm sorry about your pain and lack of motion. I can relate to everything, although I'm in no pain when I don't work my deltoids.
PT is a quite phenomenon: I have great difficulties to life my arm straight out, but after a few reps it's getting easier, before the muscles are getting tired and it's harder again. I have the same positive experience with the arm bike as you. I was thinking of building one myself if I could get hold of an old bicycle.
A similar experience as yours regarding pain is "doogiedoc"; I recommend his story as an example of human achievement. http://www.epicski.com/forum/thread/65491/broken-humerus
Hi All,
I read your blog on 3/29/09 after fracturing my left humerus at the ice rink practicing for a little skating club show to be held in June at the rink. I executed (badly) a right back inside three turn-it was my 4th in a row just about 2 minutes before the session was to finish.
I didn't prerotate my shoulders correctly on the last turn, and 1/2 way thru the turn I went down hard- don't even recall the fall-and next thing I knew I was sitting on the ice not feeling well and I couldn't feel my left arm at all. It was positioned behind me and I could not lift or move it. My 15 skating mates hovered about and covered me with clothing while 911 was called. They came quickly and I went to ER where Xrays showed a similar break to yours-not lined up and sharp edges at a 54 degree angle 1/2 way between the shoulder and the elbow.
I made some calls to medical pals for an Orthopoedic surgeon in my area and several gave the same name to me Raymond Raven III, MD in Burbank, CA. I called his office when I got home and spoke to him, He said come in first thing next day.
He is a hand, arm, upper body ortho specialist. He said we could set it and it would heal on a schedule like yours has done, or it could be operated with a plate inserted and screwed into place, shortening the recovery time to 3 weeks till I could begin PT. I had no pain, I dont know why. I opted for surgery the next morning. It took him 3 hours, they woke me up,I was in recovery for an hour then went home.
Still no pain, but discomfort like being kicked by a horse in the arm.
I am now three days post op. No cast, swollen and tightly bandaged in a soft cast, I can type with both hands, lift my elbow to shoulder height and both bend and straighten at the elbow. I have some swelling to my hand from the tightness to the bandage. I sleep well and each day feel better. He will remove my bandage at 1 week post operative. Then the staples (sutures) come out at 2 weeks post op and he said I can begin therapy at that time, and go back to skating as soon as I can move everything and range of motion is adequate (and I can pull my boot laces tight)
My work is very delicate and requires both hands at all time, I told the doc I was not willing to wait 3 months for my arm to be in a cast and heal slowly, possibly not correctly, and then need surgery anyway.
First, I want to thank the skater who posted this blog for showing me a glimpse of my future, and letting me know it would be very difficult to take that path-work and otherwise.
Second, I want any reader to know that the option I took is another possibly faster -if appropriate -way to improvement. My insurance is Blue Shield, I had to pay $4000 deductible, and they said the rest would be covered, including surgeon fee, operating room fee, pre surgery exam by another doc fee, ER fee, and the 911 men who came to my aid fee as well. PT will also be covered, but because I am only immobile for 3 weeks, bicep, tricep, shoulder recovery should go quickly.
There is one other point I wish to add. The USFSA provides a policy of coverage for its members who are injured while skating or at an ice rink. Details are on the membership website, so if you belong to a USFS club anywhere you should check this out as well - it takes effect if your primary policy doesnt pay something.
Best of luck to you and let me know if you have any questions.
Thanks for your story. It's very interesting. I strongly believe my PT was right, 3-4 days of therapy for each day of immobilization. And no doubt, a well performed surgery speeds things up, with the only downsides being cost, potential nerve problems, and post-surgery infections.
Please keep posting updates or start a blog. I'm curious about the recovery process in your case.
Hiya -
I just wanted to say your blog has been helpful for me. I broke my left humerus (spiral fracture) on Jan 9th and spent a lot of time trying to work out what to expect. I, like you, was surprised at how painful and long the process was - I always expected a broken bone to mean a cast for a few weeks and people jostling to sign it. I quickly discovered that it this was clearly not the case for humerous fractures! I live in the UK so it's been interesting seeing the different approaches to recovery and care in the US. Thanks again for the blog (especially the links included on it!)
Kelly
Thanks for your kind words! To read about the experiences of others helps quite a bit. I think the US health system has worked very well in my case. But I know about a patient who had to go to Switzerland for orthopedic surgery, where it was more advanced and cheaper.
What I especially appreciate in my case was the experience orthopedic surgeon who had suffered a fractured humerus himself, along with the ample and intense PT. But who knows what would have happened had there been major problems with my recovery on the way.
I am now 10 days PO with a metal plate and screws in my arm. The arm is bruised and I have some swelling in my hand but it is not bad at all. My 30 staples are holding my 9 inch incision togerther. It runs down the back of my tricep area from the bottom of the deltoid to near my elbow. No more bandage, or wrap or sling. I can straighten my arm I can lift my arm to parallel with the ground to the side and in front of me, I can bend at the elbow to 55 degrees in front of me and I can touch my nose with my left hand. Typing is no problem. I still have no pain, just stiffness and some discomfort after sleeping. I will go the the Ice rink to day for off ice lower body conditioning with my coach to keep strong and balanced while I cannot skate- I believe my conditioning has helped me heal. Staples come out in 3 days and I will begin PT at 1 month Post Op. I am better each day, and I would encourage anyone who has the misfortune of breaking their humorus to check out having surgery for repair. Considering lost work time, pain, reduced recovery time, less PT and knowing that healing begins right away, It is worth doing if you can find an upper body surgical specialist to do the repair. Cheers to all- keep positive.
Sorry the post above is from BrokenWing, I still cant figure out how to log in correctly
This sounds wonderful! The lack of should immobilization suggests a very short time in PT. I can't see how there could be any serious muscle-recovery problems.
I am now 3 weeks after my fracture occurred and 18 days post op. This week my 32 tiny metal staples (they look like a metal zipper) were removed from the incision. There was no pain or feeling at all when this was being done.My range of motion continues to improve. I can shave, eat and drink with both hands, dry my hair using both hands and flexing of my tricep is improving as well. I can bend my elbow up about 75 degrees from straight down as the arm hangs. I still feel the brusie from impact with the ice on the palm of my hand, at my wrist, under my forearm and some discomfort at the deltoid area of my shoulder from the impact, but still no pain at the incision site. I now notice an ache in the wrist, arm and shoulder while sleeping and 2 tylenol 8 hr or a percocet is necessary to get restfull sleep on certain nights, but that is gettin better each day. Now doing 2 sessions a week of "off Ice" lower body exercise to keep my skating condition up, and I am to begin PT for arm, hand and shoulder 3 days from now. The doc says 2 times a week for 8 weeks. I learned my P Therapist is the mom of a young figure skater which should help as well. I have been back to work since my 4th day post op, and it tires me by days end but I can finish my day without much discomfort.
I wish you all speedy improvement, keep positive and be inspired by your own progress each day.
I feel blessed (but am not religious!) that things are going well.
Thanks for the update!
My PT's estimate that it takes 3-4 times of therapy for the time spent immobilized seems to work in your case too (well, a bit less than 3 times in your case).
I have not dared to go back to the ice arena. I'm simply too scared, although it would be wonderful for my daughter to be a good skater while she is little. Biking is a different story, although more dangerous. I guess the reason is psychological, I didn't break my arm while biking.
Many thanks for sharing your experiences - your detailed insight has helped me tremendously.
Question for you - what did your Dr/PT saying about running again - when will this be allowed for you?
Thanks for your kind words!
My doc never told me not to run. He warned me about contact sports, and he was adamant about no skating, but the issue was falling, not moving. But I broke my arm in December and running outside was never an option here close to the Canadian boarder.
But I would never have done it before the bone ends had fused. I probably could have gone jogging as early as week 7 (had it been May). That was about the time when I started to use the stationary bike.
I broke my humerus in a fall from a horse a month ago. I was given a coaptation splint that tied around my neck and up on top of my lft shoulder. After three weeks of pain that is the worst at night and an x-ray at 4 weeks that WAS IMPRESSIVE to the x-ray tech, my surgeons reassured me my arm will heal without surgery. I am a super active person and the nerve damage (almost no wrist extension and a lack of abduction with the fingers of my left hand) I had many questions about why I should wait possibly 3 months for it to heal crooked as my shoulder will make up for the bend in my arm and there should not be a clinical difference from doing surgery vs. splinting only. I wanted to say 'how many of you guys would put up with this pain and disability to save money? Not to mention the pain of trying to sleep at night when the arm loses traction from laying down? I am really frustrated as I am missing an entire summer -even household chores are very painful and almost impossible and I am right handed- thank goodness! Someone said they were back on track in three weeks with surgery- wow.
Hi, this blog is great. I broke my humerus and had shoulder surgery During Christmas. This is week 14.
Its been great that I can follow along with your blog and see what I am up against week to week.
This week so far has been excellent. The shoulder is getting better and better each day. I am a little concerned about my range of motion but doing my best to get it all back. Still having trouble with my rotator cuff tendons and muscles and also my delts and biceps. it almost feels if everything just needs a good stretch but that's very hard to do.
Anyway, love the blog. Thanks for sharing.
Very good information.I am using back braces I feel comfort now . Thank you.
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