Help my elbow.

July 14, 2008 5:08 PM

Recently, my bike picked a fight with a car and it ended up breaking my elbow. Now I'm trying to recover as quickly as possible. Do you have any physical therapy tricks or tips?

I cracked my left olecranon, but it was held in place by soft tissue so pins/surgery were not necessary.

Five weeks after the accident, my bone is mostly fused but my tendons/tissues are still very sore and my elbow extremely stiff. I have been working my elbow back and forth and rotating my hand according to the doctor's instructions, but I am having trouble getting beyond the 90 degree angle, meaning it is impossible to reach and touch my face or reach above my shoulders.

My elbow doesn't feel "tight" but rather the tendons do. I've been using a combination of NSAIDS and repeated exercises to gain a few degrees of freedom. Do you have any more ideas?

posted by fake to health & fitness (10 comments total)

I am having trouble getting beyond the 90 degree angle, meaning it is impossible to reach and touch my face or reach above my shoulders.

Flexibility will come back with use. Keep at the exercises and trust your body with patience.
posted by Blazecock Pileon at 5:25 PM on July 14, 2008

Are you being seen by a physical therapist? After I broke my elbow (surgery, metal plate, etc.) it took me about six months of PT to get back to a fully functional range of motion. I also spent a lot of time wearing the Mayo Clinic Elbow Brace. (Which, unfortunately, my insurance didn't cover; maybe you'll be luckier.) But maybe this is overkill for you if your break wasn't as bad. Which brings us back to: see a physical therapist (ideally, one who specializes in upper extremity -- if you're not sure, call a hand surgeon and see who they recommend) and do exactly what they say.

It really stinks not to be able to get your arm where you want it to go, and in retrospect I consider all the time, energy, and money I spent post-op to be massively worthwhile.
posted by escabeche at 5:31 PM on July 14, 2008

It took me a few months (3?) of normal use to get full range of motion back last time I crashed (broke a 5th metacarpal). It did come back, but I can still snag things on the titanium plate once in awhile. :)
posted by kcm at 5:51 PM on July 14, 2008

Years ago I fell off a cliff and damaged my elbow (also a crack but I can't remember the name of the various bits at this distance in time).

I started physiotherapy (judging by the earlier posts I wonder if thats 'Physical Therapy' in american) which was good and after a few weeks the physio suggested I go swimming as well. May have been coincidence but I saw an immense improvement very quickly in terms of flexibility and how the wounded area felt (it felt rather wooden before that time).

Anyway I'm not a doctor or a physio but if you have access to a pool it might be worth trying. The physio told me two swim breaststroke which made sense in terms of the movement type which was restricted at the time but I suspect any sort of repeated movement whilst the area is partially supported (by water) would be good.
posted by southof40 at 5:53 PM on July 14, 2008

Wow, that brace would have been perfect while the thing was broken. As I said, the bone is mostly fused, the tendons/range of motion are problematic now.

I'm a graduate student at the moment and pay my own (very limited) health insurance. I make well below poverty level wages and cannot afford time in PT. I have been advised by a physical therapist and am following her instructions. I take this injury and recovery very seriously, but some things are simply out of my means.

Swimming sounds good, and there's a pool nearby. Thanks and I'd appreciate any more ideas.
posted by fake at 6:27 PM on July 14, 2008

Just to clarify, I too wore the brace after the bone was set -- it's for increasing your range of motion. But my guess is that your insurance won't cover it, since I have pretty comprehensive insurance and mine didn't.

I found PTs to be pretty direct and honest -- if she told you that the injury was such that you could get your ROM back by doing home exercises, then that's the case.

Remember that it goes slowly, and you can keep making progress for a long time after the break. So keep going when you feel like quitting. You'll appreciate that extra 5 degrees.
posted by escabeche at 7:17 PM on July 14, 2008

Hang in there!

I broke my elbow after a dumb flip over the handlebars back in '96 (note to self: don't brake on a wet road just before your front wheel hits a pothole). I compressed the Radiushals (which I think is the neck of the radius in English, but I was in Berlin at the time so I never learned the proper English term). I spent 4 weeks in a cast without being able to move the elbow or wrist.

In the cast my arm had been at an angle of about 100 degrees. After a month of physical therapy three times a week (which as a grad student I could afford, because I was in Germany, where it cost me $10 for a half-hour session), and daily exercises, I was still convinced I would never regain my normal range of motion. I could move it at most 10 degrees in either direction. But in the fifth week I had a breakthrough, and by the end of the seventh I had regained almost the full range. After three months I was back to normal.
posted by brianogilvie at 7:56 PM on July 14, 2008

Yep, I concur on all. I "pretty much powdered" my elbow, according to my doctors, and hey repeatedly said I'd never get normal function back after my humerus did a piledriver on my ulna. I'm a little poppy now, but it's possibly even stronger than the other one.

If you haven't gotten into PT or OT, DO IT. And I wholly agree with the swimming. It'll loosen you up in all directions, including the shoulder muscles that got used in different ways while you were immobilized. I got out of OT three weeks early, even when i was afraid I wouldn't, and I think the swimming/floating/wiggling in water was a huge help.
posted by Madamina at 8:23 PM on July 14, 2008

Now I'm trying to recover as quickly as possible.

Do as I say and not as I do. I've had a lot of minor injuries due to biking and other sports. A lot of them still bug me years later because I was impatient or lazy about the recovery. Scar tissue is weak, especially when it forms inside joints or replaces connective tissues. Rushing back into action is the mistake that I always make, resulting in improper healing.

So I'd say you should focus on recovering as completely rather than as quickly as possible. Chronic re-injury is something you should work hard to avoid. Be diligent, consistent and patient with your rehab. Take it easy. And remember that soft-tissues take FAR longer to heal than bones do. Don't expect your elbow to be back to 100% for AT LEAST six months.
posted by randomstriker at 12:32 AM on July 15, 2008

Just a followup. I am now completely healed, and have been for a while. The first few weeks out of the cast were very difficult and my arm barely moved. Though I did follow the doctors orders to manually push the arm through increasingly wide ranges of motion, the best therapy turned out to be taking short, gentle trips on my bike. I followed randomstriker's advice and didn't push it, but there was something about consistently and frequently doing more "normal" activities that really sped recovery without pain or strain. There was a definite "breakthrough" as described by brianogilvie.

Thanks again, all.
posted by fake at 3:59 PM on March 21