Posts tagged elbow surgery
Met the orthopedic Doctor again yesterday. Long story short is he gave me the go ahead for the next phase of recovery. I can start using the arm actively. The weight regimen starts out real light and gradually increases the weight each month by about 5 pounds or so. The idea is to condition the tendon to the stress of active supination.
I told him about the elbow issues over the weekend and he immediately felt the ulnar nerve was the culprit. He said scar tissue wasn’t likely this far out from the surgery. He explained that the nerve passes through an opening in the bone as it traverses the elbow joint, call the Cubital Tunnel. When the elbow is bent, that tunnel closes up by almost 40%. If the nerve get inflamed or irritated, then that becomes significant as a further irritant on the nerve.
So he gave me 2 remedies to use in tandem. One is to sleep with a pillow on my elbow on the inside portion of the arm. The idea is to prevent it from bending while sleeping at night because this is a major source of irritation for the nerve since most people (myself included) sleep with their arm bent. By preventing that, I’d be giving the nerve extra time to heal.
The second remedy is a stretching regimen that he wants me to perform 5 times a day for minutes each. The stretch is to place my hand and forearm flat against a wall and then lean towards the wall. This stretch should help with the gliding of the ulnar nerve as well as help with my range of motion when bending my arm.
Next visit in 2 months time. By then, I hope to be as good as new.
So, the elbow had been feeling great the past several weeks. Generally, it would be almost impossible to know that I’d had surgery at this point. That said, I’m still not supposed to be doing any active lifting with the arm- for extension or bending motions. I have been doing isometrics as part of my PT though.
But on Saturday, I started noticing some discomfort in the elbow area. In particular, the elbow got stiff very quickly if I left it in a bent position for any length of time. Reading a book, or my Nook, was difficult actually by the end of the day. I hadn’t done anything to hurt it though. Or at least, not to the best of my knowledge.
On Sunday, it was worse. I’d lost 75% of my range of motion. Basically, I had a small arc of about 45 degrees I could move it through. I couldn’t straighten it out, nor could I bend it fully. When I allowed my arm to rest at my side, it almost looked like I had some kind of brace on it because it couldn’t extend. I had swelling just above the joint on the backside of the arm and there was a fair amount of pain in that area if I tried to move it out of the range it was limited to. Icing and compression were of little help.
Yesterday saw some improvement, though I was still a long way from normal range of motion. Today brought further improvement. I was at PT today and they ceased the normal routine and used some electrical stim and ice treatment and told me to call if it didn’t improve.
They felt it was a result of breaking down more scar tissue from muscles that hadn’t been in use. Essentially, they called it a form of tendonitis. I’m somewhat skeptical, since I’d been deliberately using the arm- though not to it’s pre-injury potential- for the express purpose of preventing something like that. Perhaps my efforts were in vain. Or perhaps something else is going on.
Fortunately, it’s documented with PT and I’m going for my next check-up with the Doc on Friday. Hopefully, he’ll have a better idea. Until this, I’d been expecting him to green-light the next stage in my recovery. Now, I’ll have to wait and see.
Got permission from PT to ditch the brace today. And the compression sleeve. Although, she did recommend wearing it out when I’m going to a crowded setting, just as a precaution so people don’t start hanging on my arm. Because that happens all the time- people randomly start swinging from my arms like their a vine.
Still got a wad of scar tissue under the incision in the crook of my elbow. I’ll be curious what the Doctor has to say about it at my follow-up next week.
I figure now I’ll be hitting the steep part of the recovery curve. Using it semi-normally plus the exercises I’ve got will, hopefully, result in some significant reversion back to what was the norm for me.
Just in time for the holidays as well. I know Santa will need some help lifting that sack of his…
The physical therapist has now added some isometric exercises for my triceps to my home PT routine. This is in addition to the range of motion stretching and shoulder exercises. The amount of atrophy is, frankly, astounding to me. I haven’t been able to use my arm for roughly 6 weeks now. When compared against the previous 25 years worth of physical activity (and strenuous physical activity at that) it barely compares. Yet all that time hasn’t mattered compared to not using the muscle for 6 weeks. Remarkable. I’ll be curious as to what kind of muscle memory my body has. I’d like to think it’s good, but the proof will be in the pudding.
For the non-squeamish among you, here’s a video of the surgery that was done on my arm. The tendon I tore is remarkably sturdy looking.
Here’s pretty much the exact brace I’ve got for the time being. The hinge has a lock switch to immobilize the elbow completely, in addition to a couple of “stops” to limit the range of motion of my elbow. For the first couple of days with it I tried to pull sweatshirts and the like over it. But it’s too much of a hassle and I’m just wearing short sleeves now until the brace comes off.
My PT has started as well. For the moment, all that consists of is range of motion exercises and working on some of the scar tissue. I’ve got nice golf ball sized wad right under the incision in the crook of my elbow. It kind of looks like an alien has taken residence there. At least it won’t be fatal if something does pop out of there.
One final note: the lass was initially very impressed with the brace. She particularly like the “thermometer” where the hinge is. The Wife and I had to explain to her it measures a different kind of “degrees” than temperature.
Yesterday I had my the splint on my arm removed at long last. It’s been replaced by a brace that is a 100% improvement over the splint; mainly, because my wrist and forearm are now freer to “move about the cabin.” I’m supposed to keep the brace in the locked position anytime I’m not doing certain range-of-motion exercises or my upcoming PT. Once I can straighten my arm(about 5-6 weeks), I can ditch the brace. Then, it’s another 20 or so weeks of PT until I’m back to normal.
I mentioned to the surgeon (even showed him the post) about my answer to his question. He was actually pretty amused and tickled that I did so and he took the time to talk about the whole thing a bit more. It was an interesting conversation. I may have some more on it later this weekend.
Back home from the surgery. Everything went fine, except I can’t feel my left arm due to the nerve block. My arm might as well be a piece of wood. Well I also haven’t eaten since dinner yesterday. My requests for Five Guys were summarily denied.
I pecked this out using one hand and have little desire to do so again. Back tomorrow, perhaps.