How I turbo-charged my recovery from a broken elbow

When I broke my elbow on 25th December, the prognosis wasn’t great – one month in a full arm cast and another month of non-weight-bearing. After that, it could be weeks to months before I got full range of motion and strength back.

From my point of view as a cellist this was obviously a disaster as it could be four months or more before I could get my playing back up to standard. Aside from the obvious loss of ‘feel’, the sheer strength in my fingers and the toughness of the skin on my fingertips that I have been cultivating for over fifteen years (I feel so old!) would be pretty much gone, requiring a long build back up to ‘form’.

As an athlete, it was frustrating because I was coming off a great winter of base training and ready to jump into my Pre-Competition. It seemed that was going to have to wait.

I did a lot of internet research and in general my two month sentence seemed to line up with what others had experienced with an olecranon fracture. I decided, however, to take every possible step to accelerate my healing, marginal gains being the name of the game…

Six weeks later and I just got back from a seventy-five mile ride in Suffolk, with plenty of riding out of the saddle. I also completed a 3km swim set yesterday and am running more and more. Two weeks ago I couldn’t drink a cup of tea and hold a biscuit at the same time. I have been playing the cello for a week and I am taking that slowly, capitalising on a rare opportunity to step back and re-evaluate my technique – the topic of a later blog post I hope!

Here is what I did:

Week One: Recover from my concussion symptoms which essentially involved a lot of sleeping. I ate very well as healing a fracture can have pretty high calorie requirements and I had three cracks to deal with. This is NOT the time to try to lose weight or control body fat. I minimised the amount of pain relief I took and after the first couple of days I stopped taking it entirely. Studies have shown that the kinds of pain relief prescribed to fracture patients can slow down the healing response and I was happy to endure a bit of pain if it got me moving sooner. With my athlete’s hat on, this was a timely recovery week anyway.

Week Two: Now I was starting to get restless, so I began some exercise including the following:

– Core: Hollow Body holds, supine leg raises – in short, anything that didn’t require the use of my arm.

– Legs: Shrimp Squats, Wall Squats, Glute raises, Calf raises, A-steps and Lunges with running arms – these hurt at first but I wanted to keep my shoulder as active as possible.

– Wrist and Fingers: lots of movement with no resistance up to the point of pain but not beyond.

– Walking. Lots of walking. I started small but for the next month I walked a minimum of 10km every day and I think it really helped mitigate the inevitable loss in running form.

Another important strategy I used was vigorous exercise of the other arm. This can help to stimulate protein synthesis (read – muscle growth) in the inactive arm through some sort of neuromuscular effect I don’t pretend to understand.

Visualisation was also a key strategy I used. I use lots of silent visualisation practise on the cello, imagining every movement required to play in the greatest detail I can, so while my arm was incapacitated I visualised using it in every way I would usually.

My first time trial over 25 miles. I still haven't found any arm-warmers that fit my puny arms.

My TT position, which I trained in on the turbo with my left arm in a full-arm cast at ninety degrees. Yes it got quite sweaty.

Finally I was lucky that my coach Tim Williams set me up to ride my bike on the turbo trainer, leaning on the tribars. As you can see from this picture that position does put weight directly through the elbow. The first doctor I saw actually said I shouldn’t do this until I reached eight weeks after the incident, but I sought out a second opinion and he gave me the advice that would become the overriding focus for my recovery: Listen to the elbow.

Some pain is good for healing, but pain that worsens overnight and lingers the next day suggests that you have done too much. Weight-bearing is good for bone strength – this is why patients with a broken leg are strapped up in a boot and told to walk without crutches. I decided that leaning on my tribars with the vibrations of the bike on the elbow would be an excellent stimulation to bone healing. I have little to no scientific back-up for this but I ran with it…

The cast was moulded to my arm much like a normal fibreglass cast. Those are velcro straps that I could take on and off myself.

The cast was moulded to my arm much like a normal fibreglass cast. Those are velcro straps that I could take on and off myself.

Week 3: Now that second doctor said I could remove my permanent cast and replace it with one that I could take off for showering. I began going to the swimming pool regularly and doing long kick sets and lots of single-arm drills, all the time trying to coax a little more range of motion out of my elbow which was pretty stuck at ninety degrees. I made sure to do plenty of self-massage all around the elbow joint and especially the forearm and biceps in order to get my arm straighter.

Week 5: My X-Ray showed that both the smaller fractures had completely healed and were in fact invisible. The larger fracture was at least three weeks ahead of scheduled healing time and I was given permission to start using it. Listen to the elbow.

Immediately I started playing the cello again although I didn’t have the range of motion to play in all the positions. I also started swimming and managed a total of 400m freestyle in my first session, supplemented with kicking. Two weeks later and I’m still a bit slower than previously but I am able to complete all the main sets with no pain. A little discomfort later is a positive thing – Listen to the elbow.

Clearly I didn't think it worth bushing my hair with the other hand.

Clearly I didn’t think it worth bushing my hair with the other hand.

I stayed indoors for cycling for another ten days, avoiding icy roads and building up the strength to control my bike and support myself in my road position but I was able to do some riding out of the saddle. The only thing holding my running back is my legs…

My arm still looks a little wasted and the triceps is weak but I am taking active steps to strengthen it. My main priority now is to avoid any injuries to my back that my be caused by faulty movement patterns, both in sport and cello playing.

So to round up, here are my strategies for speeding up bone healing:

1. Eat plentiful, healthy food so that your hormones and metabolism are working at their best to heal the injury.
2. Try not to take pain relief.
3. Visualise using your injured limb. This takes a lot of concentration to do properly so frequent shorter sessions are the best.
4. Exercise the surrounding muscles and joints as early as possible to encourage blood flow and discourage atrophy.
5. Start weight bearing as soon as you can in a way that does not put any shearing force through the bone – compression only.
6. Massage the surrounding muscles, gently at first and then more firmly as your pain allows.
7. See a physiotherapist or similarly qualified specialist who understands movement dysfunction and its contribution to injury.

Please ask questions below and I’ll do my best to get back to you as soon as possible!

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