Broken Humerus

Crap! Skiing the cat track above Cornice on Sunday. Storm was moving in---60 mph winds with near white out conditions. I was skiing next to the snow fence so I could stay oriented. Hit a 3 foot high swale which tipped me over and I landed with full body weight on my left shoulder on the downside of the swale which was as hard as cement. I knew I had broken it because I couldn't move it. Skied down to the bottom because I didn't want to wait there in those conditions for a sled. Broke the neck of the humerus in 4 places, but thankfully it's a "non-displaced" fracture so I just have to be in a sling for 4 weeks. Getting an MRI Thursday to rule out rotator cuff injury (which I really hope I didn't do). Hopefully I'll be back out there end of February. Worst part is that we're supposed to get a series of dumps next couple of weeks...dagburnit! :

OUCH! :I bet that hurts! But, I'm with you in limping down to the lodge rather than waiting for help in horrible conditions.

I guess having a choice an arm is preferable to a leg for a skier. Hope you heal up fast doc, but take it very easy for the rest of the season when/if you do start skiing again. Falling hard on a freshly healed (?) injury can set you back farther than you were the day you broke it. Guess that slows down your song fun replies and other computer activities as well:.
Sorry to hear, get well soon!

Thanks for the kind words cr. I broke my humerus but not my sense of humor...As for skiing, I won't until doc says I can. He knows me well since I'm a frequent flyer at his office, but I'm seeing him tomorrow and that will be a question. ER doc said 4-6 weeks and back to the slopes---since it's a broken bone it'll actually be stronger than it was before and I'm lucky because I heal quickly. Yes it hurts---imagine how you feel in your shoulder after a tetanus shot and multiply that x100.

Been there-done that, right and left! Similar simple little slow speed flips. Expect some PT when it's healed. I don't know if the muscles tighten up because of the sling or because of the injury but it sure takes a few weeks of PT to get back most of your range of motion and until you do you balance is poor so it makes everything else more difficult. You'll be good to go for March.

SteveT, how long before you started PT and how long before you felt you had enough ROM to go skiing (and how long until it stops hurting so much?)

I'll beat Phil and Yuki to this one. Despite what the bone is called iit isn't really your funnybone.. In fact, nothing funny about it..

That wind was pretty fierce. I spread my arms coming over Cornice a couple times last week/weekend, and almost came to a complete stop.

As far as PT goes. ASAP. The amount of movement allowed depends on the stability of the fractures. It is probably pretty stable, or they would have casted your shoulder. If you remain in the sling you are going to get very tight. You should at least remove the sling and work on supination and extension of your elbow and wrist.

Healing in 4 weeks is very optimistic in my opinion. More likely 6-8 weeks, if younger and healthy. Up to 12 weeks if older, lessening bone density, etc. Even longer with osteoporosis, disease, infection (osteomyelitis).

I always try to find humor in situations. My wife says that my shoulder is so big from the swelling right now that I look like Ahnold.

All is Not Lost!!!

Had my MRI this morning. No rotator cuff injury (yay!) and although there are at least 5-6 fragments, they are all in good alignment so no surgery necessary! Of course, the second question I asked was, "when can I go skiing again?" and he said 6 weeks!!! So now I have to twitch until March. He said it could have been much worse and that the "tuck-and-roll" maneuver is what minimized the damage. (That and the helmet!).

Now had you not asked him, you could have been skiing in two weeks.

Not very humorous "badum-pum" (horrible I know) get better soon.

A guy I ski with claims that if it isn't specifically in the doctors written orders, it is OK to do.

Although, when pressed on the issue, he will allow that, once, testing that theory with a broken wrist and a compund bow (It was bow season as I understand it) that eventually led to a massive hematoma of the forearm and a bow string embedded in the wrist cast---and an impromtu visit to the orthopod to fix the cast---and a thorough chastising from said orthopod---it is not always the right thing to do!

heal!

Good news! You are fortunate. The more proximal the break on the humerus the more difficult the healing is. Not only the rotator cuff but nerves surround this area, and the articular surface of the humerus/ glenoid fossa.

Probably around the 6 week mark the Doc will re-X-Ray the humerus and make sure the fracture is fused. Rehab for AROM and resistive exercise generally isn't started until the fx is fused.

Most proximal humerus fx rehab protocols start AROM 6 weeks out, resistive exercises at 8-10 weeks out.

The bones density depends on stress so, even though the fracture is "fused" it won't be fully strong/dense untill you can stress and bear weight through the bone.

Yes I'm a pain.

Just don't fall on it again for a while.

doogie,
My second break was when I was 57. It was simple break below the head. My first one 20 years ago was a big crack in the shoulder joint itself. Your injury sounds worse than either of mine. The doc took me out of the sling and sent me to therapy after 6 weeks then brought me back to check the range of motion and sent me back for two more weeks of PT. I could have skied but the season was about over by then so I started back with golf after 8 weeks. I had a lot of pain and trouble sleeping for about 3 weeks. I think some of the pain comes from increasing the range of motion and activity so it’s sort of a no pain no gain situation.
My ortho doc, being the good life long friend that he, encourages me to keep skiing becasue he says old flatlanders like me skiing is better than a 401k for him!
We had a family spring break ski trip to Whistler three or four weeks after the last break. I thought surely I could gut it out and make a few runs with the family. I could not even put on my boots or get myself up if I fell so I spent the week in the village and rode the gondola up to join the kids for lunch! My biggest surprise was the strength in my hand was almost normal in some positions and VERY weak in other positions. I learned that I could not depend on it until the shoulder healed.
If you’re like me you’ll fully recover but you will always have a little reminder every time you twist that joint a certain way. After 20 years on one and 3 on the other they both continue to improve with exercise and stretching and they both get stiffer more quickly than they would have if they had not been broken, which surprised me.
Good luck and enjoy your spring skiing.
Steve

Thanks for all the good wishes. He told me the only way I could screw this up is if I fell on it again right now. He said I'd be able to "take a blow to the shoulder" at 10-12 weeks, so obviously the skiing will have to be slightly subdued at first. : I get re x-rayed next Tuesday and assuming it looks OK he's going to have me start passive ROM next week (ouch!). He said I'll be able to do a full golf swing at 10 weeks. (I have digital x-rays, but I can't figure out how to shrink the file size so I can post them. Anyone know how to do that? Epic wants jpegs smaller than 195 kb and these are 2.25 mb)

Ummm...Do you have a scanner? Scan it as a B&W photo, and reduce, might work. Or take a photo of it?

First follow-up x-rays taken today. Still looks broken to me but doc says it's in 'excellent position' so now I have to start PT this week for passive ROM to keep the shoulder from freezing up. Sounds mighty painful, but necessary. Sleep is difficult. Best position is semi-upright, but then I get 'monkey-butt' which wakes me up after about 3 hours and then I'm pretty much done for the night. I've also gotten lots of whiplash symptoms in the past couple of days on the left side of my neck---point tenderness and cramps. Doc said there's recent evidence that suggests that taking NSAIDS for a fracture may retard bone healing rates, and since he said I'm still on the 'six-week plan' to get back to skiing, and there's a boy's week scheduled for mid-March, I sure want to get back out there as soon as he gives me the green light, so no Ibuprofen or Alleve. (This was not in my Master Plan...)

Progress Report

First two PT sessions were as bad as I thought they would be. She spends about 40 minutes doing soft tissue mobilization of all of the muscles around the shoulder and neck, while telling me what muscle she's on now. It's like an anatomy lesson in pain. (Her: "That's teres minor!" Me: "Mommy..." Her: "That's Latissimus Dorsi!" Me: "Mommy...") Then, while keeping one hand around the fracture site to stabilize it, she uses her other arm to move my shoulder in all different directions. (Her: "Is that bone pain or soft tissue stiffness?" Me: "Mommy...") I told her after she was done on Saturday that I was feeling a certain afterglow from all of that and now I can imagine what a 3-day Viagra bender must be like and maybe I should have a cigarette or something. On a positive note, although I feel like I've been run over by a truck the rest of the day after these sessions, it has become possible to actually lie flat to sleep, so I'm now getting 4-1/2 hours of sleep instead of 3. She also seems to think skiing in March is realistic...we'll see...

doogiedoc - Reading of your PT session made me laugh (with you, I hope). I was reminded of the time my brother prematurely ended our (planned) three-day Mtn bike trip ... by doing an endo and breaking his collar bone thirteen minutes into the first day's ride.

I got him to the trailhead and drove the two-mile VERY bumpy road trying not to bounce him off the passenger door too many times. At the nearest Urgent Care Center the Receptionist told us, "Yeah. We see a lot of that." (I thought, "Good! Then the doc will be experienced." He wasn't....)

The newly stationed doc (who looked like he *might* have just graduated from Jr. High) grabbed the figure-eight brace and (I promise) fiddled with five or six different positions to attempt to learn how to apply the sucker. I finally spoke up and said, "I think it goes over the arms and around the back."

Once he got it positioned, it was time to tighten it. The doc said, "Prepare yourself. This will probably hurt." My brother was in a great deal of pain and opined through gritted teeth, "It couldn't get much worse; go ahead."

I could tell the tension on the brace caused more pain ... but when the strap slipped out of the doc's grasp and the tension was suddenly released ALL the color drained out of my brother's face and I had to catch him to keep him from falling off the treatment table(!).

The kid -- er -- the doc nearly ran out of the room when I snapped at him for being an idiot. Then I demanded, "Do it now, while he's still unconscious!" (And he got it right the second time.)

When my brother came to, "Mommy!" would have been funnier than all the things he *did* have to say to the doc....

Sorry for thread-jacking.

Anyway, best wishes for a speedy recovery. Do *everything* the PT tells you and remember, sometimes more than she tells you to do is not actually beneficial.

When she sends you home with the rubber band excercises, ask her if four sets through the day (rather than three) is okay, if you feel up to it. She's probably seen enough patients to know what you can (and cannot) handle....

- KK

A beer or glass of wine before PT sessions makes them more enjoyable.

Having done PT before, I just can't seem to focus as well on what I need to be doing while I'm there if I imbibe first. Maybe my PT should have the cocktail?

That's ONE pint of ale, or ONE glass of wine

Three weeks post-injury. There are now certain sleeping positions that actually don't hurt. I'm so sleep deprived that I can fall asleep at the drop of a hat. Once I pass out, then I roll into a position that isn't comfortable and wake up again, so I'm still only getting about 4 hrs per night. Back spasms are slowly getting better and I think the rolfing my PT does has been helping that although it's still incredibly painful to have to go through that. Have gotten most of the range of motion back with passive exercises but it still hurts a lot to do them and I can't tell how much of the ouch during these exercises is bone pain and how much is stiffness. Quit taking Vicodin because they were losing their effectiveness (wife said, "just double-up and take two") but that sounds like a slippery slope towards Brittney-land---don't want to go to rehab! (Or would it be 'ski-hab'?) Getting x-rays next Tuesday which will be 4-1/2 weeks. Really hoping it's fused because I can just tell that as soon as I get the green light to go to active exercises that will help my mind-set a lot. I've been taking 1500 I.U. of vitamin D every day and calcium supplements---figure it can't hurt. Have had to resort to a friend's 'herbal remedy' and that seems to help pain in the nighttime more than anything else does...This has really sucked a lot. I've broken several bones and this is tied with broken thumb for being the worst. At least this should get better a lot faster than the ACL reconstruction! Hopefully I'm done with injuries.

Rolfing??? Yikes! That's some serious PT....

Acck! He's turning into a snowboarder [Gasp!!!]!

Amen to that!!! Get well fast. Is spring skiing a possibility?

- KK

I found that when I break bones the most serious pain only lasts about three days. I also found not taking any pain medication during the day, but taking two Percocets before bedtime really helped with being able to get some sleep.

Yeah, my PT 'loves' me. The whiplash from the impact has turned out to be more of an issue than the fracture itself. Plus, the dang sling is giving me 'slingitis,' so everything from mid-thorax to C1 is quite unhappy. The deep tissue massage ain't fun but sure seems to help loosen everything up. (Or maybe it just feels better when she finally stops?) She says this is more like a motorcycle injury where the rider bonks sideways and is unprotected.

Duuuuuuude!
Absolutely! Doc was convinced that the boy's trip March 10 is still a go.

Yeah, I've been on no meds during the day and did find it subsequently was more useful at night when I took them. Bone pain is clearly less than it was---it's stiffness, tendonitis and general soft tissue blunt force trauma that's the ouchy part of this now.

Rolfing huh, does she use her elbow? Kind of sadistic in my opinion.

I'm more of a Jones Counterstrain guy.

Ask if you can get rid of the sling. Or maybe soemthing like this.
http://supports4less.com/birdcronin/...mmobilizer.htm

you have probably already discovered this for sleeping. Hug a pillow, works somewhat either on your back or on your side.

Dooood, I hope this finds you well and sleeping better every day! Tis a beyotch, ain't it?

FWIW, my orthopedist told me that taking large amounts of supplemental calcium was not beneficial for healing broken bones. They heal on their own in their own time. I wouldn't expect that to heal solid for a good long time. More like months rather than weeks.

My fibula was not set when it broke, and while 'it's in good position', it still takes time to fuse together. Luckily, that bone is pretty much worthless (that's why the acronym for it is Fook It Bone) and is just a stabilizer for the tibia. If it takes about 6 months for the non-used fib to heal, I can't imagine how long it will take a humerus to fuse solid because it moves. I would imagine quite some time.

Buy a pack of Camels. The dominatrix knows how much pain the customer needs.

Thanks for all your kind thoughts---such a nice e-community here. Hope you're doing OK Bonni---yes it's a beyotch! Apparently, once you start 'stressing' the bone with resistance exercise, it accelerates healing. My area of expertise is skin. Cutaneous wound healing actually takes up to a year to completely run its course, but most of the remodeling has run its course by 12-15 weeks. I would assume bone healing is similar, with the majority of healing occurring in the first 3 months, but completion requiring longer. (Not like I plan on it, but the doc said I would be able to take a full-force blow at 12 weeks.) I believe most of my pain now is due to tendonitis in the proximal biceps tendon. They may wind up squirtin' steroids in it. I'll find out Tuesday...

Broke the greater tuberosity of my humerus in a ski fall a few years ago.
Spring conditions, hit a patch of sticky snow that I didn't see, bindings released and I somersaulted forward.
If I'd been a bit younger, i would have harmlessly tumbled and ended up on my back; but my reflexes were a bit too slow, so when I went forward I caught just the outside tip of one shoulder.
Years earlier I'd made the same move over the handle bars of a bike, and walked away with a few bruises after landing on pavement.
The brain is supposed to get smarter as the reflexes get slower; maybe someday.