Broken Humerus

If it's any consolation, even girly sports like figure skating can be dangerous.

COLORADO SPRINGS, Colo. (March 13) - Two-time U.S. figure skating champion Evan Lysacek withdrew from next week's world championships after hurting his left arm in a fall during practice.

Lysacek's right skate blade broke on the landing of a triple axel Wednesday, and the fall injured his left forearm, elbow and shoulder. No bones were broken, but he's wearing a soft cast and will be in a sling for about a week. Doctors have told him not to jump or do spins for two weeks.

The world championships begin Tuesday in Goteborg, Sweden.

"I'm obviously disappointed that I won't be there," Lysacek said. "I've been skating very well, and I really felt like the momentum was building. I'm going to continue to train as hard as I can, work to get this equipment issue straightened out, and return strong for next season."

OK Phlogiston---that makes me feel a WHOLE lot better! :

Hey dogiedooc, I see you made it back in one piece. How'd your kid do? I think the docs didn't want you skiing because if you sucked and fell hard you would be really mess up their progress. You got it made out that way. Isn't Mammoth frequently open well into late June?

Ryan placed 29th out of a field of 82 in Super G!! He was psyched. Would have done better but someone apparently sabotaged one of his bindings by turning it all the way down before his second run so he prereleased at the thirteenth gate while he was in a maching banana turn around the gate. Shook him up pretty good but not hurt thankfully. Now we have learned the hard way to check bindings before every run to watch out for the kids that feel like they have to cheat to win (or was it a parent?!). Yeah---my attending told me I would be able to take a full blow to shoulder at twelve weeks, no sooner, so that's why he told me no skiing because he knows I push it. Falling wasn't an option so I didn't! Yes, we do have it made out here. Mammoth's "second season" starts in April, and given how huge the snowpack is this year, June is almost a certainty, and I'm guessing we'll maybe make it to Fourth of July for lift-served, and back country into mid-July. Beautiful corn snow and sunny skies for the next few months! Come on out and let's make some turns! Major milestone in PT today: although it hurt a LOT she was able to externally rotate my arm to almost 90 degrees. Today was the first day she has said that she thinks I will get it all back--prior to this she has been somewhat evasive due to how bad the break was. It makes me feel more optimistic, that's for sure! See the doc on Wednesday for X-Rays. It'll be 8 weeks tomorrow. Still having problems with moderate pain along the proximal biceps tendon and the deltoid insertion. I don't want to take any more NSAIDs than necessary, but they seem to help me get more done in PT. I was also able to extend my arm sideways (abduction) with a "wand" until it was touching my ear today for the first time. All major psychological hurdles for me. I'll let you know how it goes with the doc on Wednesday. Hopefully I'll get to start weights. Thanks for all the PM well-wishes y'all, that's helping too. Lots of nice bears here!

It's AWESOME to have kids that enjoy the same things you do. Sorry about the "school of hard knocks". I guess that is also part of the game unfortunately

I''ve made my last turns on skis this year, but will be at the beach pretty soon trying to ride my latest surfboard quiver (now back up to 2 LOL)aquisitition for the few minutes I can sneak away from the family to catch a few little NC waves:

Cheers!

I gotta get to Mammoth one of these years - everyone raves about the season out there. Seems like a lot of professional boarders and skiers move out there too.

Saw the doc this morning. They only took one x-ray instead of the usual three, so I'm looking at it when he comes in the room. He gets a worried look on his face and says, "I want to get the other views" at which point I'm thinking "Oh, Sh!t." Back for more x-rays. After looking at them he says "looks really good." Apparently the fracture was displaced a few mm at first and now it's somehow sneaked back into almost perfect alignment, and he wanted to verify that. So that's great news---clearly re-calcifying on the x-ray now. He also commented about how fast it is healing, at which point I told him about taking 1000 I.U. of Vitamin D every day (He didn't say anything but I saw his eyebrows raise up again.) I told him that the fracture pain was lots better but that my proximal biceps tendon is still killing me, and since I'm really supposed to avoid NSAIDs due to another condition, it was decided to inject steroids in the tendon sheath to see if that would calm it down. So now I've got Celestone in there, burning like a mofi-doh right now but I'm hoping that it will cool the fires in there quickly. I get to start resistance exercises in PT now (bring on the 1 pound weights Ahnold) but he said 8 more weeks of PT since I still have some limitation in my range of motion. I didn't even ASK about skiing, so he can't forbid it, but I specifically asked if there was anything I could do at this point to screw this up anymore and he said, "no"...so I'm going skiing Saturday!!! : He said 6 months until I'm no longer aware of my shoulder, but for the first time he's said he now expects a complete recovery!!! Woo-hoo!!!

My bonefixer at The Hospital for Special Surgery in Manhattan told me that anything under 8mm of displacement was ok.
I think your tendon will hurt as long as the periosteum hurts; when it stops hurting you'll know that you're healed, or dead.

My point is that the fracture pain is gone. I've had mild biceps tendonitis in the past and this is a re-aggravation of that old injury. Since I wrote that post this morning, the 'roids are already kickin' in---it's feeling like the fire is going out!!! Even if this gives me just one night of relief / good sleep it will have been worth it. Bring on the torture in PT tomorrow morning!

Doog - great news you're hitting the slopes this weekend. Have (safe and careful) fun out there.

Thanks CD. Still not going to ski with a pole in my left hand because I definitely don't have full external rotation yet and if I did a tweaky pole plant I know it would not be fun. As for safe and careful---ALWAYS! (Snicker, snicker...)

So---clicking from the tendon has stopped which is really nice. However, now I'm more aware of how much the rest of my shoulder still actually hurts. Phlog, your bone cutter is probably right. Even my surgeon said 4-6 months before it really completely stops hurting. Interesting side effect from the steroid injection. Woke up this morning looking like I've been sunburned over my entire body---kind of a rosy flush. No symptoms but it looks as if I had fallen asleep with a sunlamp on.

roids are plain scary. weird stuff. Shoulders - what a pain (I know and need some kind of surgery at some point).

Prednisone makes me "manic". I refuse it unless I can be free of responsibilities like caring for my little kids. Last time I took it for poison ivy I spent an evening (all night long) re arranging the kitchen cabinets and drawers several times using different strategies for no apparant reason among other wierd things I did. It was like being on acid or something. My wife was extremely pissed because she coultn't find anything in the kithcen for months hahaha!

Great news, doogiedoc! Just don't muff it up now.
Isn't it great to sleep comfortably? Such a simple thing, but so important.

Hey, crgildart, I know what you mean. The summer I was on prednisone for poison ivy (it went systemic) I was insane. I liked the energy, but my whole personality was messed up. Who WAS that person!? I had to stop taking it as soon as possible.

This summer I was on it for a while, too, and got up at 3 am to paint part of the kitchen, thereby exhausting myself so I could pass out again at 7 am to sleep another 2 hours. Crazy ****!

'Steroid' is in fact a conjunction of the words 'Sterile Android', which is what you'll become if you take them for too long. Not a problem for a guy whose kid is old enough to be out there tearing up the slopes, but still not an ideal outcome.

It was suggested that I get injections for my morton's neuroma; considering the side effects, I chose to ski with homemade orthotics and store-bought Vicodin instead. Two ounces of brandy per Vicodin tablet helps with absorption.

So this is the fracture that keeps on hurting, apparently. I have some positions now where it doesn't hurt too much, and some where it's still very uncomfortable. It is still painful 24 hours/day, but I am able to ignore it (mostly) during the day. The nights can still be pretty rough however. I am able to sleep in more positions now, but I'm finding that I'll fall asleep in a position that's comfy and wake up having moved into another position that makes my arm cramp up and I then have to let it dangle for a few minutes until the cramping goes away. Happens several times a night. Tried to 'snow' myself last Saturday---had two strong Mojitos and then took a Vicodin. I slept like a comatose rock---first real full night's uninterrupted sleep since I broke it in January, but I must have slept in one of the 'crampy' positions because I paid for it with shoulder pain all the next day, so I guess I won't do that again.
I have started doing resistance with weights in PT. Interesting how some muscles seem ready to go right back to where they were before injury and others are totally wimpy. Any exercise that recruits the deltoid is still very difficult, probably because one of the fracture pieces sits right under the insertion of the deltoid muscle. I'm doing "M's and T's" while lying on a pilates ball and and only using two pound weights (and there's nothing manly about the 2-pound weights---they are PINK for goodness sakes---talk about rubbing it in!), but I can already do 8 pound biceps and triceps curls (almost an Olympic God but not quite). After an hour of deep tissue massage and warming up to it, my PT was able to get my extension to 175 degrees, only five degrees short of 'normal.' Hurt like a muthah...I had to wear my baseball cap so that my whole face was covered so she couldn't see the tears. I've learned that if the PT can see me grimacing in pain she backs off, and I seem to make more progress when she pushes it with me some.
I'm going skiing next week for spring break. I'm still not sure if I'm up to using a ski pole on my injury side yet. We might get some pow next week and while I know I can do ghost poling on a nice day, I'm not sure if it will throw me off to have a ghost pole in the pow. We'll see. At least I'm getting back in the saddle again. My wife was trying to humor me yesterday when she told me that my shoulder no longer looked totally deformed and that I was starting to get some muscle definition again. I say that because the PT had a therapy student in clinic yesterday and 'used' me to demonstrate feeling all of the rotator cuff tendons. In other words, there's not much muscle there right now and you can feel deep structures that you normally don't get to feel! Oh well. At least I'm pumping iron with the pink weights!

Why do you think the expression is 'You're in the Pink'?

Good work, dd. You're a long way from 6 months post injury and from where I sit, you're ahead of the game.

Save the macho posturing for later....if you're in pain that makes you leak tears, tell your therapist. Everyone has different benchmarks in their recovery. Don't over reach yours. You'll get there.

So just back from a week of some of the finest wind-buff I've seen at Mammoth in a long time. Shoulder is feeling WAY better. I decided to try skiing with a pole on the broken side. First day my shoulder got pretty tired by the end of the day, but more cramps than pain. Absolutely no question that a week of skiing was the best PT I could have gotten. The repetitive movement / internal-external rotation with the relatively small weight of the pole has totally loosened up my shoulder. I'm back at PT tomorrow and am sure she'll be most pleasantly surprised at how much more ROM I have now. I took it easy for about the first 5 runs. By yesterday we were mach-ing it down Wipe Out chutes and I wasn't even thinking about my shoulder. All that's left now is just getting the strength back and the very ends of range of motion, and waiting for the pain to go away (only hurts most of the time now instead of all of the time.) I believe I'll be as good as new! YAY!!! : :

It beats the hell out of crying with the dominatrix wrenching on ya! Great news indeed!

cool - keep up the good news and good work

Well, they call them dominatrixes / dominatri for a reason. She was very pleased that I had done so well and did notice significant gains in range of motion, enough so that I now get to do the dreaded internal rotation stretch. You wrap a band around your wrist and grasp it, sling it over your back and above your shoulder, grab the other end of the band with your good hand and pull up and backwards. It's the same maneuver that the school bully did to you when he'd grab your arm and twist it behind your back to strong-arm you except I'm my own school bully. She also caught me cheating while doing wall extensions. Basically, you stand facing the wall, upon which is mounted a long piece of wood with little notches cut out of it and slowly walk your fingers up the notches which gets your arm to gradually extend up like you're asking a question in class. I was 'cheating' by bringing my shoulder blade up. She saw it and said, "here, I'll help," and while I'm raising my arm she's pushing down on the top of the shoulder to keep it down. Yeeouch! (I've figured it out that when she says "HERE-I'LL-HELP" it usually means "this is gonna hurt.") She also let me start doing a bench press on the upright machine with a ten-pound weight. (Me to PT: "There's nothing manly about a one-plate press!") So, I'm definitely making progress, although I clearly still have a ways to go...

So the old saw about No pain, No gain is true, eh?

I don't get PT this time. I didn't really need it last time. Darn. I guess I torture myself enough on my own.

New Torture in PT Has Begun

Well...just when I was beginning to think that my PT days were slowly coming to an end, I was reminded of what both the PT and Doc had told me, which was that the soft-tissue part of this injury would plague me the longest. I had a "guest PT" work on me last Thursday since my usual one was on vacation. She started mooshing on places around my neck and base of the skull that my usual PT hadn't been addressing. OMG it was like having someone stick hot daggers in my neck. She started doing "myofascial release" techniques on me (maybe Baja can shed more light on this). Basically, she takes a small rubber ball (the dreaded "Pinky Ball on a stick") and uses it to push down on the top of the soft part of the shoulder ("mobilizing the first rib"), then has me turn my head to the left or right and then starts doing stretch massages across my trapezius and other neck muscles. One spot, when she hits it, makes me feel like someone is shooting electric shocks across my jaw and onto my cheek, another spot makes me feel shocky feelings up into my scalp and ear. It starts out exquisitely uncomfortable and then slowly goes away after a few minutes of stretchy massage at which point she moves to a new spot. Yesterday, they measured my standing height before starting these maneuvers, then measured it again afterwards and I had gained over an inch in height! (They explained it that because of the side-impact blunt force trauma, all the muscles in my neck have gone into spasm and it is literally pulling my head down towards my chest.) Once finished, it feels like my head is a helium-filled balloon...a most pleasant feeling I might add. She said this myofascial stuff might go on for several months...oh, joy! Meanwhile, my arm is finally feeling like I'm getting better. I'm still not sleeping through the night. I'll get into a position that eventually makes it cramp up and then I have to sit up and dangle my arm until the cramping goes away. However, I'm getting my strength back and have been able to start doing some real exercises now instead of the little rubber band exercises that they start you off with. This has really been a PITA.

I guess that's why fools like me don't go to the Doctor and just use duct table for terminal injuries..

Seriously though;
Aw geez doog, I'm sorry to hear that It sounds like the time you are in the least amount of pain is when you are skiing. My migraines seem to not happen nearly as frequently when I am sick with other ailments like the flu or strep throat. Have you noticed fewer in the midst of this other suffering? I hope they can get the kinks out of you soon. All kidding aside, I would stick with what the experts recommend for the most part if I were in your boots (but would still ski given the opportunities you had!) Hoping you will be 100% by mid summer.

You don't play golf do you? An injury like that would be catestrophic to someone's golf swing.
It would probably help mine though
Cheers amigo, best wishes as always

Yes, that's been a blessing in disguise. I've only had two migraines since the injury and I used to get 2-3 per month.
Thanks! Yeah, I do think the endorphins from skiing help a lot with pain. Going to Mammoth end of April through May 4th for my 'injury consolation' week, then a weekend mid-May and Memorial Day weekend. We'll see if it lasts to 4th of July this year. That would be awesome!

I am a golfer. Unable to swing until a few weeks ago. I went out and took some easy swings with a pitching wedge and it felt pretty good, although I was hoping the fracture would cure my slice, no such luck...

Update: 'Guest PT' is really sharp. Proves the point that a second opinion is often a good idea. I have still been having pain at the front of my shoulder out of proportion to how the rest of it is feeling. She noticed that my entire shoulder blade is tilting "up and forward" and it should be "down and back." After about 1-1/2 hours of various maneuvers and pushes, she determined that the posterior aspect of the shoulder joint capsule has stiffened up somewhat, and my lats aren't contracting ('they've forgotten how') so in effect the muscles like pects and trapezius are pulling my shoulder up and around to the front with nothing balancing them, in effect stretching the front of the joint capsule (yeeeouch!). (When I hear a PT say 'I have an idea' I've found that means 'this is really going to hurt.') So they have me lying on a tennis ball so that it squishes up into the soft muscles around the shoulder blade to 'mobilize' them (meaning of course, pain) and then I have to lie on more tennis balls scrunched up into my spine while at the same time I hold onto a wooden dowel and extend my arms over my head. Try it---I'll bet it hurts even if you don't have a broken shoulder. Then they have me doing a bunch of exercises to get the lats to wake up while the PT taps the muscle with her fingertip to give my brain a cue on which muscle to concentrate on recruiting...a most bizarre sensation, I must say. (Then they put a crapload of tape all over my shoulder and suggested that maybe I should do less golfing this weekend and more drinking.) If I try really hard, I am able to raise my hands straight up and just barely touch my fingertips together, but touching my fingers together behind my back is not quite there yet. Sigh. Going skiing next week...that sure helped me a lot last time...hoping I'll get some benefit again this time! (Wait, what am I saying? It's skiing for goodness sake. Just being there will be a good thing!) More rehab to follow I guess!:

Update

Saw the doc for the 4 month follow up last week. He used the word miraculous twice during the visit, once when he was looking at the x-rays (you can barely tell there was a fracture now), and once when he saw my range of motion. I am now able to put my palms together over my head with only minimal pain, and am able to touch my fingers of both hands together behind my back, although that still hurts a lot. When I told him I'd been taking Vitamin D every day to try to help encourage the bone to heal, initially he pooh-poo'ed it, but this time when he was looking at the x-rays he seemed a bit more intrigued. When I told him how hard I had been working at PT he congratulated me and said that if everyone pushed hard as I did there would be more people like me doing well at this point.

I really had been in a bit of denial as to how serious this fracture was until I showed the original x-rays to a friend who is a radiologist who gasped, and then laughed, when he saw the images. He told me that often when he sees the 10-day follow-up x-rays for this bad of a humeral neck fracture, the arm bone has "fallen off" the head of the humerus, so he also told me how lucky I was!

It's very strange how fast some of my strength is coming back and how slowly other parts are recovering. For instance, as of last week I am back to doing push-ups with my feet resting on a 65cm pilates ball, and although it hurts I can tolerate it. On the other hand, I can only do 5 pound overhead military presses. (I was up to 45 pounds each arm prior to the injury.) Anything more than that is not possible. I am unable to do pect flies on a machine because of range-of-motion limitations but I can do pect flies lying on a foam roller, but again only at five pounds. Well, at least it's coming back slowly.

Still waking up 8-10 times at night because of cramps in the shoulder but it doesn't hurt NEARLY as much as it first did. Migraines are back unfortunately. That returned about the end of the 3rd month. I'm also occasionally having to take a muscle relaxer because all of a sudden the muscles in my neck and back will lock up in spasm. They tell me that's a leftover of the whiplash part of the injury.

So, 6-10 months to stop hurting may be realistic apparently, and I suspect that it'll be a year and a half before I'm really back to normal. On the positive side, I played a round of golf and shot a 97, which for me is really good. On the last weekend of skiing at Mammoth, I was feeling so good while skiing that I took a 12-foot ramp kicker and stuck the landing, but oh boy did my shoulder complain for a few minutes afterward because of the deceleration. Well, at least I can ski and lift weights and play golf and work and I'm not crippled!

Update

Thought I'd give you all an update since it's been a while. When the doc said 10 months he was right on the money. It's been 10 months since the injury, and it finally doesn't hurt anymore unless I really push the ends of the range of motion. Even as recently as 3 weeks ago I was still getting twinges. I have almost all of my strength back and feel I've finally put this friggin' injury behind me. The most important part of the process was the brutal PT at the beginning. If I hadn't really pushed myself then, I doubt I would have made a full recovery.

i clean snapped my humerous have a plate 10 screws u wil be very week 4 a long time trust me