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Olecranon Fracture Posts

Arm Strengthening Olecranon fracture physiotherapy exercises – TitaniumGeek

Although the metal work is currently backing out of my arm, and causing a little bit of irritation, the rods need to stay in as long as possible in order to get the maximum benefit to support the fracture. So that means starting olecranon fracture physiotherapy exercises – strength work directed at exercising and rebuilding the muscles of the arm generally – NOT about pumping iron!

Arm Strengthening Olecranon fracture physiotherapy exercises

The elbow is a vital joint in the arm – unsurprisingly, but what I mean is it is incredibly difficult to COMPENSATE for an immobilisation of an elbow – e.g. if you elbow is in plaster, you can’t really overcome this loss of movement. Wrist, and shoulder injuries, you can work around, moving your elbow, wrist, and to some degree your body, but an elbow is much more difficult.

Even when the elbow is removed from plaster, the arm is going to be weakened due to two processes in my case. i) from the pain at the fracture site and ii) weakness from the muscle immobilisation.

Side to Side Movement

Which brings me back to strength building for physiotherapy. Swimming is a very good process for rebuilding muscles strength in both arms and legs. However it has disagreed quite considerably with my olecranon fracture. I have been able to flex and extend the elbow without issue

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ARM side view – Flexion/Extension of elbow – fine & supported

However when a force is applied to the side of the elbow, such as when swimming breast stroke – possibly due to the force going sideways through the fracture, where it was not supported by the internal metal rods, I’ve noticeable pain

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Abduction/Adduction (side to side movement) of arm, causing pain at the medial/inside of the elbow

Keep it simple stupid

Based on the issue I had had with swimming, my grip strength was checked again. Which was now confirmed to be equal in both arms, and had stabilised at 46kg of force in each hand. On deep examination, no evidence of tenderness was found to the joint, so it was deemed safe to start strengthening the arm

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Grip Strength

When strength training can begin is not a defined point in time. The earliest it can begin is a 6 weeks post fracture, but more often, as was seen with myself strengthening the arm begins between week 8-12.

Shockingly slow

If I’m honest, I was quite happy to get going, and thought I’d be able to do quite well…. That was overconfidence for you! Just because I can now feed myself without issue, and support myself on the bike – a static or isometric contraction, doesn’t mean that I’m going to be able to do eccentric contractions, which are movement, rather than static based.

There is an excellent article on Fit and Me, which goes into isometric exercises in greater detail, definitely worth while checking out!

With the physiotherapist, we went into the physio gym, which has quite a lot of kit, and I was presented with a large foam foot ball… and asked to throw it underarm. Not quite what I’d been expecting for olecranon fracture physiotherapy exercises

Firstly, I’ve never been great at aiming, by now even less so. Secondly, intentional moment like that is HARD! Well it is after a fracture. You’ve really got to concentrate.

The main point of throwing the ball here underarm, is to get used to pulling the arm into full extension. Note that by throwing it under arm, most of the actual “work” of the movement is done by gravity, and your biceps, so this movement is very much about movement, and supporting that small weight of the ball with the arm extended.

As you can see, I’m not in the gym for the below pictures, but I couldnt really ask the physio for a series of photos give how busy their clinics are!

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Under arm throw – elbow in extension

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Under arm

Then it became more complicated…

My brain doesn’t work!

The next exercise was the overhead football pass…easy right.

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Overhead pass – note the metal work lumps on the RIGHT elbow

Take a look at the above picture. My broken elbow is the one on the LEFT side of the picture, or MY RIGHT arm. As I havnt done this movement in a LONG time, my brain hasn’t quite adjusted to the weakened muscles and the need to try and pull the muscles harder. So the affected elbow is sitting lower than the good elbow, and I THINK I’ve pretty much moved my elbow back as far as it will go.

 

I KNOW that I havnt from the position of my other arm, and the ball behind my head. The only way I can describe it, is that I have to concentrate to drop the ball back further behind my head.

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Nearly full flexion

With quite a bit of effort, that is as far back as I can currently get my broken arm. Again, looking at the picture, there is still a large difference between the two arms, in how far back my good arm can go.

From here it really gets hard. THROWING the ball. Ok that’s an exaggeration. Moving the ball from behind my head is a better way of looking at at. The physio advised there is no need to worry about WHERE the ball goes, or that my good arm is “helping”. I was concerned that this would slow the regaining in strength. Actually, my good arm will be guiding the bad arm when using both together, and showing it arm how to move.

But the actually throwing was SOOOO difficult. I basically just stood there and did nothing. It was mentally hard work to THINK how I needed to move my arm. I’ve stretched the triceps, and begun to compensate for general movement, but putting the ball behind my head like this isolated that muscle. It just didnt move freely. I had to THINK how to move my arm, its the oddest thing I’ve ever done!

Who said Olecranon fracture physiotherapy exercises would be easy!

We did four throws from behind the head, and stopped – thankfully… to move onto chest passes!

Feeling lack of strength

Where as behind the head throws seemed to be about flexing the broken elbow as far as it would go, and then getting triceps to contract in a pulling movement. Chest passes, have less flexion of the elbow, but are instead move of a pushing movement

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Chest pass

Here I felt that I was over compensating with my fingers, but again was reassured, whilst this is about building strength after an olecranon fracture, its also about learning normal movements of the body. Doing physiotherapy to regain strength is not strength work in the classical gym sense, where your muscles are already able to perform full movements. This is Rebuilding strength almost from the start.

Home work

Those three exercises, and that was it. I was given 2 weeks to perform those at home, trying to build up to 10 repetitions of each throw as often as possible. I was advised to go and find a foam football – a surprisingly difficult thing to do actually – an instead opted for the large tennis ball in the pictures. The point here was not so much about size, but a big ball that ALSO didnt weigh much.

Mentally this had been a real shock. I was under the impression I was doing very well with my rehabilitation after my olecranon fracture. To the degree I wasn’t doing stretching very often now. Only if I felt stiff. But to find how difficult “simple” movements were, really showed I’ve still a long away to go with my olecranon fracture physiotherapy exercises and rehabilitation, and with that strengthen exercises post fracture are going to be quite the challenge!

By working further to promote my movement, and rebuilding strength in the arm, I hope to be able to get back in the pool before too long, for a successful swim

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James Gill

Author of TitaniumGeek, which started after smashing off my RIGHT elbow. Feel free to drop me a line about sports tech, medicine, or frankly anything that you want to chat about!!