Pushing a little too far in the pool
So my initial sessions at pool physiotherapy didn’t go that well. However given a good break from the pool, and a generally well moving arm, I thought now would be a good time to return to swimming after elbow fracture, although on a slightly bigger pool.
Swimming after elbow fracture
Swimming after elbow fractures an excellent form of rehabilitation, both for the fractured olecranon, but also for the rest of the arm. In fact it’s great physiotherapy for many injuries, and helps get normal movement back. The pain benefit is that it supports the limb/arm/joint, whilst performing exercises. This allows the joint to move, and slowly develops the flexibility you want without having to deal with the original forces of gravity.
I’m now finding that I can do most of the things I really want to with the arm. I’m driving, running, and even very gingerly cycling. Although undulations and bumps in the road do send a bit of a shock down the arm, so I thought things would be very good for swimming now.
Certainly the wound has healed beautifully, and I appear to have excellent movement in the arm, in all ways other than extension, which actually seems to be going backwards now the metalwork has begun to move.
Pretending to swim!
It’s one isn’t to be able to swim, (aka walk) around the pool in the sauna.
There isn’t much real challenge in trying to swim here. If there is any discomfort, or it feels a little hard work you put your feet down. However working on the idea that the fracture is like to be well on the way towards healing now, I thought I’d actually better start pushing myself. Although not past the physiotherapy mandated 5/10 pain score. We also used to joke that the physiotherapist beat up our patients on the orthopaedic ward. Having a physio, however, say that pain is a good thing, although not too much doesn’t really improve the impression of them as government sanctioned tortures (even if it’s for our own good!!)
After warming up at the edge of the university pool, I decided to start out of The Great Swim to the Other Side!
Its a little bit surprising quite how disconcerting not being able to touch the floor in on a pool is, when you are not entirely confident of your ability to get to the other side!
You really see the effect of muscle memory/improving in confidence when starting swimming again. By the end of two laps I was feeling confident again, and that was a big plus for me.
The pool is 25m in length, and I’d set my self the lofty target of swimming 800m, to tell me I’m good to think about the Henley Triathlon in June. Also, a proper swim is needed for the swimming review on the Garmin 920XT.
However it turns out that I hadn’t consulted with my arm on this plan. At 200m into the swim I was rather uncomfortable on the inner aspect of my arm. But being pig headed I decided to keep on pushing. Part of this, as daft as it might sound, is not realising how quickly pain ramps up from using something. I’m sure its logarithmic!
By the end of 250m my arm had had enough, so I pushed on for another 50m – which wasn’t too smart. The inner aspect of the arm was rather uncomfortable at the end of the swim, but in my head I’d managed to do something worth while.
I returned home to a good dose of anti-inflammatories and set to returning to complete at least 300m again in 2 days time.
I just never learn!
That 300m mark….That didn’t happen.
I don’t know why, it seems that 300m is the furthest my arm is happy to go at the moment. I actually had to work myself to get to the 300m, and frankly that was stupid.
If any take anything away form this post DONT PUSH THROUGH PAIN WHEN YOU ARE RECOVERING FROM A FRACTURE!
The pain in my arm didn’t subside the next day, and continued to be present for the following 3 days until I had my next appointment with the physiotherapist.
Examining the arm, the movements remained strong and healthy. My elbow was deeply inspected, and in addition had a deep tissue massage, which was very reassuring as there were no great areas of pain.
At the same time we tested my grip strength with a rather cool strain gauge:
You simply grab hold of the middle section of the handle and squeeze as hard as you can.
Testing with the strain gauge is apparently quite important when dealing within a fractured olecranon as there is normally an expected loss of about 10% in strength to the hand and the arm by the end of recovery. I was overjoyed to find that with both hands I had a strength of 46kg. Even more so, when I was told that the normal average is about 35kg in a healthy person! So I might be all skin and bone, but at least the hands are level in power now! Frankly i’m putting that down to the power ball!
Whilst this is all very good, it didnt resolve the ache in my side part of my elbow, and was advised if it didn’t improve by the end of the week, we’d have an X-ray taken, just to ensure nothing had moved. We knew it wouldn’t have, but it was important to check.
By the end of the week, the discomfort was still present in the arm. Not severe, but I was much more aware of my elbow generally than I had been before the swim. There was simply a deep seated ache in the inside of the arm. Given that, we had a check X-ray, which if I’m honest I think was more to do with reassuring me that looking for any problems.
The was no movement on the metalwork. There was however a little fluffy area on the inside aspect of the X-ray, shown by the arrow above. Its not supposed to be there. What is it?
It’s possible, NOT certain, but POSSIBLE that by doing the breast stroke, I’d actually stressed the fracture a little bit and caused a tiny bleed ?
The metal work secured the fracture to bend as the normal hinge of the arm. It doesn’t however stop me forcing it from side to side, and its possible that I put just a little too much strain on the fracture site. This is NOT serious. But it shows I might have over done things.
The upshot of it, was I’m benched. No swimming, no running, ABSOLUTELY NO CYCLING OUTSIDE until the discomfort has passed. I’m ok to spin on the turbo though, particularly to help get the healing going again.
Listen to the professionals!
I think i’ve done very well with physiotherapy, followed everything to the letter. But a little too much confidence, and a little bit of trying to run before I can walk has put me back about a week.
To reiterate again PUSHING TO DISCOMFORT OF 5/10 IS GOOD. ANYTHING MORE STOP IMMEDIATELY!
Either way, I’ve elected that I’m not going to try swimming again for at least another month. I know the arm is getting much stronger with regard to flexion/extension. The normally movement of the elbow. I dont want to be putting side to side forces through it again for a while!