Swimming has been strongly advised to be an effective way to recover from my fractured elbow – however, my first attempts didn’t go every well, and frankly, I think I over did it!! FOUR months after my initial fracture and two months after my last swim attempt, I head back to the pool!
Swimming after fractured elbow
Perhaps the biggest physical challenge about my rehabilitation after fracturing my olecranon has been getting back into swimming.
Initially, pool physiotherapy is useful. But during the early stages of recovery, what I was actually doing was little more than using the water to support my arm, whilst walking around the pool trying to move my shoulder and elbow correctly. To use the word swimming would be far too generous a phrasing.
Finally getting back into the pool a month ago, it was clear that whilst my strength in both flexing and extending had improved considerably, there was still too much pain to be able to swim over 300m. I really found this surprising, and disappointing, as apart from the slight loss of extension, I really thought that the arm had improved dramatically!
Theraband to the Rescue
For the last six weeks, in addition to the work throwing a ball backwards and forwards, I’ve also been using a Theraband. Simply it’s a large elastic band. Hence the link to eBay for the cheapest one I could find. This has allowed me to do resistance work with the elbow at various angles, improving the ability to put a sideways force through the elbow (which is surprisingly uncomfortable when you first do it!)
But as long as I don’t push too much, that discomfort and resistance given by the Theraband promotes healing of the fracture. As does any reasonable activity using a fractured limb, as forces passing through a fracture actually help to stimulate healing/ossification. This is the main reason behind the physiotherapy advice, “Working to get a little discomfort/pain, about 5/10 is good and promotes healing. Pushing too much/hard risks excessive movement and damage to the healing bone” All of rehab is about balance. Similarly, being sore for ~ 24hrs after a session is fine. Being sore for >72hrs might mean you’ve pushed too much, and might need to get someone to look at the injury, just to check its ok.
Using the Therband allows you to decide how much force you pull with, like a large elastic band, it’s easy to pull on it initially, and as it gets stretched further, you need to apply further force to keep stretching – well I did say it was a giant rubber band! It is this high level of user control is when they are often used in physiotherapy, as they allow a progressive increases in force to be applied by the user when they feel ready
Normally with a Theraband you tie it one end in a knot and shut a door with the knot on the other side and use that. Personally that didn’t work for me – possibly as there is ALWAYS, WITHOUT FAIL someone walking through a door in our house…So I tied it to a chair arm instead!
In the position above, I’m slowly, and crucially smoothly, straightening my arm. Extending the elbow in this way helps to strength the triceps muscle running on the back of the arm. This was the one area that I feel have been very slow to improve, being able to straighten the arm against resistance. One of the functional issues I’ve found has been putting on a car seat belt using that arm. Reaching around to stretch for the belt, and the pull it, so extending my arm has not been easy. Swimming will greatly help strengthen triceps, hence wanting to get back to swimming after fractured elbow as soon as possible
Back in the pool
Two months after my last pool session I decided to head back to the university pool to test out the damaged arm once more. I was confident that I would be able to hit my goal of 800m, however I was very conscious that I would need to stop if there was any significant discomfort in the inside of the elbow.
I decided to test out the Garmin Virb Elite at the same time as doing the pool swim, thinking that filming my swim would give me an idea as to how my swimming technique had been affected (lots!).
Thankfully, and to more than a little surprise to myself, I was able to do the full 800m without anything other than a slight twinge to the arm, which became apparent on the final length. The actual swim was a major confidence boost, in that I had proof my rehabilitation strategy was starting to pay off.
The swim, and more importantly the arm, was not completely trouble free however. Throughout the whole swim, I was acutely aware that I wasn’t able to straighten my arm fully, or properly as I had been able to before the operation. This lead to me placing my RIGHT hand, when leading into the water, across my head, slightly affecting the direction of my swim. It certainly impacted on my ability to “pull” with that arm, which was frustrating.
During the swim I did a mixture of breast stroke, crawl and back stroke. The intention here being to work on the affected arm, but also to work generally on swimming after fractured elbow, as I am very aware of the general change to the musculature on the RIGHT side of my chest and back. Concentrating on the form of my stroke allowed me to try and work the muscles on the RIGHT side that have been neglected over the last few months.
Similarly, performing back stroke gave me an idea, when reviewing the video of how my RIGHT shoulder has become contracted slightly, resulting in a less smooth stroke. I have included a link below to the video that was filmed in the pool. When watching, play close attention to how the RIGHT arm doesn’t extend, and the clear loss of musculature on that arm
The upshot of this was to identify that I had misstepped with regard to my physiotherapy changes. Probably for the last month, I had eased off my physiotherapy stretches to work instead on rebuilding strength. This video clearly shows that I need to continue with my stretches at least until the metal work is removed. A decision that will be made next week at the next consultant review.