Humerus fracture recovery

Im glad i found this site. It comforting to read that people are goin thru the same thing as i am.  Yes I, 10/08/07 UK <3days ago broke my weaker left arm by arm wrestling, massive snap everyone watching shocked. no-one more so than me incidently etc. Im 22, 180lbs 6ft, fit and have been dumbelling upto 15kg, gym and swimming for years. Plenty of shoulder/arm muscle yet i went to wrestle...   then i was losing alot so i put in more effort then snap. I dont know if my muscle broke my own bone or if he did :s I dont know if my bad technique due to me being a bit drunk was the cause of it and the fact that i dont arm wrestle very much at all <1 a year. stupid really!
But it seems to be a common problem which i wish i was more aware of  :( anyway rushed to hospital A&E on a friday night, fortunately a clean break in the middle of the bone, humerus spiral fracture. Docs have put me ina sling (cuff n collar) with no surgery, no cast or splint :s apperently the bone will reallign and fix itself with gravity.  Am on in my oppinion weak pain killers 500mg paracetamol wit 10mg dihdrocodeine tartrate. but 3rd day in and i dont feel i need them so i dont take them, i have little pain with gravity just holding it their and medium to good use/flexibility of my wrist/fingers despite no strength (cant hold a cup of tea yet).  i still take painkillers at night to help with sleep, not that im doin much of that sitting almost bolt upright.  I have all my feelings apart for a numbness at the bottom of my elbow about 7 cm circle diameter but i think thats due to poor circulation becasuse my elbow is very swallon like a balloon.  Feeling better already altho still no moment with the arm, so frustrating that u cant stretch out or lie down.  want to weight train already and its only 3 days in.  Anyway am due a check up in 2 days (5 days from 'the snap') i expect they will re xray to see if ther natural alignment is working.  feels okay so far, though i expect they will confirm whether or not to splint/cast then. either that or say y the hell arent u in one already.  i will post back later. scary stuff tho, never broken anything before and now im worried it will re break if do anything. want to snowboard in 4/5 months and will b paranoid about falling on it i expect.  dialy im currently taking seperate coponents of ZMA (zinc upto 90mg to help healing, mag, b6) protein, glutamine, >2g calcuim to grow a new bone hopefully. will see wat the docs ses. guess ima take it easy for now. 

i found here through google a week ago but i was in too much pain to register n post then.28-year-old from new zealand. on 6/8/07 i broke my right distal humerus arm wrestling as well, spiral fracture with a butterfly fragment. i was rushed to the ED and they found no nerve damage so put me into an above elbow hanging cast. it's been the most miserable week of my life. i cant sleep in bed at night cause no matter how i position my broken arm it hurts. i just had my first follow-up clinic this afternoon. xray shows that bone has straightened but there's still a visible gap between broken bones. doc says i'm doing ok it normally takes 6-8 weeks but i actually expected to see some sort of bone union after 1.5 weeks. i'm depressed! i'm praying that i won't need a surgery cause i don't like the idea of plate and screws in my body, and by all accounts people going through surgery don't recover as well as those without. not to mention wasted time. i've been lifting weights for about 1 year before the injury and gained 7kg of muscle. i miss the gym already. but i'm not thinking about getting my strength back. all i want now is just a fully functional arm back, full ROM, no pain/disconfort, etc. i'll go from there. but i'll never arm wrestle again. it's nice to read different people's stories here even though they give me mixed feelings. at least i feel i'm not alone. i'll post back next week.

Found your site searching for "stregenth training after complete humerus fracture".
(I broke mine working cattle horseback....) My Doctor OK-ed me to go back to normal life two weeks ago, I used to be strong...for a girl (26F) no bodybuilding! but farm life and 50lb feed sacks were not a problem now I am struggling and canNOT lift the 5lb weight with that arm! (I've got a 1lb weight I've been using, but progress is very slow!) Terribly frusterating. (I've always been the one that could do anything!)

What types of exercises do ya'll suggest? Mobility is not the issue as much as stregenth is. I've spent a lot of time stretching and such, but how can I build any sort of stregenth back??

Thanks for the input!

Update – 5-day check up went okay, doc said he was happy to leave the sling on and let it heal naturally pending a check up in 2 weeks.  The bone did no doubt look more aligned than at first x-ray on the day of the break but it was easy to see it was still a couple of centimetres out of place (wide). It’s still early days though. 

So I spent the next 2 weeks resting it somewhat.  The balloon swelling of the arm started to have some yellow bruising on the forearm by day 7, then followed by a large darker black bruise on the point of break at the front of the humerus.  Then a day or 2 later a 2-inch deep red one appeared behind the break point, showing what are probably ruptured blood vessels.  Followed by a long black bruise down the bottom of the forearm.  I don’t know why my forearm is becoming so bruised; it’s a little sore if you poke it.  The other bruises aren’t too bad despite their appearance. 

Anyway the swelling started to go down over the week.  Managed to put on a stone (~6kg) and lose it with respect to before and after the swelling going down.  Bruising went away nearly as quickly as it came up (3 days), and the arm size is back to normal apart from a build up of now hard fluid collecting at the bottom of the forearm which will probably shift once I become more active.  But at the moment if I poke it, it can make an indent on it and feels a bit like a balloon filled with flour, stress ball kind of thing.  It’s still mildly numb around the elbow, if you pull the arm hair I can feel it but surface touch sensitivity is still low. I think this will go once the fluid shifts and normal blood flow can return.

I have been fortunate with the pain and hassle it would seem as I said before managed to completely stop taking painkillers after just 5 days, even at night. And by that time I managed to lie down on my side without to much trouble - although not recommended for straight bone union, I thought to hell with this as I needed some proper sleep for recovery plus my neck/shoulder was killing me after hanging that sling on it non-stop for 5 days.  I still kept the sling on while lying down just kept my arm in that right angled position making a rough fist into the mattress to support the arm and balance most the arm weight on my hip/rib cage area, otherwise the full weight of it hanging down would make it hurt a lot.  I could not lie flat on my back as the arm seemed to roll and bend over my chest and hurt although I could lie back nearly flat on a couple of pillows, I have 6 at my disposal :D  To do this I let the arm hang by my side facing slightly outwards and let the elbow rest slightly supporting itself. Of course if I leant on it by accident then it would hurt like hell.
 
The arm seemed fine during the day so long as it was kept in position and not knocked at all. After the swelling went down by day 10ish, I managed to get a lot more strength back in the hand and I can grip things quite well like x-box controllers, glasses of water etc.  I also had a mild pain in my ring finger when I contracted it but that pain went when the arm swelling went down.  So not one to be held back I hit the gym to stimulate some testosterone production on day 8 and again a week later and did cycling, leg squat presses and quad work. Cant run yet though, could barely walk fast, the juddering hurt it too much as you might expect after only a week from the break.  It used to hurt riding in a car but its fine now.

I did take one or two low doses of ibuprofen at night which worked for me better than the painkillers prescribed and I think reduced the swelling a lot but I know it’s not recommended to take anti-inflammatories (NSAIDs) early on as I’ve read they restrict healing, probably because they reduce important blood flow to that area, although reduced swelling equals reduced pain for me and they can be mixed with alcohol which is nice but again you shouldn’t do because it inhibits healing, so does caffeine incidentally.

Right went to the next x-ray check up now 18 days from the snap and it looks good, got a photo on my phone of the x-rays.  Alignment is now perfectly straight when holding your arm out in front of you and your wrist facing up in a bicep curl position.  When holding in a sling position away from the body a little bit (hand on hip kind of job except I cant flex like that yet) the alignment is heading the correct way slotting in the old grove less than 5mm from lateral connection but still about 3-5mm wide, maybe that’s as good as it will get. 
 
It’s not bad though, its not bowing from sleeping on my side, which is good, and surgery looks off the cards for good, which is great news.  Doc says I won’t see union for another 4 weeks yet, but even then it won’t show up solidly for another 2-3 months on x-rays.  He could see new bone forming but it’s not really a significant amount.  The plan is that I should be good in 4 weeks to start physio, which would make an initial heal time of 6.5 weeks, but I’m not convinced.  I can’t even put my arm past 120 degrees yet without it hurting, so I don’t want to rush into any re-break risk.  The doc says it will be strong enough but as I said it wont be rock solid for a few months. 
 
I am now taking up to double dosages of ‘Osteocare’ as part of a balance diet of course which contains a lot of things in it that I was already taking (zinc, better quality calcium, magnesium) but now includes Boron which I was missing and it is working out cheaper at the moment than my previous supplements when ordered online (£6.66 for 90 pills or something). Still on protein shakes etc - muscle wastage isn’t looking too bad so far.  Doc said supplements are a waste of time but I’ll press on, I’ve researched dosages carefully etc. Don’t want to get kidney stones eh. I will post back in 4 weeks - I hope others find this helpful.


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Cool didnt know you could post pictures up. The one above is the good bicep curl position alignment (18 days from break) and below is the sling angled picture (again 18 days after initial break).  Sorry the picture quality isn't great, the camera couldnt block out the LCD monitor glare (they dont seem to use old fashioned projectors anymore). Shame I dont have the original break pictures. Ill try and get them when I go back with a decent camera.

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hi, nick thanks for sharing your progress. i broke my arm about a week before you and judging by the pics, my fracture is more serious than yours in that it's at the bottom of the humerus and there'a a separate bone fragment in between. maybe that's why i'm in a heavy plaster cast. i went back to see the doc 3 days ago and alignment looks straight but the gaps look wider than yours. the plan is to keep me in the cast for another 3 weeks then go back again. hopefully it'll heal by then. i still cant lie down completely in bed without pain at the fracture site so i dont sleep very well. my shoulder is becoming stiff and i can already see my arm shrinking in size. ok keep us posted and good luck.

Hey people thought I would post a week 4 & 5 update.  I’ve been doing pretty well the past week/10 days.  I managed to hold my arm in a sling position under its own strength without the sling.  The bone just suddenly felt a lot more stable once past the 3 week mark (maybe its started to fuse).  Since then I have been able to lie down completely flat in bed and can also lie on the injured side if im careful. 
 
I can also now do sit-ups again which is nice because although losing weight I think I may have gained some fat due to my inactivity.  I am still at the gym once a week doing legs exercises and light work with my good arm/shoulder.
 
Now over a week on from being able to support the arm for very short periods of time I can now do without the sling most of the time.  I can wash my hands almost as normal and almost put my hand in my pockets.  To be fair it rests on my lap most of the time or on a pillow, stops me hunching over a keyboard with my sling on.  I also tried lifting some light weights to just see what I could lift and managed to pump 1.25kg weights but my range of movement was only about 20 degrees either side of a right angle position. 
 
If I don’t wear the sling for a while my arm does hurt a bit at the fracture site and also when I wake up after lying flat so I hope im not doing it any damage.  As for other movements I can move my arm behind my back on its own and just about touch my opposite shoulder blade but it feels very stressed/twisted on my arm and I don’t like to do it.  However doing arm movements while supporting it feels okay to a point. 
 
I can lift my arm up with my other arm above my head whilst still bent, a hand on head kind of movement.  Holding it up there for more than 30 secs makes it sore but its useful for washing under my arms in the shower.  I thought I could no way get it up there without support but recently using a should press action I can do (leading fist first). 
When I do I seem to get a burning sensation under my armpit/shoulder muscle because there not used to being stretched like that, maybe its the skin stretching.  I have also regained some light flexing action back in my bicep which is good because it seemed unresponsive until now.

In a sling position on its own strength I can raise it to about 45 degrees out in front of me and hold it for a few seconds at best, too sore otherwise. 

My wrist is all operating as usual and if I let my arm drop the ligaments will support it because they are tight. I can straighten my arm to about 135 degrees max then its sore at the bottom of my bicep but im sure this just needs time to straighten out. 

It’s nice to be feeling a bit more normal. I will post back after weeks 6 & 7 are done which is when I should have more pics and the all clear from the doc and then start physio.  A few days ago I regained two handed typing which is great. (I have to rest my wrist near the keyboard though).  Feeling stronger everyday.

This is a week 6, 7 and 8 update.  Only got a chance to post this now because I have gone back to work and have less free time. 

My healing has been going well and every week I get closer to normality.  I now have 95+% range of movement and am running at about 30% strength in most areas.  I can put my arm behind my back reasonably easily and reach as far up my shoulder blade as I could before the break which is quite far as I can make my fingers touch when bending the other hand behind my head.

I can bicep curl about 4-5kg now and my arm has naturally straightened out without me really encouraging it. It’s about 170+ degrees straight so not far to go.  As for lifting weights above my head I can do that pretty easily and do 5kg dumbbell.  The physio said I could start swimming again which I tried.  I found breast stroke to be pretty normal, a little sore but nothing major, obviously had a slightly bent arm while doing it.  I could not do the freestyle/crawl yet, can’t quite maintain pulling my arm over my head and round for very long (3 reps and not good form either).  But for 8 weeks from the break it not bad.  Over the past 3 weeks I’ve gone from starting to gently jog while resting the arm to doing sprints without too much trouble.  Typing and writing whilst being on the phone now is no trouble and I can fill up a kettle without it hurting.  I can also put on a jacket or rucksack normally as before although this can be sore.  

Most of these movements have only really come back to me in the past week, including driving a car.  I can’t quite do the gearbox as normal but with a slight reposition of the arm before each gear change it’s not a problem.  I can change gear in under a second so I deem it safe for other road users. Don’t want to put anyone at risk!  Steering is all fine.

I have also got back into proper arm exercises with lower weights than usual.  I can now bench press 15Kg maybe 20+Kg if I push it but I'm not going to yet.  I saw the physio for the first time last week.  He asked me why I was their which I thought was obvious but he seemed to think I was pretty much back to normal and set me some exercises and said come back in 3 weeks.  I think that will be my last visit because I think I am recovering well enough on my own.  The exercises he set seemed a bit below my level.  I am supposed to used one of those rubber ribbon strips and stand on one end with my foot and do bicep curls whilst holding it with the other end.  Although different colours depict their resistant level the things he was getting me to do were ridiculously easy considering I had been messing around with free weights (dumbbells) from week 4/5.  The resistant in the band was about 0.5kg and just felt like a waste of time.  However for other people recovering not at my level and just coming out of a caste or whatever it may help.  I cannot do much twisting with free-weight but driving the car should safely increase its strength.  I can also do some light rowing too.

Had my x-ray check again in week 7 and everything looked the same as it did 4 weeks ago.  The bone was still not what I would call joined but you can see new bone forming.  I took some more photos so you can see for yourself.  The most recent is from a reverse position showing the back of my arm and I think it makes the gap look bigger than before because of this.  I will put the pictures in chronological order so you can see what’s going on.  The doc was happy and said come back again in 4 weeks.

This is an X-ray taken on the night of the break.

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This is 5 days from break.

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it's been 2 weeks since i had my cast removed. the doc gave me a sling to wear but i ditched it because i felt well enough to just let it hang. my arm is feeling stronger everyday. i still can't straighten my arm, which is my biggest concern. it's only about 150 degree straight. i also can't bring it as close to my body as i can my normal arm. any weight bearing still causes pain so i'm not trying to lift any weights. but i'm back to the gym 4 times a week riding the bike and working out lower body and my left arm. I'll go back to see the doc in another 2 weeks and he'll clear me for physio.

Look back to page 1 for the 3 week from break xrays.  This is the 7 week from break one.  Sorry again on the poor quality, i didnt want to mess around with a proper camera because mine tends to blur a few before its good.


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Hi, Nick. Can you straighten your arm completely now? Is it shorter than the other arm?

Hi Gabe, It is difficult to measure the difference in length if any. It’s hard to say if it’s shorter or even longer than before.  If you measure under the arm to the elbow with a ruler they come up the same but muscle differences between the arms can get in the way.  I guess the best way to measure them is to stand in front of a mirror and put your arms by your sides with your forearms bent upwards and see if the end of your elbows are level.  But for me they look very similar, it’s not noticeable.
 
Surprisingly my arm has straightened almost completely on its own naturally without me having to do exercises to straighten it.  I didn’t even notice it had straighten it just happened.  It’s probably a couple of degrees out but it is still early days.  If you stand up against a wall with one arm and have your palm against the wall and force your arm straight by pushing your hip against the back of your elbow to make the front of your elbow touch the wall.  This is the kind of thing I used help straighten it and also to compare one arm to another.  Just see how far the inside of your elbow is from touching the wall compared to the other arm. Hope this helps.
 
I can lift 10kg dumbbells now if I strain a bit but am training with 8.5kg so strength is coming back.  I also tried swimming but could only do breast stroke initially.  Bringing the arm over and around to do freestyle/crawl was too painful but after 3 weeks I can do it.  Just takes time.  I also managed to work my bench press up to 40kg but still think my stronger arm is doing most of the work.  The main issue I have at the moment is not the straightness or the length; it is that rotationally the arm isn't quite right.  When you hold your arms out straight in front of you, palms facing upwards the inside of the elbow joint looks normal and level-ish.  This is true on my good arm but on the bad arm it's about 10 degrees or more out, rotating outwards.  Which is not a problem in itself because to others it looks normal and I have full movement but I am finding that when doing exercises like bench pressing my good arm will bend normally in a straight movement but my bad arm keeps wanting to bring the elbow down towards my feet/into my ribs instead of bringing the elbow behind body as normal.  A bit like if it was going to drive forwards it wants to push up towards my head a bit instead of using 100% power to drive off my chest and away from the body.  This is difficult to describe... it might be nothing and its still recovering but I’m just worried that it will kill my power and encourage bad techniques and bad development/excess stress on the elbow joint because its not bending normally.

Anyway will keep an eye on it, should have another x-ray next week or the week after.  Will post again then.  Think physio is ready to discharge me after 2 sessions, good news I suppose.

Hi, Nick. Thanks for the reply.
When I wrote my last post, I still couldn't straighten my arm. Now my forearm is only a few degrees out from being on the straight line with my upper arm. After comparing with my good arm, I find I will need to hyperextend my elbow a little to make the forearm and the upper arm on a straight line. I'm doing preacher curl to fix that. My doctor still wasn't ok with me starting to lift weight again so I'm only doing 2.5kg bicep curl. I do heaps of swimming. I can do freestyle without any problems, it's breaststroke that hurts my arm a little.
About the length, my doctor said it'll be shorter because the lower part of the bone ended up at the higher position than before the break. it also applies to your pic as well. but i think he failed to see there's space beteen broken bones, and I think that kinda cancels out the lower bone displacement. Anyway, in my case, I didn't notice any length difference either. I'm worried about that because I have short arms(I'm only 1.7m tall) so I don't want it to be any shorter hehe.
My next appointment will be on the 3rd Dec. Hopefully by then the X-Ray will show a total bone reunion.

Wow!  I never expected to find a forum specifically discussing spiral fractured humerous injuries!  I was just looking for estimations of healing time for FULL bone density recovery.(though if anyone has any input on that, please do tell)

I broke my humerous in February this year doing squats.  I was on my last warmup set (315lbs) and was doing a quick 3, after which I was going to put on the catch supports <sigh> and start my work sets.  I went down for my first rep, and had something twinge in my core.  I went forward into the cage, but unfortunately, my left side hit first, popped it out of my left hand, but not my right.  My right arm twisted backwards with the full weight in it, and I ended up with a spiral fracture in two places, the lowest of which was about 2 inches up from the elbow.  Basically, I had the bottom piece connected to the elbow, the much larger top piece connected to the shoulder, and a triangular middle piece in between the breaks that was about 1/4" at the inside of the arm, and 2.5" at the outside.

Fast forward a bit, and I got my cast off in May, after which I was in "Sugar tongs" and tensors until mid-July.  I've been slowly bringing everything back, and recently, I started the slow trek back to heavy deadlifting, though back squats are out until I get my shoulder back under control, as I have a hell of a time reaching back into that position, still.  It's gradually getting better, though.  My deadlift is back to 295 for an easy 3, but I'm not going crazy on it, until I'm sure I'm not going to reinjure the soft tissue.  My arm is also not quite straight, but it straightens far enough that I can lock my elbow as I start to rebuild my bench.

My problem now is getting all my tendons to restretch as far as they did before the accident.  Any tips?  Also, if anyone has info on how long before bone is likely to be back to 100%, I would appreciate it.  I'm 26, so I figure I'm still young enough that it should be healed, if not now, than damn soon.

Good luck to all with your healing!  May you make swift recoveries!