There’s Nothing “Humerus” about Fracturing your Funny Bone!

Five weeks ago my life changed in an instant when,  while running fast downhill on an uneven rocky trail, I tripped on a rock and tumbled down hard, landing directly on my left elbow on a rock. The impact felt like someone had struck a hammer against the back of my elbow and I sensed something snapped off in the impact. Sure enough, a few hours later x-rays revealed that I had fractured my olecranon – the infamous “funny bone”. Fortunately it was a “clean, simple” break rather than a compound one, but nevertheless the solution for healing the injury turned out to be anything but simple.

It turns out that most olecranon fractures require surgery because they typically displace (the fragments separate too much for the bone to rejoin on its own). The fragments of the bone must then be reduced or returned to their normal position until healing occurs – usually in six weeks. Surgery involves reducing the bone fragments with some type of hardwire – usually a plate and screws. If there are multiple fractures or the bone is shattered, wires and pins may be used. In my case the bone fragments were reduced a little less than an inch so a plate with one long screw was inserted into my elbow and running down my forearm (part of my ulna bone). Like most patients, my arm was immobilized for a few days with a heavy splint and ace bandages wrapped around the dressing of my surgical wound (which I kid you not was four inches long and held together with about 16 staples). Three days later a plastic, removable splint was molded to my arm and I was encouraged to wear it day and night for the next five weeks, with the exception of removing it 4-5 times daily to perform extension movements (bending and straightening of the arm)  to encourage range of motion.

The recovery from surgery, however,  proved much more painful than the original fracture. In particular the first two days after surgery I was in a lot of pain (not helped by the fact that I refused to take a narcotic – in this case Vicodin- choosing to stick instead with Advil. My entire left arm and especially my left hand was very swollen and black and blue. I was instructed to elevate it as much as possible which was only really possible at night, but which made sleeping virtually impossible. Fortunately, my clever husband rigged up a pulley system from our bedroom ceiling which was attached to my arm and allowed me to elevate comfortable and shift positions as well.

To be honest, until this happened, I never gave my elbows much thought. I took for granted that they worked well and that my relatively strong triceps allowed my elbows to extend and to some degree even hyperextend.  That has all changed now that four weeks after surgery my stiff left arm is still far from straightening. I am, however, finding some improvement every day. Today when I washed my hair I was able to wring it out using both arms and I can now floss my back molars without too much discomfort. Just yesterday I was able to scratch my right shoulder and tonight I even made a salad and was able to toss it myself. Ahhh, the little victories are sweet as I slowly get my life and independence back. I really miss my yoga classes and it’s been five weeks since I’ve been able to swim laps, but I’m back in the pool with my clients which I know is really helping my healing process.

UPDATE I:  I had a great PT session yesterday and I was told I’m a week ahead in terms of healing and range of motion (ROM). She said I can go without my splint except in situations where I can’t control my environment, such as in a crowd. I will see my surgeon next week for a follow-up and hopefully he will tell me I can begin a strengthening program. Last night I slept without my splint and I’m just about to go for a run without it – can’t wait!

UPDATE II:  It’s now been 10 weeks since the injury, 9 weeks since surgery. Saw my surgeon this week for my final post-op. He was thrilled with my ROM and strength and lifted all restrictions. The only glitch was that 10 days ago I developed a grape-size “seroma” (a collection of subcutaneous fluid) on my forearm at the end of the incision where part of the plate is. He assured me it was harmless – just the body’s reaction to irritation at the plate, but he decided to aspirate it anyways and withdrew 3.5 ml (about a thimble-size) of light red fluid – mixture of blood and plasma. He said if it comes back we may want to consider surgery to remove the plate and that he didn’t recommend that until at least 3-4 months after surgery. I just figured I would be living with this thing the rest of my life and would really rather not go through another surgery to have it removed, but he did assure me that the recovery time for plate removal surgery is much less than the insertion was. Hopefully that’s the end of it, but stay tuned….My PT also gave me my walking papers this week, so while the healing process continues she says I can do the rest on my own :)….My downward dog is slowly coming back and now I’m able to swim without even being aware of my left arm – even as I turn to breathe to the right side (where I have to fully extend my left arm) – which was painful for awhile. Now, if I could only have Summer back…..

UPDATE III:  It’s been almost 13 weeks since the injury, 12 weeks since surgery and yesterday I finally had the courage to run to the place I fell. Previously every time I thought about doing so I became both nauseas and nervous. Yesterday I was still a bit nervous – not that I thought I would fall again), but I felt ready to face it. Interestingly I discovered the way I fell wasn’t what I thought. rather than fall downhill, I actually fell on an uphill slope. I realized and remembered that I slid on loose rock, my feet coming out from under me, and I landed to the left the way the hill sloped on a rock. I saw so many large rocks sticking out of the ground yesterday that I’m not sure which was THE ROCK, but it’s clear that it could’ve been any number of them.  I felt a real sense of relief afterwards and strangely fatigued as well as though I was able to put down a burden I’ve been carrying for the past few months. When I do run on that trail again I will be extra cautious as I can see now how rocky it is and how easy it was to fall in various places. Overall my elbow is doing well. I’m working on getting the final degrees of extension (straightening the arm) and my strength is almost there in most ways. For example, I can now pull the hatchback trunk of my car down completely with my left arm with no pain and with relative ease.

UPDATE IV: It’s now been 15 weeks since my olecranon reduction surgery and my elbow is doing great. I’m even back to doing power yoga and though my left side plank is still a little shaky, I can even do wheel pose and “flip my dog”! But….I went to see my surgeon last week because my forearm, (not where the injury was, but where the metal plate and screws are)  still gets very irritated when I place it on a table, or even on my leg when doing side angle pose in yoga. I wanted to ask the doctor about having the hardware in my arm removed. He said that because I don’t have much padding there I will always be irritated by the hardware and that I’m a good candidate for removal surgery. So I’ve scheduled to have my plate and screws removed 3 days before Christmas. The recovery is supposed to be much faster and easier than the surgery to have the hardware inserted, plus I won’t have a broken bone and torn muscles to mend this time. However, I will have to avoid any heavy lifting for about 5 weeks. I’m excited to have my arm eventually return to it’s previous pre-injury, metal-free state. When the hardware is removed I will initially have holes in my ulnar bone where the screws were, but with time the bone will fill in. All for now….stay tuned.

UPDATE V:  12/23/14…Yesterday I had surgery to remove the titanium plate and six screws in my left arm. It was definitely a case of deja vu in returning to the surgery center – almost exactly 6 months to the day from the first surgery to have the hardware installed. I’m very happy to report that so far my pain is far less than the original surgery and very manageable. In fact in 24 hours I’ve only taken one 200mg Advil when I got home yesterday (and I probably could’ve done without it but they keep telling you in recovery to “stay ahead of the pain”). I’ve not needed to take anything else – even last night when I thought the pain might kick up in my sleep. The other main difference is that, unlike last time, my arm and hand are not at all swollen or discolored despite the fact that I haven’t been elevating them as much as I probably should be. I have a huge, bulky temporary cast from my shoulder to my wrist that doesn’t allow me to straighten my arm, but fortunately I only have to wear it for 2 days after which I will transition to a sling for a week or so. The only complication with my surgery was that the bone had started to grow around the plate at the elbow requiring the surgeon to dig into the bone to remove it. Hopefully that won’t delay my healing. This is another reason I’m glad I didn’t wait any longer to have the hardware removed as apparently the longer it’s left in, the more likely bone can grown around it, making it more challenging to remove. All in all, I’m very relieved to have had the hardware removed. I asked for it as a souvenir and it’s a bit eery to see what I’ve had inside my arm for almost six months, but his was my Christmas gift to myself and I’m very glad I did it.

UPDATE VI 12/24/14…Saw my surgeon today for my 48-hr post op appointment and it felt like an early Christmas gift. He removed the bulky temporary cast and was very pleased with what was underneath – so much so that he said I didn’t need to wear a sling. Additionally, he said I can get back in the pool next Monday, a week earlier than he’d previously said I could. I’m now wearing a light dressing over the incision and a “sleeve” to protect it. My pain remains very manageable and I haven’t had to take anything for it. My elbow is a bit swollen and stiff and tender to the touch (feels like I’ve scraped and bruised my arm), but really not that bad. I have to be careful for the next 4-5 weeks (no pushups or significant twisting motions), but once I get the sutures out I don’t have to go back to the Dr. unless there’s a problem.  Hallelujah!

Be Well and Happy Holidays,

Carolyn

 

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27 Responses to “There’s Nothing “Humerus” about Fracturing your Funny Bone!”

  1. Susan Says:

    You have really been through it Carolyn! I will never take my elbows for granted again. The fall, surgery, and days following sound dreadfully painful. The best news is that it sounds like you are fully on the mend with healing happening just as it should!! It’s always a longer road than anticipated but take heart…the worst is far behind you. So glad you are up and “running” again. Keep moving forward on your journey to wellness!

  2. wellcoaching Says:

    Thanks so much for your good wishes, Susan. I have what I hope will be my final appointments with my surgeon and PT today. The strength in my left arm is coming back nicely (not doing full pushups yet and my downward dog is still not quite there, but otherwise doing everything I normally do physically). I’m finally able to swim freestyle normally – where breathing to the right while extending my left was painful for awhile. I’ve got full flexion in my elbow and am working on the final few degrees of extension. I did a little trail running while on vacation with my husband this past weekend. I was very cautious, but glad to be doing it.
    Hope you are doing well,
    -Carolyn

  3. Laura J Says:

    SO glad i found this post! Has not been easy to find a perspective from a patient for an Olecranon fracture, so thanks for that!
    Carolyn, we are on a similar timeline. I fractured my left elbow the end of August, had ORIF surgery a week later and i’m now 3 weeks into my PT. Agree with so much of what you said and how much i took my elbow for granted previously. Definitely seeing some improvement but i have to take 2 percocet ahead of each session (3 times a week), and still find it verging on excruciating. Have never felt a pain like it and it’s impossible to describe. Did you find that it was sometimes 1 step fwd 2 steps back? that you arm ‘seized up’ the day after aggressive PT?
    I see my Surgeon again in 2 weeks and my PT wants me to be fully extended and flexed, unassisted, by then. Trying to stay positive but sometimes don’t see how that’s possible?! I’m about 28 degrees off straight at this point and my extension is better than my flex. How does that compare to the ROM you recaptured early on in your PT? (I can just about scratch my right shoulder now). You sound like you’ve made strong progress @ 12 weeks post surgery. I am just over 4 weeks post surgery and 9 sessions into PT. My goal is to get back to my weight training, just a basic push up and plank would make me happ.
    Hope you continue to do well. LJ

    • wellcoaching Says:

      Hi Laura:
      Thanks for your good wishes. Yes, at 12 weeks out I’m feeling pretty good – I have full ROM and am back to all activities except full-on power yoga and I can’t do as many push ups as I used to but am working my way up :). I still have tenderness when I rest my forearm on hard surfaces for extended periods, but otherwise my only complaint is some stiffness after working the arm intensely or sometimes first thing in the morning. Throughout this whole experience the only really painful time I had were the first 2 days after surgery when I experienced a lot of pain and swelling – more in my forearm than my elbow. I’m very sensitive to medication so I refused to take the Vicodin they prescribed post-surgery since I’d never taken it before and instead stuck with Advil for the first week and then I was able to go without it for most of the time. Otherwise my pain in PT and otherwise was very manageable. I saw a PT once a week for about 6 weeks, but what helped me most of all was that I’m an aquatic therapist and so I was moving my arm in warm water with my clients and on my own most days as soon as my stitches (staples) were removed. I also resumed swimming laps within a few weeks of surgery – that helped a lot as well. Do you swim? Do you have access to a warm pool? Exercising in the water – especially warm water – really increases ROM and can increase muscular endurance as well. I don’t remember my exact ROM numbers to compare to yours but I remember my PT and surgeon were really happy and surprised with my progress. I really credit my work in the water. Perhaps you can find an aquatic therapy specialist – ask your PT.
      I also recommend using Traumeel ointment – really helps with pain and inflammation after working the arm. Be sure to eat well, too, providing your body with all of the healing nutrients it needs to repair itself.
      I know how hard it is to be patient, but things will improve and I think you’ll find that by week 6 you’ll notice a big difference in your discomfort and your ROM.
      Hang in there and take care,
      -Carolyn

  4. laura Says:

    Thanks for the comments. I got the ointment! Really like the idea of a pool and will look into it. I am 5 weeks post surgery today and had a good PT, so i think you’re probably right, 6 weeks could be my turning point. My therapist did say the # of screws etc all makes a difference to recovery time and I believe I have 8 from my x-ray.
    Best wishes.

    • wellcoaching Says:

      Hope you’re able to get in the water soon, Laura. Keep your chin up and let me know how you’re doing and try not to worry – It’s going to get better!!
      Best wishes to you, too,
      Carolyn

  5. ramya Says:

    I am also going through a left arm olecranon surgery , I could connect myself with every word of yours . U have drafted it so well and it was very helpful.Thank u and God bless you.

  6. BikeNerd Says:

    Hi Carolyn,

    I recently had a bike crash and fractured my right olecranon. Its been 3 weeks since the accident and 2 weeks since the surgery. The orthopedic surgeon took the stiches out a couple of days ago and removed the splint completely. He has recommended me to go without a splint from now on and do extension exercise along with PT. Thanks for putting together an account of your recovery from the incident. I am not sure how long my road to recovery will be and if I ever will get back to my original strength. At this stage things look pretty bleak.

    Thanks.
    BikeNerd

    • wellcoaching Says:

      I’m so sorry to hear about your injury. If you can get in a pool for aquatic therapy or just swimming laps, that can really accelerate healing and facilitate range of motion. Take good care and hang in there!

    • Laura Says:

      Hey bikenerd
      I remember feeling exactly how you sound. I think I posted my comment right around the 3-4 week period and that is so early in the process post surgery. Everything still v sore and little movement. I had about 4 months PT before my coverage stopped and that got me to a really decent point and my extension on a good day was about 8 degrees off straight. I’m 18months post surgery now and for the most part don’t think about the arm. I’m probably about 10-11 degrees off straight now and my surgeon said at the time most people hover around the 10 degree mark. I still notice it from a weight bearing perspective at the gym. Cannot fully support my body weight w some movements but i am slim and always had not great upper body strength. I think for guys the strength issue might be less.
      Good luck!

      • BikeNerd Says:

        Hey Laura,
        Thanks for the response. I will see how things go and post an update in a couple of weeks. I was shocked when the surgeon said I dont need a splint anymore and just use a sling and try arm extensions as many times as I can. My current motion is about 35 to 40 degrees. I have my first PT session scheduled this week. The PT specialist warned me it will be painful. I am looking forward to it.
        Cheers.

  7. BikeNerd Says:

    How long after the surgery can one star swimming laps?

    • wellcoaching Says:

      That’s a question for your surgeon and/PT, but I would say that even getting in the pool soon to work on ROM without swimming laps might really help . Freestyle stroke can be great for restoring extension, which is typically the problem with this injury. Hope that helps.

      • BikeNerd Says:

        Thanks for the response. I checked with the surgeon and he recommended regular PT for next couple of weeks and aquatic therapy/ swimming in 2 weeks time. That will put me at about 4 weeks post surgery and about 5 weeks post accident. I gather from your post that you returned to the pool around a similar timeline.
        Cheers.

  8. wellcoaching Says:

    Glad you got the green light to get in the pool soon, bike nerd. Best of luck to you in your rehab process and please keep us posted on your progress.

    • BikeNerd Says:

      Hey Carolyn, Thanks for the encouragement. had my first PT session last Friday. It was painful but constructive with a lot of RoM exercise. At The therapist gave me a stress ball to work with and continue RoM exercises.
      I have had talk to a few people who have gone through rehab post surgery and they all seem to varied views on therapy and exercises and amount of time one should spend doing them. In your experience what therapy session frequency worked best.
      Cheers.

      • wellcoaching Says:

        My experience may not be typical and your experience may not match anyone else’s either. I think I began with 2x week with PT session for the first few weeks, but dropped back to once a week and then I ended up doing most of my own therapy in the pool almost every day. That was were I made the most progress regaining ROM and strength.

  9. Gauri Says:

    Hi Carolyn ,
    I had fractured the olecranon bone in november 2014 had 3 screws and a nail along with a plate , i was off by 10 degrees fully extending the arm.. in the end of march 2016 , i got the plates removed .. how long do you think it would take to extending arm fully .. can you also suggest a few exercises .. before plate removal i was able to fully flex it .. but now after removal i can;t do it .. should i bother about it ?

    • wellcoaching Says:

      Hi Gauri:

      You have to work to get your ROM back – it doesn’t just happen and it is worth it. If you are a swimmer I recommend freestyle to help with extension and breaststroke to help with flexion. Another exercise that can help both are “wall pushups” – doing pushups against a wall and working on bending the elbows as much as possible as you press into the wall and then pushing your body away and straightening the arm as much as possible. You have to be initially careful after you have the hardware removal surgery because the bones take some time to fill in after the screws are removed so you don’t want to do full weight bearing exercise on the arm until your Dr. tells you it’s OK, but doing the wall “pushups” should be OK and can help with your ROM. Good luck

  10. Anthony Says:

    Thank you for posting this. I just broke my left elbow but in a serious car accident that probably should’ve killed me, so Im lucky to be alive. Love the way you broke everything down, Im a military man and I am very active doing lots of boxing, gymnastics, pullups, and many thing that require stress on the elbows. After reading this Im not too beat up about my injury and am looking forward to recovery!

  11. Susan Says:

    Great post Carolyn with good information on your experience. I’m four weeks out from surgery with a plate and eight pins and your post provided a guideline on recovery. I’m at sixteen degrees on extension and 135 on flex. Goal is back on the motorcycle by July 4!
    Susan

  12. HolisticRN Says:

    I just found this post while searching for info on hardware removal. I am wondering if I should plan for it or avoid it. I will probably end up doing it after reading about your experience. I didn’t think about the bone growing around the plate.
    I fractured my left elbow the day after Christmas and had the plate and screws added the next day. I am still struggling with the reality that I will have no income until I recover. I am a home care nurse for clients needing total care. I can’t work until I am allowed to handle at least 110 pounds. Yikes! I am also bummed about missing Yoga, walking my dog, and many other things I took for granted before. I just turned 50 and this is my first broken bone and first surgery. I am not used to being the one needing help. Thankfully, my husband has been awesome.
    I’m trying to stay positive and take this as an opportunity to work on my alternative healing education. I am testing some essential oil remedies and hoping to learn more about other modalities.
    Thanks for posting your story and providing me with an outlet to share my story. I hope some day I can use this experience to help someone else.

  13. Rozie Says:

    Hi Carolyn,
    This is the most hopeful post I’ve seen about olecranon fractures / recovery. I broke my arm while running about four weeks ago and now am almost two weeks postop. During the day but my pain is totally fine but I still find myself waking up at night in excruciating pain. And we myself off narcotics a week ago but last night couldn’t take it and had to use them. Did this ever happened to you in your recovery ? I too am very active and I’ve been trying to do walking and squats and that sort of thing as I’m not allowed to put any pressure on my arm at this point- I am very excited that you were able to return to yoga and running those are both things that I enjoy immensely and a missing so much . I am wondering if you have any recommendations for exercises that you did during your recovery before you were allowed to swim ? Also wondering if you or anyone has any advice for using a computer during recovery ? It’s still very hard to type (so I’m using Siri to write this ) 🙂

    Thanks again for your post they have been very encouraging to me !

    • wellcoaching Says:

      Hi Rozie:
      So glad you’ve found my posts on my experience with an olecranon fracture helpful. I thing the thing that helped me the most was the work I do in aquatic therapy. Even more than swimming, the movements I make in the warm water with my clients helped me regain full ROM. Later on yoga and strength training helped me regain full strength. If you can find a good aquatic therapist in your area I highly recommend that. Land-based PT was also helpful in the very early stages of my recovery before I was able to get back in the pool, so I would recommend that avenue as well. I don’t have any specific advice for using the computer – but perhaps someone else can offer some words of wisdom on that topic.

      Best wishes for a speedy recovery!
      -Carolyn

  14. Cian Says:

    Thanks so much for writing this, I’m currently 4 weeks post surgery for the elbow break and you have helped answer many questions for me. Thank X

  15. Lisa Says:

    Carolyn, thank you for taking the time to describe your experience from break and surgery through healing. My sweetheart, age 71, fell off his bike this afternoon and broke his left olecranon — full break but not shattered, like your break, I think. He is in a splint now and will talk with a surgeon tomorrow. I sent him this page and he really appreciated your clear and thorough narrative. He found it informative and very encouraging. Thank you so much!

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