Shattered Proximal Humerus

[LellyDK]

10 weeks ago I tripped and flew across the room, shattering my shoulder. The first two weeks were horrendous and my husband was my carer during this time when I could do little for myself. Even getting out of bed was unbearably painful and we had to work out strategies for getting me in the shower. In the end, I sat on an upturned kitchen refuse bin and my husband hosed me down. The pain was awful and I was on codeine phosphate (2 x 30 mg) tablets 4 to 6 times a day. I have reduced this now to one, 2 to 3 times a day, as required.I slept in a recliner chair with cushions for support, I then moved back to bed and, in the last two weeks, I can sleep lying down with a little support for my arm. I began the pendulum swings as soon as the pain allowed with limited movement. I set my self small independence goals, washing, doing up buttons, getting my arm through a sleeve, hair, eating with two hands, fewer tablets, and so on. Three weeks in I began slightly harder exercises including touching my head. Four weeks in, I began formal physiotherapy (NHS) and exercises increased using bands and low weights; some are extremely painful. My cleaner, a medical doctor from Bulgaria, set me off on hand exercises with little balls which has helped things like pressing an aerosol, opening a can. Life becomes very small. I have regained a great deal of movement including raising my arm straight above my head but I cannot move my arm far, behind or up my back; the pain is excruciating. I religiously do my exercises every day and I notice continual improvements in what I can do. I am functioning at a good level and have exceeded medical expectations. I am 71 but I believe my level of fitness and spirit have been key factors in my recovery. At 8 weeks I began driving with medical approval but I am confining myself to local trips because my arm is not yet as strong as I would like. Again, with approval, I have also started rowing on a machine at the lowest level, for 15 minutes, which is also helping. This week I returned to my fitness class, a combination of aerobic, flexibility and strength classes but I am careful. I am not yet allowed to do triceps dips but I can do low level press ups against the wall and on my knees. This all sounds great but it is missing out the day to day struggle and the levels of aches and pain I am dealing with. My shattered humerus is healing and should be completely healed at the 12 week stage. I am not experiencing any pain in the injury site but, of course, the muscles, tendons, main nerve from the neck through to the upper arm and scar tissue are proving problematic. With exercise different areas are improving but it seems to set up a reaction leaving me with sometimes severe aching and very sharp pain with certain movements. There are the occasional days with minimal pain requiring no pain killers which lull me into a false sense of security then back they come with a vengeance. I am also using a small heat pad, at night, for the muscle pain. Can anyone advise, give me any insight or hope in this situation? I am normally a happy, optimistic person but this continual battle with pain and my arm resistance to behind my back or neck movement is becoming depressing. Throughout this situation, I have worked with minimal information and learned what questions to ask my consultant/registrar and physiotherapist, as I have gone along. I also found, fairly early on, an American website which sustained me through the early dark weeks. As you will recognize, I am becoming very self absorbed and I don't like it. I know I am not the only one and many, many people are experiencing much worse situations. How awful. I would greatly appreciate any shared experience or advice anyone can give. I am also hoping that sharing my experience may help someone else faced with this situation. Thank you.

[Boozybird]

Sorry to hear about your troubles but it sounds like you have done amazingly well with great spirit and determination. I would think it's still early days yet so perhaps go easy on yourself! I know it's frustrating....at some point you may like to consider therapeutic massage where someone with skilled hands can get into the tissues of the shoulder blade in particular which is always gummy with age and can cause overuse of the shoulder joint itself. Also consider more proprioceptive work rather than strengthening exercises which could well continue irritating healing structures...best wishes 😜

[LellyDK in reply to Boozybird]

Thank you for your reply and the encouragement. I have started sports massage, getting into the deep tissue, by a highly qualified person although still avoiding the actual break area for the moment. This helped although it upset the muscles; a necessary response however. I am having another one next week and I can't wait - most of the pain has shifted down my neck into the arm and the lower arm is also reacting. I recognize everything is connected. Challenging my arm to do the behind the back and neck exercises is painful (given by hospital and physiotherapist) but I know I need to do them. You are right to point out that I am being impatient and I just need to keep going. Could you explain what proprioceptive work is; I haven't heard of it. I must also add that the response and treatment through the NHS has been outstanding. Unfortunately, the only quibble is that my next review has been delayed by a month so I am unable to know if it has finally healed. This would relieve me of any remaining fear of damaging my shoulder. Thank you again, your reply has helped.

[Boozybird in reply to LellyDK]

Hi LellyDK, glad to hear you're having massage, I hope particularly the back of the shoulder and in and around the blades as I say they get chewy making the glen-numeral joint do a lot of the work....it's right to be careful around the injury site.. Also good to go down into forearm and hands and neck. Proprioceptive work is do to with the coordination of movement patterns, making sure that you are using your shoulder blades to stabilise the movement of the arm for example. So learning to feel where movements should originate and reprogramme healthy movements patterns because injury can disturb the natural order of things.. So Pilates would get you feeling how to move in a pain free way or Akexander technique.... These things should really come before strength training in my view...best wishes

[LellyDK in reply to Boozybird]

I am returning to my Pilates class in about six weeks. I am waiting to be sure my shoulder has healed. Thank you for the advice and kind help.

[Boozybird in reply to LellyDK]

I would just say that class based Pilates are not my cup of tea and are often dangerous! If you had a studio where they specialise in rehab then maybe.... 😜

[LellyDK in reply to Boozybird]

Thank you for warning me. I've taken on board your comments and will have a rethink. Good to know.

[Hidden]

Wow lady ! Be kinder to yourself ! What an ordeal you have had, and still have, your positive outlook and determination will get you far, but 12 weeks is only the bone healing time, that just means the callous has formed and is doing it's job. It can take up to 12 months for a complete recovery and as you area weeny bit older it may take a bit longer, you sound as if you are doing everything right. You just need to slow down a bit, as for being self absorbed, it's your body,your pain,your recovery, so you need to be "self" absorbed, it's what is motivating you on -wards. As you improve you will find yourself thinking less on this as it doesn't need so much of your time, but you may always have some limitation in that arm, but it will not be from lack of effort. Good luck.

[LellyDK in reply to Hidden]

Thank you for your quick response. I accept the 71 years and it will take 12 months for a recovery. However, It is the continual aching or sharp pain when I make certain moves especially those which involve reaching behind me which is dragging me down. I am doing the challenging and excruciating exercises I have been given by the hospital and physiotherapist to improve this movement. I assume I have to do them to stretch the scar tissue, muscles and tendons. I have reduced the codeine phosphate to 1x 30 mg tablets twice a day. I don't find any of the over the counter medicines helpful. Should I be handling my pain management better? I have had no advice on this. I seem to have reached a plateau. Do I just need to stick it out until the pain gets better. Knowledge is power and I don't know what I should be expecting. Your support helps.

[Hidden in reply to LellyDK]

Have you got a support worker or someone who is helping or supervising your physio? If you don't I would go back to your G.P and ask his advice, there maybe better pain relief for you, but they all come with side effects, make you dizzy and put you at greater risk of falls, make you queasy or so tired you can't be bothered to do anything, but only your Dr. can give the advice that is right for you. The trouble with cutting down your pain relief is it can make it difficult to do the exercise and movements you need to get better. You sound like a (normally) very fit,healthy intelligent,articulate and motivated woman that is trying to move too fast. You do often reach a plateau during physio when it has been an extensive injury.

[LellyDK in reply to Hidden]

Thank you. Good advice. I will talk to my GP who has not been involved since I broke my shoulder. You have put things in perspective and given me a boost.

[astitchintime]

If you can take an interest in other things that could help. I have heard the pain clinics have groups of people suffering from pain and they have self programmes of coping. There could be something on the internet. The struggle is enormous at times from my own experience of being injured and ill. I am now going through some other issues. What about antidepressants? These tablets can lift your mood. I wish I had someone to talk to daily. I saw a chiropractor for several years.

Bernadette

[LellyDK in reply to astitchintime]

Thank you. An American site focusing on people with this experience has been extremely helpful. Just learning about other people going through it, has been a support. Overall, my spirits are good with only the occasional 'down' days which I had this week. I am going to talk to my GP but I don't think I need antidepressants at this stage. Knowing where I am and what to expect in terms of day to day pain will help. I am sorry you are also struggling at the moment and don't have anyone to talk to. I am very lucky.

I am surrounded by very loving family and friends who are also sensitive listeners - some more than others. I wish I could help you and I will always listen.