Problems after broken humuourus plate operation

[jay69me]

HI

I desperately need some help! I Broke my arm over a year ago arm wrestling. The break was a spiral fracture and the DR decided that I needed to have a operation to have a metal plate fitted to my arm. The surgery seemed to go well and I seemed to recover relatively quickly. 6 Months after the operation I had full movement and no pain, in day to day use my arm seemed to be fine. Prior to breaking my arm I was a gym worshiper doing heavy weights 4 -5 times a week and a keen boxer. 6 Months after the operation the Dr said that my arm should be fully healed and I could start training lightly again. So I did. Here is where the problem became apparent. If I do any kind of repeat lifting or any kind of physical activity with my arm I get a anoying pain the day after. The pain occours when I move the arm back and forth but especially when I put any kind of preassure on my arm pushing away from my body or pulling towards it. Its not a really bad pain just enough to let me know its there and to stop what Im doing. If I do no further physical activity with my arm the pain completely goes between a week and two weeks later, and does not return unless I do any further physical activity. If I do do any phsical activity the pain get worse to the point where I can do nothing with my arm without it hurting. At first I thought that I may be taking it a bit to fast and maybe my arm neeed more time to recover but over the last 6 months I have tried all sorts of different traing techniques and every time eventually my arm gets irritated and I have to stop for a period before it recovers and I can start again. I found the harder & more frequently I trained the quicker my arm got sore, however even if I took it really easy eventually It would end up sore as well. I am at the point now where I dont think it is going to get any better. I have visited my doc who was not helpful at all. I pointed out to him the problem and also that since the operation there is a clicking in my arm when I rotate it. He said that it was probably down to tissues inside my arm rubbing and getting sore, maybe internal scar tissue created by the operation and there was not alot they could do about it, The best way to avoid any paid is to not train!!!!! This has left me very annoyed. I am desperate to start training again. This may sound sad but I have become very depressed. Training was a very big part of my life. Prior to breaking my arm I was working as a bouncer and was hoping to join the police but do not feel fit enough any more. Surley there must be some kind of operation they could do to see if they could put things right in my arm again. To be honest Im not even sure the DR has come to the right conclusion to as what is wrong with my arm and I feel very fobbed off.

I was wondering if anyone else had had any similar expreiences to me or there was anyone who could offer me any kind of medical advice. Any kind of feedback no matter how big or small will be greatfully appreciated.

[Zaynah]

hi there

i'm a physiotherapist from South Africa.
you must remember, that where you broke your arm, muslces and tissues attached. So depends on where the break was, the muslces could now be pulling at the fracture line causing the pain, or the internal fixation they used (the plate with screws) could be sticking out a bit, catching the muscles. Spiral fractures are very unstable fractures!

Where in your arm was the break? About how many centimetres from your elbow point upwards? If you press on the arm, on every muslce and every aspect of it, downwards towards the bone, do you have a tender spot (expecially near the fracture line or plate)?

As a self evaluation of what the problematic movement and possible causes are:
First without weights, and if no symptoms, try it with weights.
If you get the pain, try to remember what type of pain (burning, sharp, aching) it was and where in the arm.
Do a bicep curl... is this sore? Do a tricep pushback... is this sore? Lift you arm up sideways (deltoid)... is this sore? Lift your arm up forwards (anterior deltoid and pecs)... is this sore? Lift your arm up backwards (post deltoid, long head triceps and lats)... is this sore? If you do pushups (placing your body weight through your arm).. is this sore?

Please let me know what you find?:)

[jay69me]

Hi

I must firstly say thank you for taking the time out to write such a detailed reply to my thread. You have given me more feedback than any of the doctors have here in the UK.

The break was approximately half way up my arm. Approximately 14 cm. I have pressed my arm all over and cannot find a particular sore spot at the moment. After 13 months should the fracture not be healed fully by now? From previous trial and error with my arm doing any sort of repetitive exercises irritates it but particularly bench presses (even with a light weight). I’ve irrigated it in the past and gone the gym to see how bad it is. Have managed to do arm curls and shoulder press, it irritates my arm when I do these exercises but I can do them. But when I try to o chest/bench press I can’t even get through one rep without a sharp pain in the arm. The feeling after I have tried the bench and failed it like I’ve hit my funny bone badly.

If I put my arm at a 95 to 100 degree angle an push away from my body (kind of like a reverse arm wrestle but with my hand at a bigger angle) I get a sharp pain around my elbow lower arm area which subsides as soon as I take off any pressure. The doctor wants me to have another operation in April to have my plate removed as he said he would prefer me to have it out and it may improve things.

[Zaynah]

Glad to be of help.

Usually a fracture in the upper body starts healing at 3 weeks and has bone formation completed at 6weeks. It takes about another year for the bone to remodel itself, breaking down bone and forming new bone, ultimately getting the bone's structure and form back to almost normal. With a spiral fracture, being so unstable, healing can be delayed and can only be healed at 8-10weeks. Having internal fixation (plate and screws) you had an open wound where they cut through muslces to get to the bone, and release muslces from the bone to attach the plate. So the muslces and tendons have to heal aswell and re-grow back into the bone. It's good that you don't have a tender spot. that means that the muscles are ok.

With bench press, if you press the weight upwards, your triceps muscles contract to straighten the elbow. There are 3 tricep muslces with originate from your elbow (the pointy part at the back of your elbow) and 2 insert in the middle of the humerusbone lenght wise, (just under your fracture line) and one goes over the back of your shoulder joint and implants on the shoulderblade.

With bench press you also use your pecs to press the weight upwards. Pecs come from your sternum, the midpart of your chest bone and they (2 parts) insert on your upper humerus, about 5-10cm from the top of the humerus (just above your fracture line).

Thus your pecs pull on the upper half of the humerus, while the triceps pull on the lower half of the humerus, causing tension at the midline (where your fracture is). You also put alot of weight through the humerus at an angle when you begin the bench press. Then as you straighten your arms, the angle changes and the humerus takes weight straight through the length of the bone. This all causes stress at the fracture line.

So you see that bench press is a combination exercise with many different movement patterns and muscles acting against each other. Try to do single movement exercises, like bicep curls, tricep dips, shoulder straight arm forward lift (pecs and anterior deltoid), shoulder straight arm side lift (deltoid)... So that you only move one joint at a time. Stay away from the combination movements like pushups, bench press, lats pull down, upright rows, bent over rows... try to use light weigt first. With the above your are not causing to much strain at the fracture line because only one muscle is pulling on the bone. If you do bench press, your are putting weight through the arm at an angle, contracting pecs, triceps, biceps... and moving many joints which causes alot of stress at the fracture line. Remember that the body heals a fracture up to a year....

Best thing to do is to find a good sport physiotherapist. They will test every muscle, every movement to find out what is the problem... It will be good to look at the XRays. They will show if the fracture has healed properly, if the hardware has failed etc.