Elbow update (or, "Why yes, I do have a screw loose", or, "Fear my mighty triceps!")

For those just joining us, here's a brief recap on the elbow situation:

Ten weeks ago, I broke my right elbow (olecranon) at the Zumbro 17 mile trail race.

Heading into Aid Station #1 with a busted elbow.
No bones were sticking out, so I kept going.
(Photo: Todd Rowe)

My surgeon has since said things like, "It was kind of shattered." And, "It was a bad break."

Ouch.

But she fearlessly reassembled it, throwing out one bone fragment that couldn't be pinned in place, and holding the rest together with a big plate and six screws.

Much better.

Since then, I've run with it in a cast, then an articulated brace, then nothing at all.

And decorated the brace with race bling.

I've also been doing physical therapy -- first active range-of-motion, then some passive range-of-motion and resistance work with Therabands. I'm slowly gaining mobility in the elbow.

What, doesn't everyone graph their active range of motion?

Last week, I noticed a bump by the point of my elbow. It felt like the head of one of the screws, the one nearest the elbow. I figured maybe swelling had gone down in my elbow so now I could feel the hardware. (I could feel the plate, too). But it seemed really close to the skin. I would occasionally bump it into things, which was painful.

I mentioned it to my physical therapist at last week's appointment and she was concerned. (More concerned than I was). She got me in for an X-ray that morning and, sure enough, the screw is backing out.

Yes, I've got a screw loose.

A CT scan yesterday morning confirmed that, and showed some more bad news: one of the screw tips is in my joint space now. Not a good place for a piece of metal. The good news? The bone looks healed.

My surgeon called this morning (while I was running) to discuss the situation. She thinks my triceps may be pulling on that proximal screw and pulling it loose. Fear my mighty triceps! Anyhow, since the bone is healed and the hardware is wandering into bad places, she advises removing it sooner rather than later.

"Okay," I said. "How soon?"

"Well, I've got time in the operating room tomorrow, or Friday. Which one works for you?"

Well, that's pretty soon. Surgery's scheduled for Friday morning. Hardware out, and a closed-joint mobilization (basically, taking the elbow through its range of motion under anesthesia). Should be a quicker and simpler surgery than the first one, and result in no cast, no brace, just a gauze bandage. Then moving the joint as soon as possible -- PT early next week.

I've got high hopes that this will keep my rehab on track and maybe even improve my joint mobility. And if nothing else, I get rid of this big lumpy screw sticking out of my elbow. And that's its own reward.

Running with a broken elbow (or, "It's just a flesh wound!", or, "Come back here! I'll bite your legs off!")

Yes, you can!

When I broke my elbow at Zumbro (story in a future post), I googled "running with a broken elbow" and "running with a broken arm" the same night.  There's not a lot out there on the internets about running with a full arm cast (though a number of stories about short arm casts), so I thought it might be helpful to share my experience.  The summary?  Yes, it can be done.  If you're a little nuts.

At my first appointment with my orthopedic surgeon, I asked "Can I run?"  It was 5 weeks before Superior 50K, my first ultra, and I was not going to miss it, by golly.  She assured me that I could run as soon as it was in a cast, a week after surgery.  Before, that, low/no impact exercise was fine.

That curvy piece off to the left is supposed to be attached to something.

With my arm in a giant splint and a doctor's blessing, I was at the YWCA bright and early the very next morning.  I hit the elliptical [I believe that may be a first for me! I didn't even die of boredom], then cranked the treadmill up to 15% grade and walked, briskly, for 30 minutes up a big imaginary hill.  Hey, it beat another half-hour of elliptical.

As an aside, you want some funny looks and great conversations, go do a really sweaty workout at your local Y or running trails with a full arm splint or cast on.  Had a great talk with a guy who broke BOTH wrists and several fingers two years ago in a bike accident, recovered, and decided to bike across the country.  He concluded his story, "So you WILL get better! Hang in there!"  Oh yes I will.

My awesome orthopod fixed me up four days post injury with a ginormous plate and six screws.

Talk about race hardware!

I enjoyed two days of frequent naps, quality cat time, and Vicodin, then swapped the good drugs for Tylenol and hit the Y.  Still in a splint, I biked, elliptical'd, and did lower-body strength work (lunges, squats, situps, whatever I could think of).  Got into a cast on post op day 6 and the next day I ran a mile, on the indoor track at the Y.  It was slow and awkward, but nothing hurt.  The next day I ran 5.4 miles, no slower than usual.  (There's nothing like an 10 day, unplanned, radical taper to help your speed).  The 50K was ON!

On post op day 10, 4 days after getting my cast, I did the last big training run before Superior -- 25 miles at Afton State Park.  I wore my Hoka Stinsons, my go-to trail shoe at that point.  I carried a Velcro luggage strap in case I needed a field sling.  (I didn't).  Reasoning that I tie up my only functional hand with a handheld, I exchanged my usual Ultimate Direction bottle for a new-out-of-the-package Nathan Intensity hydration pack.  (Luckily, it worked magnificently the whole day).  I filled it with Nuun, stuffed 900 kcal of snacks into the front pockets (Shot Bloks, Gu and Roctane, Picky Bars), and I was off, in 39 degrees and crisp air, at 5:30 am.  A 30-minute out-and-back while waiting for others to get there, then the 15.5 mile race loop, then a very slow and gimpy solo 7 miles back around Africa Loop/Back 40.

It went pretty well, considering my entire dominant arm was in a massive fiberglass cast.  A little IT band problem on the opposite hip in the first 3 miles or so went away fairly quickly.  It came back in the last 5 miles with a vengeance, and I mostly walked the last 3 miles or so, occasionally jogging a segment or two.  I've never had IT band problems to speak of before or since.  I theorize they related to decreased arm swing on the right because of the added weight of the cast.  I had a pretty serious bonk at the end of the full loop, around mile 18, but got a second wind after eating an entire Picky Bar.  It was very difficult to get back up and head back out for the last 7 miles, but I did it.

I was in the cast for 3 weeks and ran over 75 miles in it.  It was funky, and awkward, but it worked okay.  I always felt like I would feel worse if I didn't run, so I just kept going for runs in it.  When I got it off and graduated to the articulated arm brace, it was a relief, but also a triumph.  Nothing was going to stop me from doing my 50K.

Graduated to a brace. I added the Superior bling myself.