Rest day – Physiotherapy 1

My first physiotherapy appointment this afternoon. Almost as soon as I left the office on my bike the weather started with the heavy sleet so by the time I got to the JR2 I was soaked.

I had an assessment from Chris, the Oxford Triathlete I saw a couple of weeks ago at the Trauma Unit, and in between diversionary chats about bikes and training and  so on he worked out what I could and couldn’t do. Filling in the questionnaire before the appointment reminded me of how much my life is still affected by the injury – sleep is interrupted, I’m still taking a couple of paracetamol a day for the pain (Ibupfrofen is an anti-inflammatory and you need the inflammation in the bone break to promote healing, so that’s a no-no), and I can’t do much in the way of chores around the house. He saw me carry my (nearly empty) rucksac into the treatment room left-handed though, and reminded me I’m not supposed to be lifting much with my arm at the moment! I’ve got at least another week before the crucial 6-week healing period is over and my arm bone is strong enough to take more abuse.

He cut me a length of yellow elastic (there was also a red strip, but he thought it too strong for me at the moment – I can always double up the yellow if I need to) to do my exercises with. For that I was charged £1! I was shown three rotator cuff exercises, to be done 3×10, three times a day. I can’t manage them all the way through, or with the full range of movement at the moment, so I have a bit of a challenge ahead of me. Because of the Christmas holiday, my next appointment isn’t until 3 January! That seems ages away.

It rained again on the ride back to the office, pesky weather. Later, back home, having got wet outside enough today, I didn’t feel like doing much training. It was horrible outside and I had presents to wrap. I realised today that there are only 30 weeks to Challenge Roth so I need to pick up the training hours as soon as I’m able.

Turbo 33km (5x5min) + Trauma Unit 4

PM. Turbo 33km inc. 5x5min (5min)/1:03:53 (31.0km/h), brisk, HR147(163)

10 min w/u
5 x 5min @ 300W (5min @ 230W rec.)
9min w/d

Average power 259W
Average cadence 91
Tacx Flow gradient +3

Trauma Unit
Back to the JR2 Trauma Unit for another X-ray and check up this afternoon. I didn’t ask to see my X-ray this time, but had the same consultant as two weeks ago. He seemed keen to have a chat about how things were going, and thought I didn’t need any more X-rays, the healing process was going well, and straight. He gave me the names of a couple of shoulder surgeons, at both the JR2 and the Nuffield Orthopaedic Hospital (NOC) who would be able to sort out my shoulder surgically if I didn’t regain full rotation, although he was of the opinion that given how far I’ve got with it after just 3 weeks, it would likely be 100%.

He signed me on for physiotherapy (saying “someone as active as you will soon find the exercises they give you trivial”!) and I went straight to that appointment. The two physiotherapists – one of them was an Oxford Tri member, eager to find out what racing I’d done – were keen to just have me keep the joint moving over a decent range of movement. The big danger here is that scar tissue will form and “freeze” it. I have a couple of rotational exercises to do and told not to ignore any pain in the movement – this is not yet the time for “no pain no gain”. I’ve got my first full physio follow-up in 2 week’s time. Cool, I was in a good mood when I stepped on the turbo back home.

Turbo 32km + Trauma Unit 3

PM. Turbo 32km/1:06:35, steady, HR137(147)

Ave power 236W
Ave cadence 92
Flow gradient +3

Starting to get the hang of this, same power & lower heart rate. Also helped by being able to slightly rest my left hand on the bars from time to time.

Trauma Unit
Another trip to the JR2 in the afternoon for an X-ray and appointment with yet another consultant. This weeks X-ray shows the join at the major fracture to be much fuzzier, starting to knit back together. All straight though – gravity is doing its stuff. If only they could reduce the amount it aches, I’d be happy. Got slight disbelief from the doctor about my age – always good ;)

Rest day – Trauma Unit 2

Back to the Trauma Unit this afternoon for my second appointment and X-ray. Being in a bit more of a reflective mood than when I came in last week, straight after my accident, I was able to ask a few more questions and got to see my X-rays.

Basically, the consultant described my humerus as “like a broken egg balanced on a stick”. It’s OK for now but what I don’t want is for the loose “ball” at the top to be displaced in anyway before it heals to the bone below. He sympathised that it was likely to be painful for quite some time yet. I have a couple of other minor fractures in the “greater turberosity” on the outside, caused by the direct impact with the ground, although they’re not such a worry. As long as I keep my arm hanging by my side the two big bits should heal together in a straight line. I asked if I needed the sling and he said it was mainly a precautionary measure for fat people, so it’d be fine just to let my arm dangle if that was more comfortable. They see so many fat people that it’s done as a matter of course – if you’re fat, it pushes the lower bone away from the body, splinting it at a permanently crooked angle and the sling stops this happening!

Here’s what my X-ray looks like, fractures drawn in red. Last week’s and this week’s X-rays were not a lot different. The main fracture is right across the “surgical head” of the bone:

Pretty heavy traffic in Headington when I left. It was a nice evening so I walked home.

Rest day – Trauma Unit

Had a bit of an assessment of my jacket and jeans. Neither were damaged, just very grubby, as were my trainers. They got chucked in the washing machine. I rang into work sick and Jules drove me back to the JR2 for my 11am appointment. I got seen just before 12, so not too bad a wait.

The consultant thought I had two routes to recovery: (a) conservative 4 to 6 weeks in a sling (you can’t really set your humerus in plaster) or (b) a screw through the top of my shoulder into the bone to set it straight, which’d involve a general anaesthetic, etc. He said he could see I was pretty fit and asked my about what sport I did – that was good! I told him I was concerned about losing mobility in the shoulder joint for swimming. He thought that my chances were good, whichever recovery method they chose, although either had their risks. He wasn’t keen to operate and as I had time to recover in the winter off-season, the slower, conservative approach would be fine. (I am always slightly suspicious though that they don’t want the hassle/expense of arranging an operation. For my part, yet another general anaesthetic and bone operation is not a major worry if it means a better long-term outcome.)

Looks like I’m going to keep my sling for a few weeks yet, and they’ll X-ray the joint every week to check it’s setting straight. If it’s not, they’ll have me in for surgery and put that screw in anyway. I sorted out my appointment for next week and picked up my antibiotics from the pharmacy on the way out. Jules came back over to pick me up and I spent the rest of the day sloping about the house. Pretty knackered with the stress of it all.

Cycle 65km

AM. Cycle 65km, steady, HR129(152)

Took the day off work, went for a steady spin in the morning and spent the afternoon faffing about: took some old cardboard and rubbish to the recycling centre and then did some maintenance on my racing bikes – a new front mech for the lo-pro and new brakes and a rear mech swap for the road race bike.

Crash
Went to Brookes University Sports Centre in Headington for another meeting about redevelopment of the Harcourt Hill site for cycle sport: grass-track, MTB, BMX & a road circuit. It was a good meeting, although when I left the car park in the dark, turning left on to Cheney Lane, my bike went from under me on the wet road/leaves. I wasn’t going too quickly (I’m never in much of  hurry around town), but I’d pumped up my tyres a couple of days ago. Ironically I’d put off fitting some new ones to my town bike in the afternoon, bah.

I hit the ground pretty hard and straight away knew I’d done something bad. My left eye filled with blood from a cut in my forehead, and my left shoulder was very, very painful – I couldn’t raise my arm. I managed to pick up my bike, walk it back to the bike stands and lock it up before going back into reception, holding a glove over my brow to stem the bleeding. I realised I must be quite a sight – there was blood and road grime all down me, but I asked the receptionist to call 999 for me and a few people left over from the meeting were still around to give me a hand. It didn’t take long for the paramedics to show up and I rang Jules to let her know what I was up to before they carted me off to hospital, plenty of gas and air on the way, and with the cut on my forehead bandaged up. I was in a lot of shock and struggling to breathe slowly, but feeling better by the time we got to the JR2.

Jules showed up soon afterwards and I had a couple of X-rays. Broken my shoulder was the verdict from the X-ray man. My collarbone clearly hadn’t done it’s job and I broken the top of my humerus instead, bugger! We had a bit of a wait, as usual in Minor Injuries, but the triage nurse gave me some painkillers and a sling. Around 1:30am I got six stitches in my eyebrow, some codeine, a ‘scrip for antibiotics and an appointment for my favourite hospital department, the Trauma Unit, the next morning. We got home just after 2am, Jules on her bike, me in a taxi. I managed to drop off to sleep, upright, on the sofa. Don’t think I could’ve managed sleeping lying down.