I haven't realized the significance of posting here until recently. My previous Distal Biceps Tendon Rupture post has had many hits recently and I thought it might be a good idea to actually put some useful information regarding recovery here. I am currently about eight months post surgery and I thought I would give a little timeline about my recovery and the tactics I used for a successful recovery.
A little history-
I ruptured my bicep on Dec 18th 2010 while bouldering (rock climbing) in Joshua Tree National Park in southern California. For those interested, I was climbing an iconic boulder problem called Caveman that was established by John Long when I was a wee boy. I was actually doing the longer (and harder) sit start version and was very close to finishing the climb having done the crux downward climbing (not using the cheater jug out left) when things went wrong...
The sequence goes like this-
I was climbing feet first through the horizontal roof. My left hand was in a shallow two finger pocket/dish and my left foot was hooked on an enormous hold. I reached through with my right hand to awkwardly match my foot and hand. I then released my left foot and flagged it out on the wall, at this point my right arm was twisted in a very strange way to hold on. My palm was facing up but my pinky was pointing towards me and my thumb was pointing away (towards my feet). All of my body weight is now on my right foot, which is smeared on the adjacent face, and my right arm which is uncomfortably loaded. I then shifted my weight to the left, which twisted my right arm even more, and moved my left hand from the nearly worthless pocket/dish to match on the big hold. As soon as my left hand touched the hold there was a loud POP and I fell to the ground. I knew immediately what had happened. I yelled to Mer that I had just ripped my bicep from the bone. My bicep was rolled up into my arm and laying to the side. It was definitely grotesque looking but there was not much, if any, pain associated with the injury.
Off to the emergency room-
This was a worthless thousand dollars spent. They took X-rays that no one ever looked at and gave me nearly useless information, except that I needed to have surgery within ten days or two weeks.
Surgery on Dec 28th 2010-
Surgery went well, like I said in my previous post I had the endo button procedure that is supposed to greatly reduce recovery time. Which it did! I highly recommend this procedure, if doctors are trying to prescribe old school methods find another doctor.
-Two weeks post surgery in a splint
-After two weeks change from splint (mummy arm) to removable splint (cyborg arm)
-Start PT during week three. I was supposed to go 2x's per week and wear my removable splint at all
times except during PT for the next four weeks
-Each week increase range of motion by 15 degrees or so
-At six weeks post surgery I would be allowed to lift up to 5 lbs.
-At nine weeks I would increase to 10 lbs.
-At twelve weeks I would lift up to 30 lbs
-At 24 weeks I would return to unrestricted activities given;
1) Normal muscle strength in upper extremity
2) No pain
3) Full range of motion
4) No muscle atrophy
After surgery I took pain killers for a day because I was expecting a lot of pain. It never came though, the hardest part of it all was sleeping. It is very difficult to sleep with your arm in these contraptions. I found that sleeping on my left (non injured side) or back with a pillow to prop the injured arm up relieved the most discomfort. I had read that sleeping in a recliner works well, but we don't have a recliner...
My recovery went really well, when the splint was first removed I felt very vulnerable and protected my arm as much as I could. I was scared to see what my full range of motion was and babied it for about a week. However, I made sure to keep up with the minimal requirements for range of motion during this time frame. Supination and pronation of my wrist was (and still is) the most difficult exercise. My PT instructions said to do the exercises 4-6 times a day on my own. I took this as a prescription for the average person, I consider myself an athlete with a high tolerance for pain and tried to do my exercises 8-10 times a day. Often focusing on the things that gave me the most trouble. Stretching was VERY important during the early stages, but massage was EXTREMELY important for me. The scar tissue that built up in my arm from the surgery really hindered me and I can't express the need to break it down enough. It hurts like hell but leads to a faster and safer recovery (IMHO). I also began running and working on cardio machines at the gym about a week post surgery. My theory was; with the increased heart rate associated with the exercise, this would increase my blood flow to the injured area, and expedite the healing process. I did have to make sure to elevate and ice my arm afterwards, in fact I iced and elevated my arm several times a day for the first 3-4 months (swelling inhibits healing).
When it came time to start lifting light weights, I was told to do so many sets, so many times a day... I became obsessed with lifting these and would do sets of 50 to a 100 reps with the light weights. I continued this with the ten pounders as well. It felt sooo good to feel some burn in my arms again. Five pounds doesn't sound like much, but when you lift a thousand times a day it causes some fatigue!
So basically I went completely over board and obsessed with my exercises. This OCD behavior got me several things;
1) I only went to PT 2x's a week for two weeks
2) I felt comfortable without my cyborg arm at about 4 weeks (I would wear it in public for 6 weeks
and skiing for several more months)
3) I started skiing about 4 weeks post surgery (due to full range of motion)
4) I finished PT about a month early
5) I was released from the doctor about a month early
6) Started light climbing around 10-12 weeks post surgery
All of these things happened because I did what I was supposed to and then some. I can't recommend this enough, if you are lazy with your recovery your arm may never recover fully. As someone who loves to get outside and be immersed in adventure, full recovery was my only option.
So in the end my elbow never really hurt, but my wrist was in some pain. It would often get very tight and I would lose a lot of mobility. I believe this was due to the build up of scar tissue in my for-arm. That was one draw back from leaving PT so early, I did not get the regular massage. If you end up in the same situation I recommend visiting a massage therapist.
Around five months post surgery I was bouldering a bit. I even tried hard on occasion and this often led to a lot of wrist pain afterwards. I also tweaked my shoulder/neck at one point. These muscles were probably weakened due to the lack of use. So, I slowed down after an exciting start. Around 26 weeks 95% of all weirdness was gone. I would occasionally feel some resistance in my wrist but it would go away quickly. Now I don't think about my arm much at all. The huge worm like scar reminds me of the incident and I often shy away from underclings, but I am at 99.5% and I expect a 110% recovery. The added 10% is from the wisdom gained from the experience and improved footwork to keep the weight off my arms.
So, after feeling completely devastated and depressed thinking that I would not be able to climb at the same level again and that my ski season was over, it turned out to be the exact opposite. I will probably be climbing harder than ever soon and I skied around 100 days for the 10/11 season.
If you have any questions please leave a comment or e-mail me (my email is on my profile page). I will answer any questions ASAP as I know this is a stressful event in anyones life.