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Recovering from a broken thumb + atrophy
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CJxxx


Jun 9, 2013, 2:00 AM
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Recovering from a broken thumb + atrophy
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So, I broke my thumb on may 18th, got x rays a few days after that and got a cast halfway up my forearm a few days after that. The cast is set to come off on June 20th and I'm just curious if anyone else has had a similar experience and can point me back in the right direction for recovery. I was training incredibly hard before I broke my thumb and just don't really know how to ease myself back in.

Few more things, when the injury happened, there was bruising near the top of my nail and swelling. I could only bend it a little at the joint without pain. However, orthopeditist told me it wasn't a serious fracture at all and after the cast comes off, I'll just have to deal with the thumb being stiff.

Also, I can feel my left forearm shrinking. Once I start training again, will this muscle recover more quickly or will it be like starting from square one? I know no one here's a doctor just looking for similar experiences.

Thanks a lot! Attached is a picture of the thumb cast.
Attachments: Photo on 2013-06-05 at 22.49 #2.jpg (108 KB)


altelis


Jun 9, 2013, 12:57 PM
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Re: [CJxxx] Recovering from a broken thumb + atrophy [In reply to]
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So, first of all, this site (and climbing, specifically, outdoor sports generally) is FULL of doctors and other medical professionals, like PT's, medics, nurses, NP/PA's, etc. Not all of them are active in this board, but they abound!

Onceahardman, who is the resident voice of experience and helpful posts in this forum, is a PT.

You're in a "thumb spica" cast. As I'm sure OAH will tell you, the thumb being stiff is going to be a big deal, and working diligently on that is going to be important.

In terms of atrophy (ps- the forearm is not a single muscle), yes, you will have some in your forearm, as well as the muscles of the hand, including the thenar muscles. I'm not a PT, but my hunch is that after a month in a thumb spica cast, in which I assume you've been using your hand a lot, simply easing you're way back into climbing will be enough to get back to strength. And it shouldn't be like square one.

I think you're going to notice it will take more "work" (at least directed diligent activity) to get your thumb stiffness to decrease than it will to get strong again.


CJxxx


Jun 10, 2013, 12:39 AM
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Re: [altelis] Recovering from a broken thumb + atrophy [In reply to]
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Cool thanks. I just hope this thing is actually healing under the cast, I can see my nail is still bruised so I feel like I'm gonna get unlucky or something, haha.

Any idea what type of PT one would do for an injury like this?


onceahardman


Jun 10, 2013, 9:18 PM
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Re: [CJxxx] Recovering from a broken thumb + atrophy [In reply to]
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CJxxx wrote:
Cool thanks. I just hope this thing is actually healing under the cast, I can see my nail is still bruised so I feel like I'm gonna get unlucky or something, haha.

Any idea what type of PT one would do for an injury like this?

First, he or she will try to get the motion back, with manual stretching, and joint mobilizations.

Then comes strengthening. This should include resistance exercises in all thumb motions, to tolerance.

In the meantime, just keep your fingers moving actively. Don't try doing isometrics with your thumb inside the cast. A fracture is an extreme injury of instability. Scar tissue, at this point, is your best friend. Let it heal, be patient. Most of your strength gains will come through climbing.


(This post was edited by onceahardman on Jun 10, 2013, 9:19 PM)


CJxxx


Jun 25, 2013, 1:27 PM
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Re: [onceahardman] Recovering from a broken thumb + atrophy [In reply to]
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So cast is off, doctor didn't send me to PT because I said I could really just do what the physical therapist could do, just on my own. He said avoid pushups or anything that could really put a lot of stress on it and just move it around with my other hand, soak it in warm water. Sound like all I need to do? Got the cast off on thursday and it's feeling pretty good already, just stiff and a little sore as well, with reduced range of motion. My wrist also is sore, is that normal fort he type of cast I was wearing?


shotwell


Jun 25, 2013, 5:03 PM
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Re: [CJxxx] Recovering from a broken thumb + atrophy [In reply to]
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CJxxx wrote:
So cast is off, doctor didn't send me to PT because I said I could really just do what the physical therapist could do, just on my own. He said avoid pushups or anything that could really put a lot of stress on it and just move it around with my other hand, soak it in warm water. Sound like all I need to do? Got the cast off on thursday and it's feeling pretty good already, just stiff and a little sore as well, with reduced range of motion. My wrist also is sore, is that normal fort he type of cast I was wearing?

Not to be a dick, but you're making a mistake. I skipped physical therapy after fracturing my leg for the second time. Half a decade later I still have ROM issues that I'm confident I wouldn't have if I had been under the supervision of a therapist. My personal rehab was just not as effective.

It is your body, but I strongly suggest you take care of it. Good luck.


onceahardman


Jun 26, 2013, 12:27 AM
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Re: [CJxxx] Recovering from a broken thumb + atrophy [In reply to]
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I think too many doctors tend to look at an x-ray and say, " see? it's cured". The bony anatomy is healed, but the function is not restored. I'd look for a good manual PT or a CHT (certified hand therapist) . CHTs are usually PTs or OTs.

Even see if you can private pay a few visits if your insurance doesn't cover it. It will probably cost the same as a teeth cleaning, or a brake job. Consider it body maintenance


CJxxx


Jun 26, 2013, 2:36 AM
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Re: [onceahardman] Recovering from a broken thumb + atrophy [In reply to]
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Yeah, set up a PT appointment while I was at work today for thursday. I was looking around in the gym, cleaning all these holds and shit and thought, damn, I hope I can grab all these in a few weeks, then picked up the phone and set it up. Not worth the risk. Now, I'll just lose sleep over how not going to PT for a week might affect things.


(This post was edited by CJxxx on Jun 26, 2013, 3:32 AM)


MrEction


Jun 26, 2013, 3:48 PM
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CJxxx


Jun 27, 2013, 6:44 PM
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Re: [MrEction] Recovering from a broken thumb + atrophy [In reply to]
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Thanks for the PT advice everyone. First session was killer.


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