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Post-op elbow surgery: how do you get comfortable in the brace?

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I broke my elbow on 08/22/10 and had to have surgery on 08/27/10. My break was pretty bad according to the dr and it happened when I was riding my horse--he tripped and fell and I landed directly on my elbow. For the surgery, he only had to make one (though large) incision on the outside part of my elbow, thank goodness. The dr put a Vantage therapy brace on me this past Wednesday which allows me flexion of 120 degrees but only allows extension of 90 degrees. I was hoping the brace would be more comfortable then the splint I had on before and directly after surgery, but unfortunately, it is not. Sad I have gotten maybe 8-10 hours of sleep for the past two nights. I'm not a night person! It's 3am now and I'm miserable. The brace has foam padding, but the inside part of my elbow (a pressure point) isn't seemingly aided by the thin amount of foam that covers the dial in that spot. It's extremely painful and uncomfortable. I can find a position with my arm propped on some pillows, but after about 10 minutes, I'm uncomfortable again. I've also tried adding extra padding with a sock and part of a hand towel, but it just isn't enough. I am so tired. I don't see my dr again until next Wednesday... so I'm hoping maybe someone has some advice. I just want to be comfortable enough to sleep--and it's not the surgery site or the bones that had the surgery hurting. It's the inside of my elbow... from the weight of my arm against the brace.
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replied September 25th, 2010
Elbow Fracture
equestjess,
Sept 25, 2010

I shattered my elbow on July 19,2010. I had surgery and had 2 plates and 9 screws put in. I had a splint on for two weeks and then was put in a cast for 3 weeks. I know what you are saying about getting comfortable. I still cannot sleep. I started Pt 4 weeks ago and have seen little progress. My arm will not straighten out, my hand constantly swells and they think my shoulder has frozen up. I am in constant pain. I do hope things improve for you. The PT group keeps telling me it will take time. I go back to the Dr. next week, so we will see what he says. I hope it will be good news.
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replied July 17th, 2011
Elbow Surgery and issues after
If anyone is still reading this thread - esp. equestjess - I had elbow surgery on May 9, 2011 - my hand still swells, shoulder in horrible pain all the time and elbow won't fully extended - it is now July 17 - just over 2 months after surgery - if I try my hardest with PT do you think there is hope the swelling will stop and other issues might improve? I know everyone is different, I'm just so frustrated.
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replied November 21st, 2011
Elbow
I had surgery september 6 2011 because of the wonderful surgeon and the physical therapist who only treats hands and arm I have over 140 degree flexion and almost zero extension .... Find an expert physical therapist and exercise your arm every 15 minutes!
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replied July 17th, 2011
Especially eHealthy
nicumom,

The swelling in the hand is due basically to three things. The lymphatic system has been disrupted by the injury and surgery (I assume you have an injury for which surgery was opted to treat). The venous system, which is a low pressure system has also been disrupted. Both of the systems require muscle contraction to get the fluids back into the core. Also, you still need to elevate the hand over the head when the hand swells. This will allow gravity to assist the muscular contractions in getting the edema resorbed. I know, I know, it's hard to elevate your hand as much as needed. Just saying, it will help if you can.

With time the lymphatic and venous systems will make new channels and veins, you will do more work with that upper extremity, so swelling will become less and less of a problem. But, it may bother you off and on for many months, even up to a year or so.

In terms of getting full extension of the elbow, it is very common after a significant elbow injury, to never regain full extension. However, that is usually not a problem for the vast majority of patients, as there is actually very few activities which require full extension. Army push-ups, certain gymnastic moves, and a few other are the only ones. The functional range of motion of the elbow is from about 25 to 125 degrees.

This range allows the patient to reach the top of the head and mouth, and to the perineum for bathroom and hygiene purposes. Almost all heavy lifting and pushing/pulling are done with the elbows slightly bent, due to the advantage in muscular biomechanics.

The shoulder pain is also very common after upper extremity injury/surgery. Patients often splint, hold their shoulder very tight and still, with the arm pulled into the chest wall. With keeps the rest of the upper extremity from moving and causing discomfort. But, the shoulder then doesn't get the motion it needs and it becomes painful. The muscles become sore from being contracted all the time.

You can help with the shoulder by doing Codman's exercises. These do not require any elbow motion. If you look them up on the internet, there will be pictures. But, they are essentially pendulum swinging of the shoulder in forward/backward, side to side, and in circles. Then, with time, you can start doing active range of motion. If you don't get the shoulder moving, you risk getting a frozen shoulder.

This is also true of the wrist and fingers. ROM here will also help pump swelling and edema back into the body.


Keep up your physical therapy. Elbow injuries are difficult to over come, but it is very possible. It will take effort and hard work, but you are actually over the hard part. Just keep at it. Good luck.
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replied May 20th, 2013
Fractured Humerous
That is excellent advice Gaelic. I had surgery on 30JAN13 for a fractured humerous. I still have constant, nagging pain almost 4 months later and not full extension. I can reach the top of my head and mouth, but not my shoulder. My forearm looks like I am carrying an invisible purse Sad I do ROM, strength and extension exercises daily and had PT for a month. I do miss the soft tissue massages from PT. I am hoping things will improve but I am seeing little results from my exercising. I am 54, maybe that's why.
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replied May 20th, 2013
Fractured Humerous
That is excellent advice Gaelic. I had surgery on 30JAN13 for a fractured humerous. I still have constant, nagging pain almost 4 months later and not full extension. I can reach the top of my head and mouth, but not my shoulder. My forearm looks like I am carrying an invisible purse Sad I do ROM, strength and extension exercises daily and had PT for a month. I do miss the soft tissue massages from PT. I am hoping things will improve but I am seeing little results from my exercising. I am 54, maybe that's why.
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