# Advice for protecting my elbow after serious fracture



## rufflove (Jan 12, 2010)

Hi folks, could someone give me some quick advice on choosing some elbow guards, please? About a year ago, I shattered my humerus at the elbow whilst out riding. I now have a plate on either side, held together by 15 screws, along with a pin and wire through my olecranon. The joint is still quite stiff and mildly painful, but I've managed to regain almost full range of motion and I'd like to start riding offroad more often again.

After looking at the options, I'm guessing the soft neoprene guards are not a good option in terms of orthopaedic protection, but am also guessing that hard shell guards might be a bit impractical for day-long riding where I need them to fit under long sleeved tops.... 

Which brought me to the 661 d3o evo guards; are they thin enough to fit under a windproof etc? They are a bit on the expensive side, but peace of mind is paramount... Are there any other suitable options? I looked at the the lite version too, but can't find anywhere to buy them online in the UK.

Any advice would be greatly appreciated! Knowing that I have suitable arm guards will no doubt go a long way to helping me regain my confidence


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## BadHabit (Jan 12, 2004)

rufflove said:


> Hi folks, could someone give me some quick advice on choosing some elbow guards, please? About a year ago, I shattered my humerus at the elbow whilst out riding. I now have a plate on either side, held together by 15 screws, along with a pin and wire through my olecranon. The joint is still quite stiff and mildly painful, but I've managed to regain almost full range of motion and I'd like to start riding offroad more often again.
> 
> After looking at the options, I'm guessing the soft neoprene guards are not a good option in terms of orthopaedic protection, but am also guessing that hard shell guards might be a bit impractical for day-long riding where I need them to fit under long sleeved tops....
> 
> ...


My wife shattered her left elbow (and hip) while riding about eight years ago. Hardware installed. I insisted on protection for her, and she rode with 661 neoprene for a year. I wish she still used it (only one used). She finds it too warm.

Hard shell--I looked into hard shell hip protectors and eventually saw some that did not concentrate force. I'd make sure hard shell elbow protection worked the same way--that it "rises up" around the injury site so that the elbow would be isolated in a fall. Describing it ok?

She has some numbness in her arm and hand when awakening. One pin that sticks out is subject to contact and sharp pain.

Really what helped her riding is Ergon grips. Recommend you look into those.

Best wishes.


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## rufflove (Jan 12, 2010)

BadHabit said:


> My wife shattered her left elbow (and hip) while riding about eight years ago. Hardware installed. I insisted on protection for her, and she rode with 661 neoprene for a year. I wish she still used it (only one used). She finds it too warm.


I'm hoping the thought of the potential consequences of a direct impact to the unprotected joint will be enough to make me bear the additional warmth. Saying that, in the kind of conditions we've had recently, the added insulation will no doubt be welcome!



BadHabit said:


> Hard shell--I looked into hard shell hip protectors and eventually saw some that did not concentrate force. I'd make sure hard shell elbow protection worked the same way--that it "rises up" around the injury site so that the elbow would be isolated in a fall. Describing it ok?


Yep, I think I understand; the greater the surface area, the greater distribution of force... I'm looking at the Joint VPD Elbow by POC now, too. They claim that their VPD foam ("Visco-Elastic Polymer Dough') has a more progressive absorption ramp, which distributes direct impact better than most. I dunno how well it compares to d3o...



BadHabit said:


> She has some numbness in her arm and hand when awakening. One pin that sticks out is subject to contact and sharp pain.


Luckily, I managed to escape with little nerve involvement, and the numbness and tingling on waking has gradually becoming less frequent. I can sympathise on the protuding pin thing though!



BadHabit said:


> Really what helped her riding is Ergon grips. Recommend you look into those.


Really? I might just have to invest in pair of those. Thanks for the heads up


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## bryan_d (Mar 16, 2009)

Hey rufflove,

I just had my fracture last summer, and started to hit up some easy trails with protection. My awesome girlfriend surprised me with the D3O Evo's for my brithday and I wear them underneath my windbreakers. I do however still feel some discomfort during full flexion as the pin presses on my skin against the elbow pads; they do however feel much better than some hard plastic pads that I used to wear. And yes they do feel hot, but as a nice coincidence, my elbow feels the best under heat!

I have full flexion back, but did lose extension which I am not too worried about as I had a negative extension to start off so it is "full" in normal terms.  Glad I suffered no nerve damage too.










I also ride with Cat Eye Bar Bones that give some surface area to rest on along with a change in had position when I need.

Bryan d

PS - Are any of you going to get the hardware out when it is allowed? I cannot see my self living the rest of my live with this Guyver enhancement.


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## rufflove (Jan 12, 2010)

Hi there Bryan,

Good to hear you got back into the saddle pretty quickly  Also glad to hear the Evos will fit under a wind breaker. I'm using a neoprene support atm and find the warmth helps as well - just not the sweatiness!

I don't think I'll be having any hardware removed in the foreseeable future. I was told that the medial plate may cause some irritation around the ulnar nerve and that it could be removed afters 12 months, if this turned out to be an issue.










Notice the slight "flare" outside of the lateral plate -- thats a bit of heterotopic ossification. It seems my body reacts rather aggressively to surgery; the scar also became hypertrophic, with a fair amount of tethering. Removing any of the hardware could be more trouble than its worth...

Yeah, I have some natural hyper-extension too - good innit  I struggled with extension more though and did all exercise on my back to assist the bicep.

P.S. Guyver -- wow, now that brings back memories :cornut:


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## bryan_d (Mar 16, 2009)

Dang,

At least your k-wire is still intact.  

My range of motion was worrisome at first, but just constantly moving the arm really helped it out. Still have pain when activating my triceps and holding the arm fully extended, but overall I am happy about where I am.

Here's to a full recovery fo rall of us!

Bryan d


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## rufflove (Jan 12, 2010)

bryan_d said:


> Dang,
> 
> At least your k-wire is still intact.


Indeed. How did yours come to fail, if you don't mind me asking? It looks like the tie off has risen up at some point.



bryan_d said:


> My range of motion was worrisome at first, but just constantly moving the arm really helped it out. Still have pain when activating my triceps and holding the arm fully extended, but overall I am happy about where I am.


Same here - it was hard work, eh! They were initially going to book me in for a emergency physio, but after a week of constantly trying to eek a bit more movement out of my elbow, it was much improved. I found that feeding myself peanuts, one by one, to be a handy exercise - it was xmas afterall!

The surgeon who looked after me refers to the elbow as the unforgiving joint. I pretty much accepted early on that full recovery of ROM was going to be impossible, but am also happy that I eventually arrived at a better-than-expected outcome.

I hope you see a further improvement if you have the hardware to be removed


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## BadHabit (Jan 12, 2004)

bryan_d said:


> PS - Are any of you going to get the hardware out when it is allowed?


My wife chose not to. Additional surgery, recovery and rehab were unwelcome. Her surgeon was noncommittal; saw little benefit.

I've always wondered about the decision.

Best wishes.


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## bryan_d (Mar 16, 2009)

Dove into a pool, arm collapsed and cocked waaay back, pain for a whole day, full flexion the next day with a large reduction in pain even prior to my dumb-ass diving. 

I just thought I gave the arm a "good" stretch until I saw my doc for a check-up to find out that I snapped the wire. Luckily I had full matrix developed with bone growth near the bottom as pictured. The giant pins are stabilizing the fracture for the remainder of the healing.

I know I'm stupid like that, but sometimes stupid can bring some positive things, hahaha. And when I get the chance, I will get this floating wire and metal out of me; it's like a little alien trying to wither and pierce itself through my skin (or scar to be exact).

Bryan d


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## anthony.delorenzo (Aug 17, 2006)

I had a similar injury in September... Distal humerus fracture, ORIF surgery, looks kind of like rufflove except I don't think I have the pins/wires through my joint. I'm at around 100 degrees of motion right now, mostly straight. 

Funny thing is, the day after I shattered my elbow the Race Face elbow pads I had ordered showed up at LBS. Not that I would have been wearing them on the ride, they were for DH, but still kind of funny. 

I have been on my Pugsley since November, a couple of minor crashes but thankfully snow is soft. I'm not sure about protection for next year, will definitely wear the Race Face pads for DH but maybe not for XC. Those EVO pads sound like they might be something to try on.


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## bryan_d (Mar 16, 2009)

anthony.delorenzo said:


> I had a similar injury in September... Distal humerus fracture, ORIF surgery, looks kind of like rufflove except I don't think I have the pins/wires through my joint. I'm at around 100 degrees of motion right now, mostly straight.
> 
> Funny thing is, the day after I shattered my elbow the Race Face elbow pads I had ordered showed up at LBS. Not that I would have been wearing them on the ride, they were for DH, but still kind of funny.
> 
> I have been on my Pugsley since November, a couple of minor crashes but thankfully snow is soft. I'm not sure about protection for next year, will definitely wear the Race Face pads for DH but maybe not for XC. Those EVO pads sound like they might be something to try on.


Funny thing too, my friend was going to lend me his downhill armor to try out. It was the full elbow to forearm armor. I regretfully declined. 

If you are going to check out the EVO's I would do as one suggested in this thread and check on those POC pads. They sound like a better option with hardware present, because they mold to your body.

bryan d

PS - I came in for my check-up on the elbow, only to find that my insurance somehow no longer exists. Sucky.


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## anthony.delorenzo (Aug 17, 2006)

Finally got some of my xrays, these were back in November. Flying down in March for more xrays and a consult with my surgeon.





Just to tag the search engine: 
distal humerus fracture
broken elbow
open reduction internal fixation
ORIF surgery


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## homestyle (Mar 22, 2010)

I just had surgery done to my distal humerus and distal radius bone 2 weeks ago. 3 plates total.

I'm very worried about my range of motion and future pain/problems...

Right now, I can only go from ~40-110 degrees of arc.

1. I've read a lot about elbows becoming stiff quickly... do I have a window of opportunity now to get maximum range of motion or should I go easy now and try to increase range of motion as time moves on?

2. How many weeks after the surgery did you notice an increase of Range of motion?

3. After 3 months, did you notice an increase in range of motion from 3 months - 1 year?

4. What is limiting the range of motion? Soft tissue, metal plates, or bone structure? I've stretched some soft tissue and know it feels like there is some mechanical thing limiting my movement.


Thanks.


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## anthony.delorenzo (Aug 17, 2006)

I did physio 3-5 times a week for 3 months, starting maybe 3 weeks after my surgery. My elbow goes almost totally straight but flexion is capped out at 90-100 degrees. So yes, after about three months I stopped doing physio, I would get an extra 10 degrees or so and then lose it again. 

Impossible what to say is limiting your ROM, your physio and surgeon are the only ones that can answer that. I did a follow-up with my surgeon about six months out, will be doing additional surgery in the next few months to remove some bone to help it bend more. 

An average recovery is 100 degrees, so if you get anything more than that you are lucky. Sounds to me like you should focus on getting it straighter. 

I was off painkillers two weeks after surgery and haven't had pain problems since. Been riding since the second month (on snow) and now road and dirt. Had some days where it is cranky, and survived some tumbles. 

Good luck with your recovery. It is a pretty serious injury but amazing what they can do these days.


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## homestyle (Mar 22, 2010)

Can you explain this gaining extra 10 degrees and then losing it? I think I have what you're describing.

With PAINFUL stretching, I can get my arm almost straight... maybe 5-10 degrees short of full extension.

And then again with PAINFUL flexion, I can get about 120 degrees.

The problem is linking the two. Once I get the stretch one way, going the other way is painful and it takes a good 5 minutes to get it the other way.

And if I do something else and stop stretching for 1 hour and come back, I have to do the restrech again.


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## anthony.delorenzo (Aug 17, 2006)

homestyle said:


> Can you explain this gaining extra 10 degrees and then losing it? I think I have what you're describing.


Definitely, going from flexion to extension is an issue. If we were doing one at physio I would lose on the other end.

What I was describing was, at the end of a physio session we would measure out at say, 110 degrees but in practice, once I was home the next morning it was never that much. It seemed I could never sustain that last little bit.

Edited to add: Sounds like you are doing very well for this type of injury. I wouldn't be worried, you still have lots of time.


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## homestyle (Mar 22, 2010)

do any of you have pain when you try to extend your arm and supinate your hand (palm facing up)?

I have pain in the area around where my radius meets my humerus whenever I try that motion. But I don't get the pain when I supinate with my arm at a 90 degree angle.


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## bryan_d (Mar 16, 2009)

homestyle said:


> do any of you have pain when you try to extend your arm and supinate your hand (palm facing up)?
> 
> I have pain in the area around where my radius meets my humerus whenever I try that motion. But I don't get the pain when I supinate with my arm at a 90 degree angle.


I do not get pain when doing what you asked, but can make it do an extra "click" if I extend hard enough.

Going to see a new doctor soon to see about removing the hardware... I am sick of not being to put my elbow down on things. My shoulder is experiencing more discomfort than the elbow now because I cannot rest my arm on things.

Bryan d


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## homestyle (Mar 22, 2010)

Good luck.

bryan d, I noticed you got back "almost" full extension....

How many weeks after surgery did you get back full extension?

I can also get almost full extension if i push my arm open with my good arm and stretcth it. i lose it if i stop stretching in as little as 20 min.

how many weeks after surgery were you able to have full extension without having to stretch first?


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## jimithng23 (Feb 11, 2009)

thought I would chime in with my elbow injury:

busted my radius and dislocated my ulna.










I took a spill, while in granny gear no less, and my elbow broke my fall directly on a rock. that was May 31st. I have since been to physical therapy twice a week for nearly 2 months and I'm very close to regaining all ROM. I am at 20-120 after a session and can nearly reach those angles on my own after using the green therapy band my therapist gave me.

In the last 2-3 weeks I've been able to get back on the bike...I'm also looking for a good solution for elbow protection.

rehab has been frustrating, but every little bit of ROM gained I look at as a win. getting back on the bike feels great, the arm will get a bit sore - mostly the triceps tendon...

good luck to everyone in this thread on a successful recovery, and hope no one reading this ever has to endure an elbow injury :thumbsup:


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