scaphoid fracture - anyone else done this?

[nomummytummy]

Hi there all - so I posted about the worlds most stupid crash a couple of weeks ago and how lucky I am that I wasn't hurt. Well......it appears that I have fractured my scaphoid. I went back to Dr after 5 days of increasing pain in my wrist. As a chiropractor I both know about these injuries & really really need my hands working. No fracture on films at both day 5 & day 14, but orthopaedic surgeon felt that if just a sprain wouldn't be that sore after 2 weeks of immobilisation. So will get x-rayed again next week & if it doesn't show they'll do a scan. I'm still being very optimistic that it really is just a sprain, but given how little use I can make of that hand and thumb even with the cast on, reality may be different.

What I really would love to hear about is:
Anyone else had a scaphoid fracture?
How long after you were out of the cast before you could ride comfortably again?
I am (was) training for a century late Nov & am now restricted to a trainer (hurts hand) & spin classes (don't hurt b/c handle bars different angle). 8 weeks will be mid Oct - does it seem realistic to get back on the real bike 5 weeks before a century and plan to take 6-hours, and hand be OK?
I should be prioritising work before riding, so am thinking of another century to do in the new year as a more sensible option, but.......

Thanx in anticipation
L

[silver]

help me out here. where is the scaphoid bone?

I broke my arm and rode with my cast. I had to do some ....."unauthorized" modifications of the cast on the area that went between my thumb and forefinger ( I broke the bottom bone in my arm near my wrist)

I had to kick my elbow out a bit and even after the cast came off it took me awhile to get my form back.

I certainly think that you could still train for the century on the trainer and spin bike.

I hear that doctors make the worst patients

[bike4ever]

I broke my hamate bone last year. While casted I wasn't able to ride my rode bike. I was able to ride my frankenstein/commute bike. It has a straight bar with Ergon grips. For about 8 weeks, it hurt terribly while riding. I often ended rides one handed.

Around week 8 I began trying my rode bike. Because of the location of the broken bone, I was in a lot of pain. I just pushed through it, but I know I wouldn't have been able to do a century on my hand.

I know each person is different. I do have a high tolerance of pain, but I definitely was frustrated with my wrist. Good luck.

[Zen]

Silver- You likely broke the scaphoid as well. here's a nice little primer on wrist injuries.

[Thorn]

Not a doctor and thankfully, never fractured the scaphoid...just a former x-ray tech that worked in orthopedic hospital. While things have changed since I zapped people for a living, the scaphoid bone has the reputation for being the hardest bone to heal from a fracture (lousy blood supply). It isn't unusual not to be able to see the fracture--it is a hard bone to x-ray well and the fractures are often hairline.

We had one of the orthopods break his scaphoid bone. Unlike the patients he treated for it, he immediately did the bone scan and he immediately put himself on the electrical stimulator. Even with that he was out for almost 2 months.

I guess, if I were you, I'd be pushing to get a diagnosis and agressive therapy, but I hate sitting idle and am not known for my patience.

[Wahine]

What I really would love to hear about is:
Anyone else had a scaphoid fracture?
How long after you were out of the cast before you could ride comfortably again?
I am (was) training for a century late Nov & am now restricted to a trainer (hurts hand) & spin classes (don't hurt b/c handle bars different angle). 8 weeks will be mid Oct - does it seem realistic to get back on the real bike 5 weeks before a century and plan to take 6-hours, and hand be OK?
I should be prioritising work before riding, so am thinking of another century to do in the new year as a more sensible option, but.......

Thanx in anticipation
L

Ouch.

L, I fractured my scaphoid a little over 2 years ago. I'm a PT and a manual therapist at that so like you I had to take it very seriously. I was in denial and didn't even get it x-rayed until 2.5 weeks after my fall. But then, due to some connections I was able to get into see the best hand surgeon in my City. He re-xrayed, thought he saw something, radiologist disgareed and said there was nothing on the films. Hand surgeon decided to assume the worst and casted me. I was in a cast for 8 weeks and when I came out of that cast....yowza. It felt way worse than it had before we put it on. But, fortunately the bone was healed and I could stay out of the cast. This was great news as my surgeon had told me that it could take 4 months in a cast to heal it and even still that didn't guarantee I wouldn't need surgery.

So I headed off to PT, after 4 weeks I had 90% of my ROM back and I could ride my bike without problems. My bike was not limited by ROM but by significant pain with hitting even slight rough spots in the road. How much pain I had was also time dependent, the longer I rode the worse it was.

I might suggest putting aero bars on your bike and practicing with those on a trainer at home while you heal, then you might be able to tolerate a long ride much sooner after getting out of the cast. I really don't think that it would be possible to do a century, or the training for it without aero bars.

Having said that, your hand are your livelihood and you should probably be conservative. I am also qualified to so spinal manipulation and I can tell you that my scaphoid is still tender when I use that hand for certain manipulations.

I hope that helps.

[maryellen]

When I crashed last August (367 days ago, not that I'm keeping track), I had shoulder surgery for a few fractures but it was only when I continued to complain of pain in my right thumb/wrist that we realized I injured my right hand in addition to my left shoulder (you need special skills and talents for that combo!).

Xrays on two different occasions using different views did not show any fracture. Fortunately, my shoulder surgeon requested an MRI for a possible scaphoid fracture. The MRI showed that it was a fracture of the first metacarpal at the wrist joint (base of the thumb). Off I went to the hand surgeon -- fortunately I was advised to wear a brace (no cast) -- it was more than 8 weeks past the accident at that point.

Good luck!!

[BikeDutchess]

here's a nice little primer on wrist injuries.

Zen, thanks for posting that link, very informative!

[silver]

Thanks Zen! OK, I fractured my ulna. There were two fractures in it. So different situation for me.

I was actually happier in the cast. The arm felt more protected and secure in the cast than out.

I was only able to do some of the easiest of my silversmithing work. It was just prior to christmas and I wasn't able to complete some of my orders.

[Zen]

The wrist is such an intricate joint. I always try to roll on to my butt when I fall. Plenty of cushioning there and I've gotten way too much practice

Wahine- If the fracture had healed and you had 90% ROM, what causes pain at that point in recovery?
Now that i think of it, what causes pain at all when a bone is broken? Bones don't have nerve endings...

[silver]

The wrist is such an intricate joint. I always try to roll on to my butt when I fall. Plenty of cushioning there and I've gotten way too much practice

very true....if I hadn't mostly rolled onto my back/hip in the original accident, it would have been way worse, I actually broke the ulna just after the wreck in a drug induced/cranky/lack of sleep stupor walking fall, but we found during that x-ray that there had been a smaller break in the bike wreck.

Wahine- Now that i think of it, what causes pain at all when a bone is broken? Bones don't have nerve endings...

Good question...because I will say that broken bone pain is the worst that I've ever felt. And I still feel it. I've been told that you'll feel broken bone pain for years.

[Wahine]

Well, the interesting thing is that bones *do* have nerve endings and are in fact very pain sensitive. It's a common misbelieve that they don't have nerves. The pain that I still experience is likely due to sensitivity of the local nerves from the original injury. In addition to the bone injury I also had local ligament injury so that is part of my ongoing pain as well. However, it shoudl be noted that it is very unusual to break a bone close to the joint without causing ligament damage at the same time. Most docs focus on the bone healing and don't mention the co-existing soft tissue damage.

[RoadRaven]

My daughter (then 17) crashed a couple of years ago - at slow speed, a truck came behind her, she got nervous, went too far off the road, lost it in the gravel and fell at relatively slow speed.

Her wrist was aching, we slathered it with arnica, but it was still sore two days later to the point of slightly teary eyes (she is very brave). We went and got it xrayed, but even though there was nothing at all visible on the film, the doctor recommended and temporary cast and explained how the break can be very fine and may not be visible for a week or so. Thank goodness we had a cautious doctor. Sure enough, she had a fractured scaphoid.

A very hard few weeks ensued - a Hawkes Bay summer is frustrating to endure in a cast...

She has healed well but still gets occasional aches in her wrist. Sorry NMT, but her priority wasn't cycling so I can't tell you how quickly you could do long miles on a bike, but even after the 6 weeks in the cast, it was months before she could put too much weight on her wrist - so go softly softly.


Zen... even if bones didn't have nerves (I hadn't thought about that Wahine) the tissue, muscles etc around bones would be damaged and bruised and pushed outta place - I guess thats why it hurts.

[nomummytummy]

Thanks all. Great link ZenCentury - picture looks exactly as it feels.

Silver - even if I could hold onto my handle bars, I am pretty sure that I would be very unpopular with DH if I rode with a cast on. Mr Silver is obviously a "saint". I did get a DVD of the Les Mills last 2 releases of RPM. Yay! I Might take my trainer out into the yard if it's a nice day on the weekend.

Road Raven - cycling isn't meanst to be my priority either (haha). I know it's a cliche, but I had planned to do Round Taupo. I'll just wait & see how it feels in 2 weeks. There is always the Mt Taranaki ride or the Grape Ride to aim for. My trainer suggested I find a team for Taupo, but I'd rather skip it if I can't do it all myself. Well I say that at this stage. We've already booked accommodation - maybe DH can ride my bike for the 1st half & I'll finish.

Bike4Ever - I thought I had a high P threshhold - but this is worse than having a baby without drugs. It's just a deep boring pain - especially after doing too much. Like typing on my computer! - that has no cute reward at the end!

Thanks Wahine for your insight. Luckiily it's my left hand so use that less when adjusting. I'm trying not to think about what happens if I need surgery. It just isn't a pretty thought actually. My associates are working really hard & we are already one chiro down, so now wasn't the ideal time. Luckily, I have a great team who I can trust and great patients who've been great about seeing others. They keep poking their heads into my office for a chat & so I'm still able to procrastinate on the jobs I usually claim I never have time for - like paperwork! Aerobars - Mmmm... bike bling! Not that i needed an excuse!

Well I will keep you all updated. Thanks again for your insights

[nomummytummy]

Well I got my cast off on Thursday and had an appointment with a hand physiotherapist today. She agrees that although it didn't show up on film it's all too likely that it was a scaphoid fracture. Still really intense point tenderness over the actual bone. I've a brace to wear for 2 weeks. But....

went for a ride on Sunday. Didnt tell DH I still had suspicions about it as just really really wanted to ride and then re-assess if it hurt. I did about 55k & 3 big hills. Was nervous abouut climbing out of the saddle as that wasn't pleasant in spin classes. Was OK.

Cannot highly enough recommend spin classes if you are off the bike. I climbed better than I did before the fall & could have ridden further, but had agreed to not do whole ride.

Now 2 more rides this week & a week skiing for the school holidays next week should bring me back up to my required speed thrills before I return to work!