Recovery - Broken Wrist

Alpha_7

Cannon Fodder
So looks like I have a broken wrist (pending some further x-rays). I was wondering if anyone else has had a similar injury and can relate what their recovery time was like and how they went back on the bike afterwards ?

I've got a more senior mate nearing 50 and he came back to cycling too soon he says and re-injured his wrist causing even further downtime so I guess I won't want to rush back but at the same time it's killing me to think how long I might be out of action.
 

Mywifesirrational

I however am very normal. Trust me.
Time of healing basically depends on the type of fracture, the extent of the trauma (especially to ligaments around the wrist), your general health and fitness and a bit of luck.

I have broken mine 3 times(x1 radius, x1 scaffoid, x1 ulna+radius), each time healing time was quite different, ranging from 4-16 weeks (mild radius vs scaffoid).

As a general rule it's 6 weeks minimum, yes you can ride earlier than that but the stresses of riding onto the fracture site + the chance of a fall make this a dubious proposition. The Dr/Surgeon/Radiologist will make the best decision and err on the side of caution.

Best thing you can do in this period is get on a wind trainer of some sort, that requires no loading of the limb. Also to reduce the amount of strength lost in the broken wrist, strength train the good limb, as crazy as that sounds, it minimises contralateral loss of strength. Which will speed up rehab / return to normal strength once a cast is removed.
 

shirtz

Likes Bikes and Dirt
what he said. ^^^ i did my scaphoid, waited to heal naturally for months, didnt happen then got an op and it still took months. still never the same. take your time, do reasech and get second opinions.
 

Bryce88

Likes Dirt
Tips to maintain weight with broken wrist

Bit of a grave dig here but... I just fractured my wrist (radius) yesterday and had a cast put on today, I already know im basically done for riding for the next 8 weeks which is terrible but what I am more concerned with is my weight.

I'm a hard gainer and not being able work my upper body at the gym will be a nightmare as I lose weight extremely easy. Is their anyway to help minimise muscle loss and maintain weight over the next 8 weeks or should I just accept the fact that I will have to start all over again?

Thanks in advance.

Best thing you can do in this period is get on a wind trainer of some sort, that requires no loading of the limb. Also to reduce the amount of strength lost in the broken wrist, strength train the good limb, as crazy as that sounds, it minimises contralateral loss of strength. Which will speed up rehab / return to normal strength once a cast is removed.
Just read that too. Good advice as per usual MWI
 
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eyes

Likes Bikes and Dirt
Bit of a grave dig here but... I just fractured my wrist (radius) yesterday and had a cast put on today, I already know im basically done for riding for the next 8 weeks which is terrible but what I am more concerned with is my weight.

I'm a hard gainer and not being able work my upper body at the gym will be a nightmare as I lose weight extremely easy. Is their anyway to help minimise muscle loss and maintain weight over the next 8 weeks or should I just accept the fact that I will have to start all over again?

Thanks in advance.



Just read that too. Good advice as per usual MWI
Maintain excercise/weights on your opposite side - proven to reduce muscle mass loss on the injured side due to body's ability to maintain symmetry to a certain extent.
 

Leeroy Davies

Likes Bikes
Maintain excercise/weights on your opposite side - proven to reduce muscle mass loss on the injured side due to body's ability to maintain symmetry to a certain extent.
i fractured my scaffoid in march this year, spent 12wks in fiberglass cast due to some dodgy doctoring. came out of fiberglass the 1st june, specialist said im good to go 4 weeks later dodgy doctor said i need a bone graph op.spent most of winter riding my bike and the odd day snowboarding, have been riding thredbo dh most days since it opened for the bike season but took a few wks to get back into the swing of things. still a lil bit tender but still waiting for my op which wont be till march next year hopefully
 

driftking

Wheel size expert
Bit of a grave dig here but... I just fractured my wrist (radius) yesterday and had a cast put on today, I already know im basically done for riding for the next 8 weeks which is terrible but what I am more concerned with is my weight.

I'm a hard gainer and not being able work my upper body at the gym will be a nightmare as I lose weight extremely easy. Is their anyway to help minimise muscle loss and maintain weight over the next 8 weeks or should I just accept the fact that I will have to start all over again?

Thanks in advance.



Just read that too. Good advice as per usual MWI
with the cast on there are exercises you can do talk to the physio or dr about what is acceptable and what is not. I did my radius 3 times, each time was a good 6weeks in cast. The good thing is out body has its natural composition and also muscle memory so the lose muscle will be regained at a faster rate than when you first tried to put it on. The longer you have had your muscle the quicker it should return, If you just finished a bulk then you would suffer more compared to someone who has had the same muscle size and density for 10years.
no doubt mwi will be on to disprove or prove some of these comments. I have a feeling muscle memory will be a point of discussion.

Maintain excercise/weights on your opposite side - proven to reduce muscle mass loss on the injured side due to body's ability to maintain symmetry to a certain extent.
This is true but very minor I believe its only about a 5% gain, in terms of maintenance ability im not sure how much it will do but the evidence is there so defiantly work the other side.
 

eyes

Likes Bikes and Dirt
And I forgot to say, yes I am well experienced on the matter with 6 breaks in arm/wrist/hands, all seperate events.

driftking - yes it is minor, however the number is more like 25% for maint...
 

pharmaboy

Eats Squid
Just a couple of side points to speed up bone repair

1. Avoid NSAIDs for pain - so no ibuprofen , stick with paracetamol (NSAIDs interfere with bone regrowth)

2 cardiovascular exercise is good for repair - causes more blood flow which equals faster recovery times
 

driftking

Wheel size expert
And I forgot to say, yes I am well experienced on the matter with 6 breaks in arm/wrist/hands, all seperate events.

driftking - yes it is minor, however the number is more like 25% for maint...
cheers, wondering if you have any studies on maintenance of muscle mass for this topic. Curious to see the actual results from studies. They intrigue me :)
 

knob scortcher

Likes Dirt
i fractured my right wrist it took about 4-6 weeks to heal. once the cast was off i had to wait another 4 weeks before i could do any sports. but i was naughty and went riding while my cast was still on.

DONT ride with a broken wrist.
 

Mywifesirrational

I however am very normal. Trust me.
Maintain excercise/weights on your opposite side - proven to reduce muscle mass loss on the injured side due to body's ability to maintain symmetry to a certain extent.
Nope, certainly not proven, but the theory / mechanism look promising. It's got nothing to do with symmetry, but bilateral cortical activation of the motor cortex during a unilateral contraction.

with the cast on there are exercises you can do talk to the physio or dr about what is acceptable and what is not. I did my radius 3 times, each time was a good 6weeks in cast. The good thing is out body has its natural composition and also muscle memory so the lose muscle will be regained at a faster rate than when you first tried to put it on. The longer you have had your muscle the quicker it should return, If you just finished a bulk then you would suffer more compared to someone who has had the same muscle size and density for 10years.
no doubt mwi will be on to disprove or prove some of these comments. I have a feeling muscle memory will be a point of discussion.
This is true but very minor I believe its only about a 5% gain, in terms of maintenance ability im not sure how much it will do but the evidence is there so defiantly work the other side.
Haha, I will indeed, well not so much disprove because you guys are kind of on the right track, but clarify.

There is no such thing as the muscle memory, its a stupid body building term they use to explain something they don't understand. Muscles don't have any necleus's (clusters of synapsing neurons) so they don't have any memory. They do get greater capillirisation from training which hangs around in a detrained state and satilite cells that support the nervous system also hang around in a detrained state. So when you retrain you physically already have some the the 'physical' adaptation there, so it shortens the time it takes for strength to return. Automatic fail in neuroscience if someone puts down muscle memory in the exam.

Secondly, muscle atrophy is not a significant factor in short term strength loss (unless you are massive body builder on the juice going cold turkey), neural factors account for the vaste majority of strength loss over 3-6 weeks (papers report this to be as high as accounting for 85% of the strength loss). Basically you motor cortex gets lazy at recruiting the muscle. We see less activation (more muscle at rest during a maximal contraction), greater cocontraction between agonist and antagonist, lower rates of force development - loss of power (ie. muscle twitches do not summate effectively), reduced coordination of synergists and various other things I can't think of late at night.


And I forgot to say, yes I am well experienced on the matter with 6 breaks in arm/wrist/hands, all seperate events.
driftking - yes it is minor, however the number is more like 25% for maint...
I also have some experience with bone fractures (I have broken 11 so far) and orthopaedic rehabilitation and am currently half way through a PhD in this very topic. The next sections is bits and pieces from my thesis - it's already published so I am not fussed about plagarism and all that shit.

Cross education is defined as a unilateral resistance training stimulus that results in a strength increase in both the trained muscle group and untrained contralateral homologous muscle group [1]. Whilst an interesting phenomenon that was first observed in the 1800’s [2], until recently the potential of cross education had not been exploited. There is emerging evidence to suggest that in times of immobilisation, specifically casts and slings, that the cross education phenomenon can attenuate strength loss in the immobilised non-trained limb [3-5]. However, a significant limitation to this research is that it has only been conducted in healthy participants without any underlying pathology. Therefore, there is a need to extend these interesting and important findings into a relevant clinical population.

Carroll et al. [60] updated the previous meta-analysis [59] and pooled data from 3 more recently published studies and showed a mean strength improvement to the homologous muscle group on the contralateral limb was a 7.6% improvement and a transfer of 52% of the strength gains made by the trained muscle group. this is over a three to four week period in which they only trained the one limb

Until recently, the cross education phenomenon, whilst fascinating to researchers, had not been exploited to its full potential. A recent study has shown that during times of single limb immobilisation, strength and muscle loss can be attenuated during a three week period by training the free or non-immobilised limb [3]. This finding has since been replicated in two recent publications [4, 5]. Whilst limb immobilisation is considered a safe an effective therapy, it is well documented that it results in a rapid and significant loss of strength [73-75], muscle CSA during a prolonged duration [74, 76, 77] and function [78, 79].

It appears that the initial rapid loss of strength (<3wks) is primarily neurological in nature due to the influence of CAD [80, 81] with minimal muscle atrophy observed [81-83]. Underpinning this initial loss in strength includes; a reduction in motor unit firing rates [73, 75] which leads to a reduction in the rate of force development [84]. As the time of immobilisation increases, atrophy becomes the dominant factor (>4wks) [76, 77], with a loss of CSA resulting in a reduction in muscle fibre pennation [77, 85, 86]. Although cross education research has shown promising results in attenuating these mal-adaptations due to limb immobilisation, it is unclear if cross education will have the same benefits in an underlying pathology resulting in CAD due to AMI.
CAD is central activation deficits, which is your central nervous systems inability to contract a muscle

So over a three to four week period cross education completely attenuates strength loss by 100% (when we took people out of there castes and slings after three weeks the immobilised arm was actually stronger than before!! but only by about 4% so it wasn;t significant) But this has only been shown in healthy subjects immobilised to mimic injury - actual injury has a lot more occuring in the nervous system that may make cross education not work - who knows?

cheers, wondering if you have any studies on maintenance of muscle mass for this topic. Curious to see the actual results from studies. They intrigue me :)
I've got 67 papers on the USB specific to this topic, but these are probably the most relevant ones. If you want more reading yell out (can email papers if you cannot retrieve them).

These are the papers that have looked at the attenuation of strength loss.
3. Farthing, J.P., J.R. Krentz, and C.R. Magnus, Strength training the free limb attenuates strength loss during unilateral immobilization. J Appl Physiol, 2009. 106(3): p. 830-6.
4. Magnus, C.R., et al., Effects of cross-education on the muscle after a period of unilateral limb immobilization using a shoulder sling and swathe. J Appl Physiol, 2010. 109(6): p. 1887-94.
5. Pearce AJ, H.A., Bowen WB, Kidgell DJ, Corticospinal adaptations and strength maintenance in the immobilised arm following 3-wks unilateral strength training. Scandinavian Journal of Medicine and Science in Sports, 2012.

These explain the phenomenon of cross education
Zhou, S., Chronic neural adaptations to unilateral exercise: mechanisms of cross education. Exercise and sport sciences reviews, 2000. 28(4): p. 177-84.
Munn, J., R.D. Herbert, and S.C. Gandevia, Contralateral effects of unilateral resistance training: a meta-analysis. Journal of applied physiology, 2004. 96(5): p. 1861-6.
60. Carroll, T.J., et al., Contralateral effects of unilateral strength training: evidence and possible mechanisms. Journal of applied physiology, 2006. 101(5): p. 1514-22.


Just a couple of side points to speed up bone repair

1. Avoid NSAIDs for pain - so no ibuprofen , stick with paracetamol (NSAIDs interfere with bone regrowth)

2 cardiovascular exercise is good for repair - causes more blood flow which equals faster recovery times
This is the only thing I wholly agree with from the post tonight! good advice, I'd also suggest looking at a calcium supplement as well in regards to fracture healing (have a chat to the Dr, Surgeon or dietetics, they'll know if it helps) - it probably only works if you are lacking calcium in your diet in general.
 

Bryce88

Likes Dirt
Update

Thanks for the advice everyone, it is much appreciated.

Had a check up yesterday, Doc is worried that the radius will displace (although he said "it currently is in a good position") so I have to be in a sandwich cast until friday 28th and have more xrays. If it displaces I'm up for surgery, so I'm trying to be extra carefull this week to try and help minimise any chances of that happening. Fingers crossed! Although I'm a bit worried already as sometimes small movements of my arm are causing the wrist to jar and crack as if its not sitting in place correctly.

An early Merry christmas to everyone (if the world doesn't implode or whatever it's suppose to do :peep:) I'd say I'm done on RB for a while.

Bryce
 
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