A Broken Humerus — Road to Recovery

Maddie Wirthman
Aug 28, 2017 · 18 min read

I recently fractured my left humerus and found that reading humerus fracture recovery blogs has been helpful in anticipating the healing process. A broken humerus is fairly uncommon, but quite debilitating and information online is limited, so I’ve decided to write about my journey in hopes that it will help others in this unfortunate situation. I’ll also include survival tips that I learn along the way.


The Accident

On Saturday, August 6, 2017, I slipped and fell down a staircase. Upon standing up, something in my left arm felt off. My partner instantly knew that I’d seriously hurt myself. I was in shock, so wasn’t in much pain at first. The top of my arm felt disconnected from the bottom, so I held onto my forearm for support in a taxi to the public hospital. We went straight to the emergency department admissions window. I sat down and as the nurse told us that it would probably be a bit of a wait, I looked down at my arm, which was three times it’s normal size, and the shock subsided. I was in excruciating pain and started crying hysterically. The nurse finally realized how serious the injury was and admitted me. I was given a morphine drip to help with the pain.

My fractured left humerus

An x-ray revealed that my left humerus was badly fractured (spiral) in four places and the doctors said surgery would be needed as soon as possible. After a few hours, the doctors decided to try to reduce the fracture. I was sedated and the bones were placed back together. My arm was plastered from above my shoulder to my fingers. I spent that night in the emergency room. The next day, an orthopedic surgeon was set to see me and discuss surgery options.

The fracture after reduction

When the surgeon finally arrived, he said he had great news: I wouldn’t necessarily need surgery. The reduction was done so well that the bone was likely to heal on its own in a cast. At the time, this wasn’t what I wanted to hear. I had a trip to Bali and Europe planned in two weeks and didn’t want my arm to get in the way. I was hoping surgery would be a quick fix. After some back and forth with the doctor, he said to sleep on it and we would discuss again in the morning.

I was checked into a room in the hospital with an ocean view, on a floor with other patients with orthopedic injuries. I was hooked up to a PCA (patient- controlled analgesia) pump so that I could control my own pain without waiting for a nurse. When I pressed a button, pain medicine was released into an IV line. I also had an oxygen mask. My arm felt heavy, too heavy to move almost at all. I ended up spending three nights in this room.


Week 1: Acceptance

On Monday, the Orthopedic surgeon returned to discuss treatment options. After much debate, we decided not to go ahead with surgery. He explained that most humerus fractures heal without surgery and because I am young and otherwise healthy, it wasn’t worth taking the risks involved in surgery. These risks include nerve damage and infection. Surgery also meant a massive scar and a second surgery down the line to remove the metal hardware used after the bone heals.The doctor explained that surgery was the internal route of treatment, while casting and rest was the external treatment and the recovery time was similar for both routes. My fracture is spiral, which also increases the odds of healing on it’s own.

I was also told that it was time for a new cast. The massive plaster one was cut off and my broken arm was removed. This was one of the most painful things of my life. A hanging U-Slab Cast was applied meaning my elbow was placed at a 90 degree angle and plaster was applied in a shape around my elbow and up to the top of my cast. The arm was not completely plastered. Some areas only have gauze over them. I’m assuming this is to account for swelling. The idea of the U-slab is that the weight of the cast/ gravity help assure the bone goes back to where it should be. The cast was very bulky and made getting comfortable in any position impossible. I had another x-ray taken and made an appointment with the orthopedic surgeon for a visit in one week.

The bulky U-Slab Cast applied at the hospital

I spent one last sleepless night in the hospital and the next day was cleared to leave the hospital. Emotionally, arriving home was hard. I had a breakdown upon walking in the door. It finally hit me that the road to recovery was going to be long and difficult, physically and mentally. I realized that simple things like doing dishes, making a cup of tea, and cutting an avocado were going to take a great deal of effort and other things like flossing and wearing normal clothes were going to be impossible. Over the next couple days I was able to take my first shower and wash my hair with help. I went on a short beach walk. It was very hard to slow down and attempt to take things day by day. Overall I felt waves of depression and hopelessness.

Top Tips — Adjusting to the U-Cast

  1. Stock up on face wipes, body wipes and dry shampoo. Washing my face with face wash is messy and difficult with one hand. Showering (especially washing my hair) is a big time commitment, which can be postponed by using baby wipes and dry shampoo instead.
  2. Sleep with as many pillows as possible. I‘ve found that sleeping upright is the most comfortable while adjusting to the new cast.
  3. Ice the areas of the arm that are not covered in plaster — this helps reduce swelling especially when trying to fall asleep
  4. Embrace off the shoulder look. The only tops I have been wearing have a looser neckline. I don’t put the sleeve of the broken arm on at all. I have also cut the strap of some couple of tank tops so that I can tie it on, as no sleeve will fit over the bulky cast.

Week 2: New Cast, New Me

I started off the week with my first visit to the Orthopedic Surgeon’s office at 9am. The night before, I realized that my cast was sliding down my arm a fair bit, so I was pretty excited to get my arm into a better, more comfortable, and secure cast (not that any cast is comfortable) and to see if I was still on track to heal without surgery.

I had x-rays taken and reviewed by my doctor. The bones haven’t moved since they were put into the first cast in the emergency room, which is great news and means that surgery is still very unlikely. The doctor was also pretty unimpressed with my clunky cast and attributed the sliding to reduced swelling — which I think is a positive.

A very friendly physio with 45 years of “casting” experience took me into her office to cut off the old cast and create a new one. Cutting off the cast wasn’t painful, but it was pretty creepy seeing my deformed looking broken arm on it’s own. She heated up the plaster and applied it in a “U-shape” from the top of my shoulder down and around my elbow. This part was painful… I screamed at one point. She then carefully wrapped gauze around the whole thing, below my elbow and up to my shoulder and pinned a sling around my neck to keep everything at a 90-degree angle. When it was complete, I was so happy. My arm felt safe, secure, and warm from the plaster. She even gave me a deal — the cast was only $60.

The broken humerus in-between casts

My doctor was happy with the new cast too. He decided that I should keep it on for three weeks. At that point, I will get a custom-made brace (basically two pieces of plastic that clamp together around the humerus). I’ll have another x-ray next week to confirm that the healing is on track. I was instructed to avoid crowds, public transportation and alcohol. I’ve also discontinued using the heavier pain medicine: Oxycontin and Oxycodone. I’m limiting pain medicine to Panadeine Forte before I go to bed.

My physio noticed that I wasn't using my left hand at all and was letting it stay limp. It is important to keep using the hand and wrist. Simple exercises help avoid mobility and strength issues after the cast comes off. I’ve been moving my fingers around as much as possible, creating a fist with my hand and rotating it in circles etc. since then. A stress-ball and shoulder shrugs for shoulder strength are also okay.

I now feel more confident leaving the house with my new cast. I walked to the hair salon around the corner to get my hair washed and ran some basic errands on my own. I have some friends in town, so I’ve even gone to a beach up the coast and a bar with them (I drank hot lemon water).

Feeling happy in my new cast

Mentally, the week has been up and down. The day I got my new cast, I was very happy and energized, but the next day I woke up crying and didn’t want to leave the house at all. Even when I do go out and do ‘normal’ things, I’m very scared that someone walking down the street will bump into the broken arm. Everything takes more time than it used to and I have to give myself some serious pep talks to get out of bed and do activities. Luckily, my company has been very understanding and I haven’t had to attempt my one hour commute to work. I had already put in my resignation before the injury, so will be able to heal without worrying about work. I’ve also had a lot of visitors which helps.

Top Tip — Take Your Vitamins

One of the most common humerus fracture recovery tips is to eat as healthy as possible. Your body needs as many alkaline fruits, leafy green vegetables, nuts, seeds, and proteins as possible — sometimes even three times your normal caloric intake. On top of that, I’ve been taking these vitamins and supplements to support bone and overall health.

  1. Hydrolyzed Collagen (Bone Health)
  2. Calcium + Vitamin D + Vitamin K2 (Bone Health)
  3. Organic, Antibiotic/ Hormone Free Bone Broth
  4. Fish Oil (Joint Lubrication)
  5. Turmeric (Inflammation)
  6. Amalaki (Antioxidant)
  7. Multi-Vitamin (Overall health)
My daily vitamins

Week 3: Tough Times

Even though I’ve been getting more used to my cast and a slower pace of life, this week has been the hardest yet.

On Monday morning, I had an x-ray that showed everything is healing okay. The x-ray was almost identical to the week before. That good news was overshadowed by a great deal of sadness and anxiety. It’s been difficult to accept that I won’t be able to make an of my travels happen until my arm heals. Before the accident, we were planning our move home from Sydney to LA. I had already quit my job, sold my car and started packing up my belongings. This is a major transition period and I had wanted to take advantage of having time off between jobs. Spending my savings on rent, food etc. while sitting around with a broken humerus is not really what I had in mind. I’ve had a few serious breakdowns over the whole ordeal and sleeping has been difficult.

I’ve been keeping busy by reading, going for walks, laying on the beach and listening to podcasts. Even when I plan things with friends, the pain in my arm can unexpectedly get in the way, so I’ve been trying to avoid making plans as much as possible. I’m also not drinking alcohol at all, which makes social situations a bit more difficult.

Top Tip — Avoid Anti-Inflammatory Medicines

Inflammation is a necessary part of the fracture healing process. Anti-inflammatory medicines such as Ibuprofen and Aspirin stop the inflammation needed to clean and re-build bones. This delays the healing process. Tylenol or Paracetomal are recommended instead.


Week 4: Backtracking

On Monday and Tuesday, I was feeling a fair bit of pain around the site of my fracture. I reached out to my doctor who instructed me to get an x-ray ASAP. The x-ray showed that the bones had curved out and weren’t as straight as they had been. I went back to the orthopedic surgeon who removed my cast, pressed the bones back into place and then applied a new cast. This cast feels like the best one yet, but means I’ll have it for an additional week. The x-rays didn’t show any sign of regrowth, which is a bit disappointing as this should be visible at this stage in the healing process.

The fracture before and after my new cast was applied.

Week 5: Business as Usual

No major updates this week. On Sunday and Monday, the fracture site pain returned. I went in for an x-ray to make sure that everything was okay and was able to see the first signs of callusing!


Week 6: Cast off!

After 5 weeks, I finally got the cast off! Once removed, I was fitted for a custom-made plastic brace. The brace is much more comfortable and can be removed for showering. I was given some elbow straightening and shoulder range of motion exercises to work on at home. At this point, my arm only straightened to 70 degrees and bent up to 110 degrees.

After the brace was complete, I got another x-ray which showed that the bones had started to come together. I won’t need another x-ray for three weeks, when the brace should be able to be removed.

X-ray post brace application shows signs of bone growth/ union.
Rocking my new turquoise brace

The next day, I flew from Sydney to Honolulu and then Honolulu to Los Angeles. Flying with the brace wasn’t too awful. Luckily, Hawaiian airlines was very helpful in securing a window seat to protect my broken arm. I placed a pillow on the arm rest and then rested the broken arm against the pillow. Flying would have been tough if not impossible without my partner there to help with baggage, security checks etc. I underestimated how much help I would actually need. My arm got quite swollen during the flight and we had to loosen the brace several times during the journey.

Top Tip — Book Safe Airline Seats in Advance

If flying, make sure to book window seats with your broken humerus closest to the window. I was lucky that these seats were still available, but should have booked seats further in advance. Sitting anywhere else would have been uncomfortable and risky as other passengers could easily bump into it.


Weeks 7–8: Stretching

Much to my dismay, my left arm still does not straighten and my shoulder still feels just as weak as it did last week. I’ve been doing the following exercises as recommended by my physical therapist:

  1. Elbow Straightening: Remove the sling, intertwine fingers and bend elbows up and down as far as possible — slowly to increase range of motion over time.
  2. Twisting the wrist so that palms shift from face up to face down — for both wrist and elbow
  3. Letting arms hang down while leaning forward and moving arms back and forth to increase shoulder strength.

I reached out to my doctor to see if I could remove the sling occasionally. He gave me the go ahead to remove it at night and while at home. I’m hoping that I’ll be able to straighten the arm at my elbow sometime next week.

Top Tip — Buy A ‘Shower Sling’

I purchased a basic sling at the chemist to use specifically for showering. I didn’t want my arm to be hanging free when out of the brace in case it was injured in the shower and this means that my everyday sling doesn’t have to get wet. I also don’t need assistance to shower when I use the ‘shower sling.’


Week 9: More Delays

I did my stretches constantly until my first appointment with a doctor in the US. I even went a little further and was putting my arm above my head.. or well as far as I could and tracing my fingertips up a wall to extend my shoulder range of motion. I had also stopped wearing my sling almost completely in hopes that my elbow would be trained to straighten again. I was expecting to be able to stop wearing the brace completely after this appointment.

The doctor was okay with me not wearing the sling but wasn’t thrilled with the healing so far. She recommended increasing my intake of iron and Vitamin D through supplements and sunshine. She also said that I would need to wear the brace for an additional 4 weeks.

I told my doctor that I was planning on traveling in South America for the next 7 weeks and she was confident that I would be fine to travel. She advised that I avoid bicycles and falling at all costs.

The next day, I went to see a physical therapist. He was happy with my range of motion so far and said that the exercises I was doing were too easy and that I would need to be more aggressive to get my shoulder/ elbow back to normal. He recommended doing the following 2–3 times per day:

  1. Shoulder Pulley: You can buy these devices on Amazon. Put the pulley over a door, sit in a chair with your back to the door and pull over your head for a few minutes at a time.
  2. Rotation Stretch: Stand with the elbow at your side, elbow bent 90 degrees, with palm against doorway, turn body to the right and hold stretch 20 seconds. Repeat for a few minutes.
  3. Elbow stretch: with elbow at edge of table or bed, hold a 1 pound weight (water bottle) in your hang and let arm hang for 1–3 minutes. I also started doing bicep curls with the 1 pound weight immediately to speed up the elbow straightening.
  4. Shoulder Stretch: Lift arm above head and press against a wall
These x-rays meant ANOTHER 4 weeks in the brace :(

Weeks 10–12: South America

At the start of week 10, I hit the road for South America! I was pretty nervous about my arm and being far away from a doctor in case of an emergency, but was getting bored after weeks of rest and decided it was worth the risk.

In the first week, I was in Chile and did A LOT of walking. I found that my shoulder would become very sore mid-day and especially at the end of the day from the walking. I would hold my arm in the way that a sling would support it to alleviate pain. I tried to avoid ibuprofen — which would be my normal go to in this situation — and rode out the pain. I figured that I was probably giving my shoulder a much needed stretch and also helping my elbow straighten.

I also continued to do my new physical therapy exercises 2–3 times per day. This combined with the walking led to my elbow becoming straighter day-by-day and being more comfortable with shoulder movements.

I was still very cautious not to bump into anyone, especially as I had a jacket over my arm at all times and it was almost impossible for anyone to tell that I was injured.

Top Tip: Be a Smart Traveller

If traveling with a broken arm, make sure that you are able to explain that your arm is broken in the language of the country you are visiting. This was essential when asking other passengers to help put my bag in the overhead bin and warning the person next to me not to bump into it on accident.

Luckily, it was still spring in South America, so I was able to hide my arm with a jacket.

Week 13: Uncharted Waters

At the start of the week, I took my brace off for dinner with a friend. I regretted this within the first hour when she got excited and hit my arm when telling a funny story. I hadn’t realized how common the gesture of hitting someone’s upper arm really is from sharing a laugh to getting someone’s attention. I felt like I had to be on high alert at all times.

Later in the week, I took my brace off to go swimming and one night even forgot to put it back on before I fell asleep. But when I woke up, it felt fine, which gave me the confidence to start wearing it less and less, with caution of course.

Sleeping was still uncomfortable and I woke up many times in the night and had to readjust. My shoulder was weak and my arm would sometimes feel crushed in the night.

I was lucky enough to meet a Canadian physical therapist in the Amazon. She had a look at my arm and said that it was indeed almost straight but noticed that it didn’t fold up as much as it would normally. I started working on bending my arm up as well as doing the straightening exercises.


Weeks 14–17: Still on the Road

At this point, my arm was completely straight and I had successfully worn the brace for another 4 weeks, as instructed by my doctor. But, as I wasn’t able to get a new x-ray, I was still worried that if I fell, I could re-break the humerus.

Brace carefully hidden under my windbreaker for high risk activities like hiking in the rain.

I decided to stop wearing the brace except for in high risk situations. I wore the brace on slippery hikes and when driving the motorcycle I needed to get around the tiny Caribbean island where I was staying. I did a sailing trip from Colombia to Panama and wore the brace whenever we were at open sea and the risk of slipping on the boat was high. I also avoided pulling the arm and picking up anything heavy.

I tried kayaking with my arm but realized that it was not yet strong enough to paddle comfortably. Anytime my arm feels off, I stop whatever I’m doing that is making it feel that way. That may seem obvious but a lot of people ignore the signals that their body is giving them, which can cause further injury and could postpone the healing process.


Week 18: Success!

I had both a doctor and physical therapy appointment scheduled for a few days after I arrived back in the US.

I went to the physical therapist first and he was very impressed by my range of motion. The things he noticed were that I couldn’t reach as far up behind my back as I can on the other side and that my arm doesn’t bend up as much as the other side without assistance. My shoulder is also weaker than it should be. He gave me some new exercises and said that going to yoga would likely really help the healing process, but to clear this after my x-ray with the doctor. He was sure that I would be 100% back to normal strength in the coming months.

I had x-rays done and my doctor was very pleased with the results (photos below). Even though from one angle, it doesn’t look as straight as one might expect from a healed humerus, she cleared me for all normal activity including lifting heavy objects and yoga! This was the best news I’d had in a long time!

These are my final x-rays.. all healed!

Week 22: Healing Never Stops

You’d never know that this humerus was broken a couple months ago!

At the time of writing, I am in Week 22. My arm is back to normal, I’ve even gone to yoga. My shoulder still gets sore easily and some shoulder movements (lifting my arm over my head and behind my back) give it a big stretch. I also sometimes get minor aches around my humerus and elbow. It sounds like this is fairly normal though and should go away in the coming weeks. There is a small bump in my arm, but this is not obvious and can only be noticed when running fingers over the fracture site.


One Year Later

Wakeboarding helped confirm that I was completely back to normal!

It’s been a a little over a year since I broke my humerus and wanted to give another update. My arm is completely healed. I went wakeboarding this summer which requires quite a bit of upper arm strength and was about as sore as I always am the next day. I’m also now able to hyperextend my elbow again (so it completely straightens and then stretches a little further), which the doctor and physical therapists said would never be possible.

Thanks for reading my humerus blog! After this was initially posted, a Fractured Humerus Support group was started on Facebook. You can ask the community for any specific questions and will likely be able to find people with similar fracture. Join here.

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