To be clear - the recovery is NOT (ever?) over. The orthopedic doctor (Dr. Yu) that is advising me reminded me that most people are not done with increasing their mobility and hand strength for about 1 year post-injury. But 6 months is a good time to check-in and guided physical therapy sessions are over. Now it is all on me to do my self-care and set reasonable targets.
- Life: I have returned all day to day activities. This means turning door knobs, cleaning dishes, scratching my own back, etc. are all things I can do on my own. This is not at all surprising to doctors but is certainly important.
- Fitness: I have returned to doing most recreation activities and exercises. I can ride my road bike for a few hours, put my body weight overhead, deadlift heavy, pull-ups, squats, power snatch, jerks, jump rope, rowing, etc.
- Pain-free: I do not have any random pain that is unaccounted for. If it hurts, I know exactly what I did. I take one 12-h Aleve about every two weeks and continue to ice / heat as necessary.
- Stiffness: My wrist is still stiff. Flexion (bending at the wrist, with arm moving toward top of hand) is still really difficult. When my wrist is cold, this is exacerbated.
- Strength: My right hand grip strength has returned to about 75% of my left (non-dominant) hand.
- Mobility: I cannot do a handstand push-ups but I substitute with dumbbells and do them strict, when I feel like it. I have a hard time with dips - it just hurts and I feel weak, but I am working on it. I cannot do a full clean due to lack of extension in my wrist, but I am working on it. It is the extension movements that are most difficult / painful.
Homework Exercises that I continue to do
- Crawling up the wall with my hand
- "Prayer pose" with my hands together vertically, trying bring my elbows up
- Putting a weight in my hand and letting rest of the edge of a table or counter, palm up (extension) and then palm down (flexion)
- Squeezing objects
Then, after about 6 weeks post-cast, I started working on strength gradually but consistently. This means grip exercises, twisting wrist with weight, etc. At about 8 or 9 weeks I began putting weight over my head, even if it was just 5 kg. Now at 6 months I can put my body weight overhead with almost no pain. Of course I used to be able to do 1 1/2 of my body weight overhead but this should give you some idea of progress for yourself.
Mobility. Mobility. Mobility.
This is important not just at the injury site. Your whole body will become more stiff due to the limited activity with the affected arm(s). Keep moving and learn yoga if possible. Try http://romwod.com/ - this greatly improved my outcome and ability to get moving well again. When you are able to start putting a little weight on your wrist, long holds will do well to improve your range of motion (extended arm lizard, seated and standing straddle, etc.)
Eat clean and don't deprive yourself of nutrients. You may be restricting your diet a bit because you are not moving around as much. But make sure you eat enough protein and fats. I also supplemented with a multi-vitamin, fish oil, and joint supplements (chondroitin, MSM, and glucosamine).
Eating well and working mobility are especially useful when you are still in a cast. These are the two things you can do make a positive impact on your outcome.
Personally, I think whether you are a strength athlete or not, strength training will be critical to long-term recovery. Even if you are not an athlete at all, use this as an excuse to learn about strength training and make a positive / fun change in your life. Strengthening the muscles around your newly modified joint will help support healing.
The key thing is - I worked VERY HARD on mobility with my physical therapist (1-2x per week) through hands-on work for the first 6 weeks post-cast removal. This means my PT actually put a lot of pressure on my wrist and hand (more over time). Each week he pushed a little bit harder until I could push on my own. He started with helping me to supinate by pressing on the forearm (NOT the hand) and then over a few weeks began mobilizing the actual wrist joint.
In my opinion if you go to a PT and they just soak your wrist or hook you up to machines, it is not worth your time. Find someone who is not scared to hurt you a little : ) Also, he gave me homework to work on my own and that is also key. Go hard or go home. Your recovery is your responsibility. Don't wait.
I will post less often in the future but will continue to post photos when I reach a new milestone or learn something new about the injury. Thank you all for your support and continuing to push me. I look forward to 2016.