Yet Another Cycling Forum

General Category => The Knowledge => Health & Fitness => Topic started by: rob on October 30, 2018, 03:35:42 pm

Title: Something broken in hand ?
Post by: rob on October 30, 2018, 03:35:42 pm
I had an off just under 3 weeks ago landing on my right side.  The majority of the issues have subsided but I am left with a painful wrist/hand.

The day after the accident I went to A&E and was told it was a sprain (by 2 people).  I’m now some time down the line but still in a lot of pain.  I did a 200k on Saturday but couldn’t ride out of the saddle.  The pain is mostly along the back of the hand and hurts when braking, opening doors, undoing screw caps, etc.   The pain is in the wrong place for a scaphoid break.   I consulted a web doctor and he told me to go back and get x-rayed, big we’re on holiday at the moment.   

I’ve managed to book an early boat back and will get checked out on Friday morning.

Anyone had anything similar ?
Title: Re: Something broken in hand ?
Post by: hatler on October 30, 2018, 03:43:04 pm
A GP friend was knocked off his bike and only by his insistence that something 'wasn't right' was the underlying problem picked up.

It involved a ligament he'd never even heard of which, if left unattached, would have resulted in permanent instability of the hand in about five years.

His take away from that was that hands are complex things and the best person to diagnose a hand problem is, surprise surprise, a specialist
Title: Re: Something broken in hand ?
Post by: hellymedic on October 30, 2018, 06:52:20 pm
I think that's right.

You need an expert to listen, look, see, feel and image your hand.

FWIW my partner had wrist pain after a forced off many years ago. It was diagnosed a a problem with the the triangular ligament by the consultant he saw, I don't think he had any specific treatment.
Title: Re: Something broken in hand ?
Post by: Ham on October 30, 2018, 08:07:28 pm
3 Weeks ago? if it isn't getting better there's summat not right.

Adding to panoply of potential injuries, I managed to fracture a bone in my palm once. nothing that could be done, but only picked up some weeks after when I whinged.
Title: Re: Something broken in hand ?
Post by: gibbo on October 31, 2018, 09:55:56 am
I'm no expert in the medical sense but have broken my left radius, right scaphoid and right carpal(s). All of these were initially put down to sprains but after several weeks of continued pain, a hospital revisit and subsequent x-ray they were deemed to be broken after all. Each time I was told that analysis of the x-rays are difficult early on after the break because of the initial swelling.

My last break, the radius, in fairness they did suspect to be broken so they actually did a MRI scan to verify but again didn't do it immediately and waited a few days for the swelling to go down.

For what it's worth I'd go back for a second opinion.

Gibbo.
Title: Re: Something broken in hand ?
Post by: Oaky on October 31, 2018, 10:10:23 am
I had an off where I fractured my triquetrum, which caused very similar symptoms. 

Treatment choice was a cast or a wrist splint.  I opted for the latter.  I was doing light cycling maybe a month after and first "proper" ride 7 or 8 weeks later.  I think there was still some low-level discomfort at that time.
Title: Re: Something broken in hand ?
Post by: hatler on October 31, 2018, 10:31:05 am
My GP mate had another fracture experience, this time a foot as a result of a footballing injury.

He told A&E that he thought he had broken his second meta-tarsal. The A&E doc pinned up the x-rays and declared that there was no fracture there. He was right. The fracture was in the third metatarsal, but he didn't spot that on a first pass.

Treatment determined and a follow up visit to the fracture clinic was lined up.

Fracture clinic x-ray (a week later) showed no fractures at all, and Doc there could not be convinced otherwise, despite the amount of bruising and the obvious tenderness of the injury. (My mate's view is that they view the x-rays first and then devise a hypothesis to fit the x-ray, rather than the other way round.)

Outcome from that was that it would be fine in a week or two.

Mate not happy with that and went for a second opinion with a foot specialist. MRI scan revealed that both second and third metatarsals were broken.

Moral of story - get a second opinion from a specialist.
Title: Re: Something broken in hand ?
Post by: sojournermike on October 31, 2018, 04:04:07 pm
A few years ago our oldest bent her finger backwards when she failed to catch a netball. GP is over the road and saw her as we walked in, saying he thought might well be fractured and to go for an x-ray. That was clear, so 3 days later she sat her grade 4 piano (distinction). A week later we had a letter from the hospital advising that a second review of the imaging revealed a fracture. Hey ho, she’s lived out on that one for a few year!

Mike
Title: Re: Something broken in hand ?
Post by: hellymedic on October 31, 2018, 04:33:12 pm
I would be concerned about a possible volar plate injury to a finger that had been forcibly 'bent back' but I'm no hand expert and never saw your daughter.
Title: Re: Something broken in hand ?
Post by: sojournermike on October 31, 2018, 05:20:06 pm
I would be concerned about a possible volar plate injury to a finger that had been forcibly 'bent back' but I'm no hand expert and never saw your daughter.

Never heard of that one. It’s a few years ago, but early arthritis wouldn’t be good given she wants to be a musician.

I’ll look it up thanks!
Title: Re: Something broken in hand ?
Post by: hellymedic on October 31, 2018, 05:25:42 pm
The volar plate is a fairly critical structure on the palmar aspect of proximal interphalangeal joint. It prevents the joint bending back and dislocating, while allowing smooth flexion.
Title: Re: Something broken in hand ?
Post by: rob on November 02, 2018, 12:49:28 pm
Fractured scaphoid.   There you go.
Title: Re: Something broken in hand ?
Post by: hatler on November 02, 2018, 12:52:23 pm
Oooo. And that needs fixing. Another friend ignored that for six months and now he needs a bone graft off his hip. I think you have six weeks to get it fixed or the broken bit dies.
Title: Re: Something broken in hand ?
Post by: rob on November 02, 2018, 01:05:22 pm
Just a fracture and it’s starting to heal already, hence a splint and not plastered.

Back to the fracture clinic on the 14th.   Turbo work only for a while, at least.
Title: Re: Something broken in hand ?
Post by: hellymedic on November 02, 2018, 01:58:11 pm
Hope you mend well, rob!

There are two rows of little carpal bones in the wrist. The scaphoid is in both and is the only rigid 'bridge' between the 'front' and 'back' rows, so it tends to crack  if there's excessive shear between these rows.

To complicate matters, it has a rather fragile blood supply and good circulation is needed to ensure healing. A fracture can sever the vessel that supplies the bone, resulting in 'death' of a fragment.

But yours is apparently healing, which is good news.

I am still paranoid about the scaphoid, as I posted on Facebook...
Title: Re: Something broken in hand ?
Post by: woollypigs on November 02, 2018, 02:32:16 pm
ermm something wrong with the matrix .... cause no one asked how is the bike ! :)


GWS
Title: Re: Something broken in hand ?
Post by: hellymedic on November 02, 2018, 02:53:31 pm
Rob was too restrained to answer questions about the offending dog's wellbeing elsewhere.

Canine encounters seldom damage bikes much...
Title: Re: Something broken in hand ?
Post by: quixoticgeek on November 02, 2018, 06:55:56 pm
ermm something wrong with the matrix .... cause no one asked how is the bike ! :)


And given the medical knowledge, and a discussion of the wrist and hand, I'm surprised noone's mentioned some lovers try positions that they can't handle...

Get well soon Rob!

J
Title: Re: Something broken in hand ?
Post by: rob on November 02, 2018, 07:17:46 pm
The bike needed the front wheel trued.  New Brooks has a scrape and the bad tape needs a patch.

From general reading I suspect PBP will be fine.  I’m not so sure about goals for earlier 2019.

QG - filth....
Title: Re: Something broken in hand ?
Post by: quixoticgeek on November 02, 2018, 07:26:14 pm
The bike needed the front wheel trued.  New Brooks has a scrape and the bad tape needs a patch.

From general reading I suspect PBP will be fine.  I’m not so sure about goals for earlier 2019.

Eep! Hope you're healed enough for RatN!

Quote

QG - filth....

Observation or request?

Find me a better way of remembering the bones in the wrist...

J
Title: Re: Something broken in hand ?
Post by: rob on November 02, 2018, 08:00:06 pm
I’m going to wait and see what my recovery looks like.

I wouldn’t want to turn up at a race not able to give it everything, particularly if it includes time away from home and using up annual leave.
Title: Re: Something broken in hand ?
Post by: Wowbagger on November 02, 2018, 08:26:16 pm
A few years ago our oldest bent her finger backwards when she failed to catch a netball. GP is over the road and saw her as we walked in, saying he thought might well be fractured and to go for an x-ray. That was clear, so 3 days later she sat her grade 4 piano (distinction). A week later we had a letter from the hospital advising that a second review of the imaging revealed a fracture. Hey ho, she’s lived out on that one for a few year!

Mike

That's very interesting.

I suffer from "palindromic" rheumatism, a subdivision of rheumatoid arthritis. Most days I'm fine (methotrexate is a wonderful drug) but every so often I get pain in the smaller joints. These days it's almost exclusively in my hands and wrists.

I have found that swollen, painful fingers are scarcely any impediment to piano playing, but they hurt like hell when trying to lift a kettle. I had some pain and swelling in my left wrist earlier in the week, and piano playing did make that hurt.
Title: Re: Something broken in hand ?
Post by: rob on November 05, 2018, 08:53:29 pm
Bit more investigation work ongoing.  Hand in a splint.   Bit of turbo training going on.
Title: Re: Something broken in hand ?
Post by: Wowbagger on November 05, 2018, 10:28:00 pm
Hope it isn't too painful and that they find out soon what the problem is.
Title: Re: Something broken in hand ?
Post by: rob on November 07, 2018, 02:43:40 pm
I have my MRI on a DVD ROM.   No idea what I'm looking at but it's distracting us all from work for a while.
Title: Re: Something broken in hand ?
Post by: woollypigs on November 07, 2018, 02:50:55 pm
yup me too a full body MRI. It does prove that I got a brain, well ok some sort of mass in my head and yes it does not prove that I know what to do with said thing.
Title: Re: Something broken in hand ?
Post by: ElyDave on November 07, 2018, 02:53:27 pm
I got to have a look at my lower spine, elbow and pelvis yesterday.

All reassuringly bony and well aligned. Only the small matter of a chip in the pelvis
Title: Re: Something broken in hand ?
Post by: simonp on November 07, 2018, 04:35:30 pm
When I broke mine it was examined the next day.

Just a sprain. Got see your doc if it doesn't improve in 7 days.

It had improved, was just a bit of an ache. But it didn't improve further so I went to see the doc and he did the snuff box thing and off I went for x-ray which confirmed scaphoid was in two pieces and distal end had rotated 90 degrees in the intervening time during which I was still cycling.

On goes the cast, consultant decides surgery to correct the misalignment not worthwhile, and 6 weeks later it's all healed.

Still cycling during that time - I postponed my driving test.

When I injured my wrist (strain/tear to the TFCC) last year I had an MRI after it wasn't improving. This showed a perfectly healed scaphoid and no sign of any arthritis subsequent to the fracture. I'd had some pain on the scahpoid side of the wrist and it turned out I had as well as the TFCC injury a ganglion between scaphoid and lunate which was probably causing that pain.

I have heard of a few tales of people needing bone grafts after untreated scaphoid fractures, so well done for getting it reassessed.
Title: Re: Something broken in hand ?
Post by: rob on November 08, 2018, 10:03:40 am
I'm waiting for feedback from yesterday but the early look from the X-ray showed what looked like a fracture of the scaphoid, but also a couple of cysts growing on it.   Early call back from the first hospital also referred to 'lesions' which needed investigating further.   This could be what is causing the pain.   I was also asked if I had broken it before but I have never been told this, although I have fallen off bikes a few times in my life.

Early indications were that surgery was 'probably' not required but that does make me wonder if a cyst just disappears as the bone heals.
Title: Re: Something broken in hand ?
Post by: rob on November 09, 2018, 03:30:03 pm
Now in a cast.
Title: Re: Something broken in hand ?
Post by: hellymedic on November 09, 2018, 04:35:34 pm
Gone are the days when a scaphoid cast encased half the thumb...
Title: Re: Something broken in hand ?
Post by: rob on November 12, 2018, 10:58:58 am
MRI report makes for  interesting reading :-

- occult fracture of the capitate
- impaction fracture of the volar tubercle of the trapezium
- unsufficiency contusion of the distal scaphoid
- synovitis of the dorsal carpus

I make that 3 'breaks' with some additional swelling ?

Still I'm learning a lot.
Title: Re: Something broken in hand ?
Post by: rob on November 23, 2018, 06:27:03 pm
Now in a cast.

2 weeks down.   Sounds like 4 weeks to go.
Title: Re: Something broken in hand ?
Post by: woollypigs on November 23, 2018, 07:07:03 pm
Got some cool autographs ?
Title: Re: Something broken in hand ?
Post by: hellymedic on November 23, 2018, 08:17:24 pm
Modern resin casts are very difficult for creative artists to embellish... :(
Title: Re: Something broken in hand ?
Post by: woollypigs on November 23, 2018, 09:33:12 pm
well that is me going breaking body parts :)
Title: Re: Something broken in hand ?
Post by: rob on November 23, 2018, 10:40:00 pm
Got some cool autographs ?

If I let people at work at it someone would have drawn a cock on it by now.
Title: Re: Something broken in hand ?
Post by: woollypigs on November 24, 2018, 11:42:03 am
Got some cool autographs ?

If I let people at work at it someone would have drawn a cock on it by now.
Well do have a thread for that :)
Title: Re: Something broken in hand ?
Post by: ElyDave on November 29, 2018, 01:06:08 pm
THREAD HIJACK ALERT

I'm having some pain in my right wrist, for a couple of weeks now. Down the ulnar side, point tenderness around the head of the ulna, and other knobbly bits there and down the back of the hand along the metacarpal. 

It's post my accident, and it's on the RHS, where I was hit from the left.

Thoughts are either
1) fracture that was not immediately obvious, due to me holding handlebars and handlebars being wrenched?
2) tendonitis, or other RSI from walking with the stick being held in my right hand?

Worth getting it looked at?
Title: Re: Something broken in hand ?
Post by: mrcharly-YHT on November 29, 2018, 01:07:31 pm
It is probably a combination of strain from accident and unusual stresses imposed from using a stick.
Title: Re: Something broken in hand ?
Post by: rob on November 29, 2018, 01:13:12 pm
Did you land on your right hand ?   I wasn't sure that I had, and it's all a bit blurry, but I must have given the injuries.

My experience (now) says go and get it checked.
Title: Re: Something broken in hand ?
Post by: ElyDave on November 29, 2018, 01:28:41 pm
I landed on my LHS, elbow and hip mostly hence massive elbow swelling and bruising adn pelvis fracture on the left.

Handlebars took a big clout as well, so I'm wondering whether there could have been sufficient force transmitted through that way - can't remember any direct impact, but I was likely to have been holding the bars at the time.

I have a fracture clinic appt next week, could raise it there I guess.
Title: Re: Something broken in hand ?
Post by: rob on December 13, 2018, 11:06:41 am
My cast comes off Monday afternoon - it is getting a little minging to be honest but nearly there.   There's the odd bit of pain particularly when turning the hand (keys, taps, can openers).

I'll have an X-ray and a follow up consultation.   The company changed insurers on the 1st Dec but it seems to have all be handed over OK.

At the moment I have no real expectation of how much I'll be able to ride.   I suspect the hand will be weak and I'll need to mix and match the turbo and road.   This is starting to put RAtN on 1st May in doubt but getting to PBP in Aug should be fine.
Title: Re: Something broken in hand ?
Post by: ElyDave on December 13, 2018, 11:13:11 am
Good luck with it. Similarly I've got long range goals for August, and it's a matter of building between now and then.

What is clearly coming through in my case is that it's the soft tissue damage that restricts more than the fracture aka my back is still fu@ked despite the pelvic fracture healing well.
Title: Re: Something broken in hand ?
Post by: rob on December 13, 2018, 11:27:00 am
Yeah my right hip has needed some work.   The left had started to compensate on the turbo.   My existing physio is used to me and stretches seem to be alleviating the issue.
Title: Re: Something broken in hand ?
Post by: DuncanM on December 13, 2018, 12:28:00 pm
Yeah my right hip has needed some work.   The left had started to compensate on the turbo.   My existing physio is used to me and stretches seem to be alleviating the issue.
Which stretches? My right hip is playing up - I think it's a combination of compensation from when my foot was screwed (and it's still not better) and my driving position. Hurdle stretch seems to work OKish, lunge stretch is meh.
Title: Re: Something broken in hand ?
Post by: rob on December 13, 2018, 12:57:45 pm
Yeah my right hip has needed some work.   The left had started to compensate on the turbo.   My existing physio is used to me and stretches seem to be alleviating the issue.
Which stretches? My right hip is playing up - I think it's a combination of compensation from when my foot was screwed (and it's still not better) and my driving position. Hurdle stretch seems to work OKish, lunge stretch is meh.

I would google piriformis stretches.   Basically lots of stretching by pulling the legs over to one side so the pull is across the hip and down the ITB.   In cycling you work permanently in a vertical plain - even more so on the turbo - so you lose side to side mobility.   Pilates includes a lot of hip rolls and mobility exercises side to side which have really helped.
Title: Re: Something broken in hand ?
Post by: rob on December 17, 2018, 09:16:12 pm
Hand out of cast and back into splint.   It felt very weak just after taking it off so I wasn’t at all surprised to be told I couldn’t get back on my bike.   The capitate seems to be more of a problem than the scaphoid.

I have a CT booked for 2nd Jan and a follow up appointment a week later.  It didn’t help that my company changed medical insurer while I was in the cast but it all seems to have transferred over OK.

I would say that the takeaway from this is that no matter how innocuous your crash may have been it can have quite a knock on.  Next years plans are being adjusted.
Title: Re: Something broken in hand ?
Post by: hellymedic on December 17, 2018, 10:49:49 pm
I would say that the takeaway from this is that no matter how innocuous your crash may have been it can have quite a knock on.  Next years plans are being adjusted.

This, in spades.

The hand is a VERY complex thing and has much clockwork crammed into a small volume.

Not all significant injuries are immediately apparent.

Hope your onward recovery is smooth and you have a good festive season, rob.
Title: Re: Something broken in hand ?
Post by: rob on January 10, 2019, 09:57:27 am
12 weeks from the crash and the scaphoid and capitate have healed.   I'm about to start some physio so will continue to recover steadily.