Help: Can't fully pronate my left forearm to ride..

needles

Well-known member
Hey Barf-

Not sure if this goes to riders on the mend or general.

In October on a ride back from Death Valley I picked up a case of recalcitrant tennis elbow. In February I had surgery to fix it. Surgery didn't go quite to plan and I've got a left forearm I can't fully pronate. in other words, sitting at a keyboard I can't put my hand flat on the keyboard. Not great for someone who types all day.

The physical therapist I'm working with suggests grabbing just below the wrist with the right hand and twist left forearm so it learns it can go further. She's suggesting long holds with low force. The problem is I'm now getting symptoms on the right side from grabbing the elbow and holding it for long periods of time.

I'm wondering if anyone might know of a tool that could help me with this. I'm thinking of something like a plastic claw with a lever on it that I could stick my wrist into and gently press the lever with the other hand to twist the left forearm. I've got about 20 degrees to go before I can ride without my elbow sticking out awkwardly.

I've tried an oil filter strap wrench (https://www.acehardware.com/departm...s-and-maintenance/oil-filter-wrenches/8567604) but it grips around the forearm to tightly and shuts off circulation to the fingers.

Does anyone know of a tool that looks like it could wrap fingers around my forearm and exert downward pressure on the radius (larger, inside bone) for 10 to 15 minutes at a time? Or, anyway could talk somebody into fabricating something?

Many, many thanks in advance...

Dan
 

Gary856

Are we having fun yet?
Get a stiff wrist brace (I had one when I broke my left wrist) and clamp your filter wrench over that.
 

berth

Well-known member
Can't you just grab...something fixed (i.e. position your body to where the hand is flat holding, like a bar or something), and then try to "stand up" (for lack of a better word).

What about holding something like a sledge hammer and using its weight to apply tension. With the handle, you can adjust how much torque it applies over time. Would that work?
 

davidji

bike curious
There are braces specifically to increase pronation ROM. Maybe your doctor or PT would prescribe one for you as part of your physical therapy.

Since you mention riding, would you be able to ride in a more supinated poition, e.g. with swept back beach bars?
 

islemann

Re Tired Not Dead
After my left elbow self-destructed, I had reconstructive surgery. Lucky me. No, really, lucky me. I was living in Memphis, TN at the time and the elbow guy was the guy who rebuilds almost all of the MLB pitchers. Even so, the PT was extended over nearly 4 years. I started pronation exercises at about 9 months post surgery. The tools used were various weight hammers from a wee 2oz to a 5lb bruiser, held still and as close to horizontal as 'no-pain!' PT would allow. Every week (as long as I was careful about not over-doing the exercise) I was able to add a couple of ounces to the hammer weight and would start over with my thumb against the head of the hammer. By the end of that week I'd be holding the hammer at the middle of the handle. Rinse, lather, repeat.

Then there was that one time that about 18 months into the PT process that I went for a ride on my clip-ons equipped Triumph Thruxton and nearly biffed because my left elbow collapsed under pressure. But, that's for another 'oh-shit' story.
 
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needles

Well-known member
Can't you just grab...something fixed (i.e. position your body to where the hand is flat holding, like a bar or something), and then try to "stand up" (for lack of a better word).

What about holding something like a sledge hammer and using its weight to apply tension. With the handle, you can adjust how much torque it applies over time. Would that work?

I'm currently doing the same with a regular hammer and what I'm finding is the twist tends to be on the hand side of the wrist where I want to target the other side of the forearm where it ties into the elbow.
 

needles

Well-known member
There are braces specifically to increase pronation ROM. Maybe your doctor or PT would prescribe one for you as part of your physical therapy.

Since you mention riding, would you be able to ride in a more supinated poition, e.g. with swept back beach bars?

hey David, I see that you are in LaMorInda. I am in Walnut Creek. Do you have any recommendations for someone in the area?
 

needles

Well-known member
After my left elbow self-destructed, I had reconstructive surgery. Lucky me. No, really, lucky me. I was living in Memphis, TN at the time and the elbow guy was the guy who rebuilds almost all of the MLB pitchers. Even so, the PT was extended over nearly 4 years. I started pronation exercises at about 9 months post surgery. The tools used were various weight hammers from a wee 2oz to a 5lb bruiser, held still and as close to horizontal as 'no-pain!' PT would allow. Every week (as long as I was careful about not over-doing the exercise) I was able to add a couple of ounces to the hammer weight and would start over with my thumb against the head of the hammer. By the end of that week I'd be holding the hammer at the middle of the handle. Rinse, lather, repeat.

Then there was that one time that about 18 months into the PT process that I went for a ride on my clip-ons equipped Triumph Thruxton and nearly biffed because my left elbow collapsed under pressure. But, that's for another 'oh-shit' story.

Hey Michael,

This is really interesting. What I been concerned about is only getting the stretch on the hand side of the wrist. It appears that the radius and the ulna are frozen in the elbow side of the bone. Will holding a hammer in the pronated position over time stretch the tendons on the Elbow side of the joint?

Dan
 

Frame Maker

Well-known member
... Do you have any recommendations for someone in the area?

Find a new PT. They should have devices for this...

Hi Dan, Are you by chance a Kaiser member? I started PT soon after my deer strike (shattered elbow and broken shoulder). I now have a plates and screws holding my elbow together.

At first I was worried that I'd never be able to eat properly or take care of common bathroom activities. My elbow sustained the worst injuries and for a month or two wouldn't bend past 90 degrees or fully straighten. I wasn't too worried about my shoulder as the injury was clean break that healed well.

Now going on six months, my elbow has almost normal motion, but its my shoulder that is making slow progress. I can now ride (motos and bicycles) normally and day to day activities are no longer an issue. Only thing I have problems with are reaching up over my head (not really something I NEED to do everyday).

Even though your injury is different than mine, I mention this because the process is very slow and you don't always see the progress as its happening. I mention Kaiser, because I'm a member and I love how their PT is set up. I see (when we're not in SIP) a primary therapist once a month, but then rotate between two other therapist during the other visits. This has been amazing because each therapist has a slightly different technique and set of exercises they like. I think this approach has done very well in my case.

On a side note, a friend of mine told me about breaking his elbow years ago in a track crash. For weeks afterwards he would walk around his yard carrying a bucket of water. He started with no water in the bucket then gradually added more water each day. Finally he gained strength and extension with his arm. The idea here is to figure out a devise that you can increase the force in very small increments.

Anyway, be a patient patient and you will get there. Cheers.
 
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berth

Well-known member
It may need to be mentioned that a lot of insurance plans only cover so much PT, but for anything major, it's never enough. The PT is worth maintaining in my experience.
 

Whammy

Veteran of Road Racing
Whammy has been where you are over the years of putting your body back together.
Nothing can be more frustrating than the lack of progress.
Sometimes we have to push just a little harder to get a better result, and sometimes we have to be pushed.
Its a tricky slope to navigate and sometimes there are just bad therapists too.
Try to ease yourself into getting a better result like others have said, without reinjuring yourself.
If you feel your therapist isn't getting you there then it might be time to go outside on your own.
If it were me id pay outta pocket and do my own thing.
There are a good many sports medicine therapy places in the bay, do your homework and choose.
Here is one who might be worth trying.
https://www.tingsportsmed.com/
 
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