Recovering From Injury – Lessons Learned
As I mentioned in this post, I broke my hand a few weeks ago.
I wanted to use this as an experience builder when it comes to recovering from injury – I would learn how to approach training when injured and report back the results.
As a personal trainer, I believe there is always a way we can exercise despite injury or inconvenience. This was a chance to practice what I preach.
This post will outline the steps I took when recovering from injury and the lessons learned on the way.
Recovering from Injury
Saturday 5th January 2013.
I fall on a step and land with all of my weight on my hand. I heard a crack but wasn’t sure I had broken the hand as the pain was far less than I have experienced with other broken bones. Some confirmation could be found in the image of my hand – I used to have 4 knuckles, I now have 2!
X-Ray shows a fracture on the 4th metacarpal…
Good news – the break is clean and aligned. Bad news – doctor estimated it would be 8-12 weeks before I was training again and could expect pain for a few weeks afterwards.
Broken Hand Treatment
Initially the Doctor ‘buddy strapped’ my ring and little finger together to prevent movement. In truth it did very little and was a pain to redo every time I washed my hands. After two days I removed the strapping and didn’t put it back on.
I consulted a man called Noel Jensen who has a twitter following and provides some excellent, practical nutritional advice. He suggested I increase my mineral intake to help bone healing – I started taking multivitamins on top of my usual meat and veg-filled diet.
The other change was my consumption of Evian water. The mineral content is very high, so 2-3 litres per day in the acute stages of healing were being drunk! It makes logical sense that this works and even if it only made 1% difference, it’s still an improvement.
On the tuesday after the break, I had a session with Hilary Farrer, a Bowen Practitioner in Stockport. She performed a treatment on my (very) swollen hand…
Remarkably, within 48 hours of the treatment the swelling had all but disappeared and I was back to having a sore but normal-sized hand!
It was now just a question of regaining mobility in the hand and let nature take its course during the healing. I was given a couple of tendon gliding exercises by my girlfriend (a physiotherapist), where I had to lay my hand on a flat surface and lift my hand off, keeping my fingers flat on the surface.
Although this was painful at first, I kept the range of movement to within levels that I could cope with. Basically, I let pain be my guide to how far I could push it.
I kept up the exercises on a daily basis because I didn’t want to lose any range of movement in my hand. I was also taking my multivitamins and drinking my mineral water daily. Another step I took was avoiding alcohol completely as I know that has a dramatic negative effect on recovery.
Within a fortnight I could push my fingers a significant distance without pain. I could also make a fist with only minimal discomfort. The real pain came when I accidentally knocked a finger when I wasn’t concentrating! The unexpected pain was far worse than the tendon gliding pain!
After 3 weeks my girlfriend did some massage to prevent scar tissue build up and help with range of movement. In the early stages this was slightly painful but quickly went away. It also helped to bring back blood flow into the tissue and reduced the size of the lump around the break.
After 4 weeks I could use the pads with my personal training clients during boxing sessions – this was almost pain free. After five weeks it was totally pain free when boxing and I could make a fist with only a tiny amount of pain.
Exercise with a Broken Hand
A key factor for me was exercise. I was unable to grip anything, ruling out most of the upper-body exercises. Push ups were even painful given the pressure on the hand. My legs were fine, but only for exercises that allowed me to carry a weight on my back or perform the exercise using my body weight as resistance.
In addition to the leg work, I could do some basic core work and lots of flexibility stuff. I also wanted to cycle, so managed to get a weekly spin class in which helped me stay active beyond squats and lunges!
My weekly training volume dropped as there is a limit to what your legs can take! I couldn’t squat really heavy as my grip was weak/non existent in my right hand, making the bar feel unsafe and unstable. I managed plenty of lower weight, high rep work and the flexibility work. I probably averaged 3 sessions per week during my recovery.
I could feel my upper body muscle catabolise quickly, and have to work hard to keep a decent level of muscle. Without regular exercise I would deflate pretty quickly!
I started to train my upper body again after around 4 weeks, with lots of grip issues still working against me. I was capable of a few push ups, some TRX work and dips, but anything requiring a good, strong grip was beyond me at this point.
Notably, I have lost SO MUCH strength! I felt weak as a kitten and am still battling on to recover that. I imagine trying to regain strength after 4-5 weeks of not lifting anything with my upper body will prove difficult!
After 5 weeks, I started almost all of my training. I can now bench press, chin up, dip, shoulder press etc without problem. My deadlift is tricky as if I am not in the correct position my hand hurts quickly, so I am relatively self-limiting on those.
I was spending a significant amount of time practicing the Olympic lifts before the injury, and that has had to be put on the back burner for now as the catch position still gives me trouble. Overall though, I am able to train just as I could before the break, with reduced weight!
Weighted chins, trying to get my strength back! This picture was taken 5 weeks and 3 days after the break.
Lessons Learned Whilst Recovering from Injury
Having had an injury that affected my training, I feel like I learned a lot of useful information around the recovery process. I am not going to pretend a broken hand is the worst injury known to man, of course it’s not. It is however a broken bone and it did have a dramatic effect on my ability to exercise, so the lessons hold true for anyone in a similar position.
So, here are the lessons I learned whilst recovering from injury…
- Nutrition is key. Garbage in = garbage out. Eat well, get plenty of vitamins and minerals and give your body the best tools to rebuild you.
- Be proactive. Don’t just wait for the body to repair, help it. Use exercises, massage etc.
- Find out what you are capable of in the gym. I broke my hand, but I could still do other things. Unless you have really done some damage, get into the gym!
- Don’t be a slave to healing times. I imagine there is an element of self-protection in the Doctors advice, so people don’t go back complaining they are still in pain after only 6 weeks. That said, I took steps to help recovery and believe they worked.
- Don’t shy away from using an injury, as long as it is within acceptable pain barriers. I kept testing the hand to see if I could hold a coffee cup etc. As I could do more, I did.
So there is what I learned from my experience. I am now 6 and a half weeks post injury and 95% better. I have been back at almost full training since 5 weeks, when I was told it could be as long as 12 weeks. I don’t think I am blessed with rapid healing powers, I just took the steps to manage my injury and help my body heal itself as quickly as possible.
If you know anyone who is injured or are injured yourself, take these steps and see how you go – my bet is your recovery time will be reduced significantly!
Here is my hand now – 4 months post-break. No pain at all!
Being injured isn’t much fun for anyone – the injured party or those around them, but recovering from injury needn’t just be a waiting game – I wanted to take an active role in speeding my recovery, rather than just letting nature take its course and do the work. My approach significantly reduced the time it took me to recover from the injury and I would suggest others do the same thing going forward.
Recovering from injury needn’t simply be a question of waiting for nature to do the work. You can help yourself – just follow my steps.
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hey man, just broke my hand two days ago and was looking around the web for information, found your blog. how bout a after picture? do you have knuckles again? i lost 2 of mine as well, ring pinky on right hand.
Ah sorry to hear that – I know your pain!
I have just uploaded a pic to this post, taken today. I still don’t have the ring finger knuckle really and it’s unlikely to ever come back. It doesn’t matter though – I basically have full function of it back, and no pain at all!
How did you do it?
Hey man, just recently broke my hand abd got the exaact same thing as you, sunk in at the 4:th knuckle – hand working alright – for daily things? 🙂 Appreciate answer
Hi there!
I don’t have a knuckle there any more, but I have full use of my hand! No problems in day to day life whatsoever! It recovered perfectly – just follow the steps in the post and you will be good to go!
Hey, thanks for the post.
I broke my hand 4 months ago, I got really angry (i’m a very calm person, it took a lot to get to it) and punched a wall like a dumbass. I broke the 4th and 5th metacarpal bones, the 4th one was just like yours, very close to the knuckle. The 5th metacarpal (pinkie) broke in the middle section, I needed surgery for this one, I now have a 4.5cm scar on the back of my hand, a metal plate and 6 screws attached to my bone. Like you said, I didn’t wait for my body to heal itself, i did a lot of exercises every day, I used to plunge my hand into hot water and massage it for about half an hour a day to prevent scar tissue forming. I read that scar tissue can stick to your tendons and compromise your movements if not attended. After 4 months my hand is healed, my pinkie moves fine, no lumps, just the barely visible scar. I lost my 4th knuckle just like you, but no movement impairment so far, the 4th finger was a little “lose” at first, but it’s tightening up nice. I miss my knuckle :,( but my hand is now fine.
Hey Venyton – we all lose our cool sometimes (just maybe next time don’t take it out on a wall!)
I was lucky not needing the surgery, but at least you know it has been fixed properly now.
Glad you did the exercises too – maintaining the range of movement, especially in your hands because they are used all of the time.
Welcome to the missing knuckle club!
I don’t think I broke my hand it doesn’t hurt but I’m still missing 2 knuckles on my right hand
Have you had it checked out by a Doctor, Nate?
I recently in a motorcycle accident also fractured my 4th metacarpal, except my fracture was in my left hand and the fracture was very oblique (angle was acute and ran 1/4 way from the metacarpal head all the way down to the metacarpal base). I asked for surgery, but the orthopaedic surgeon advised against it, saying it would increase the recovery time by several months and there would be little medical benefit, especially since there was minimal displacement and angulation. 7 weeks later, the splint is off, but I’m now starting to regret not having the surgery because my knuckle looks sunken. Did your doctor give you the option to have surgery? If so, how did you come to the decision not to have it? Thanks in advance for your kind advice.
Hi Adrian!
So, the nature of my injury was such that the break was clean – similar to yours, there was no displacement or angulation, so I wasn’t offered surgery, nor would I have taken it even if I was.
If your concern is cosmetic, then I understand it. However, if there was no physiological reason for having the surgery then it’s totally unnecessary and your surgeon is absolutely right, all you would be doing is adding to your recovery time. Just make sure you do plenty of tendon gliding exercises when you feel you can.
I have a sunken knuckle, but it doesn’t affect my hand in the slightest – I’m lifting heavier weights than ever before and can do everything I always could.
Hope that helps!
Steve
Hi, Steve. I broke my left-hand 4th metacarpal in karate brick-breaking practice a few months ago – didn’t properly align the hand to the brick. The splint is now off, but I have a sunken knuckle and a bone callus on the back of my hand. I’ve heard that placing stress on your bone by exercising (e.g. chin-ups) can lengthen the bone. Now 3 years after your fracture, has your metacarpal lengthened and your knuckle risen somewhat? Secondly, did you have any visible bone callus on the back or palm of your hand and did it get smaller with time?
Thanks,
Zach
Hi Zach
Let’s see if I can help…
So, the first point – lengthening the bone. As far as I’m aware, that’s nonsense. Bone isn’t elastic like muscle tissue – it can’t lengthen with stress.
My metacarpal hasn’t lengthened and I still have no knuckle there, which is how it’ll be for life I imagine. It doesn’t matter though, it doesn’t affect me in any way at all – I can still do everything I ever could and more.
The second point – I did have a visible bone callus and it did get smaller. In fact it has gone altogether now.
Is your pain all gone?
Steve
Nice article. 3 weeks ago I also broke 4th metacarpal and I’m also lost my knuckle. It seems that I will get the full funtion of my hand back, but I’m sad about the missing knuckle :(. I guess I still need to assume it.
Hi Thomas!
I understand how you’re feeling, but honestly you just get so used to it – I don’t even notice my missing knuckle now!
Thanks for replying, Steve.
Yes, the pain is gone. Now that I’ve healed up and the inflammation is gone, I can see that my knuckle is sunken by about 3mm. In fact, my hand now looks almost exactly like the last picture of your right hand on this page except that the fracture is on my left hand. in addition, there’s a huge bony callus on the back of my hand that forms a hill about 30mm long and 4mm high.
All the knuckles on the hand are stiff and creaky, but the thing that i notice most is the pressure that the callus exerts on the soft tissue at the back of my hand. I’m hoping that with time, the callus will disappear and knuckle stiffness will resolve.
Zach
Hey i have also a broken hand in CMC and metacarpal bone before 6 weeks ago, now i can mobilize my hand but there is some swelling is remaining and pressure on hand is not bearable and it is painful.how long it will take to heal more? Can you suggest some exercise?
Hi there! Did you have it treated straight away? The 6 weeks sounds a long time for the swelling to still be there, but ask your doctor for some more advice! It’s impossible for me to give advice without knowing much about the problem!
Hope that helps.
Steve
Hello,
Great article I’ve got two sunken knuckles and i’m waiting to recover. How would your injured hand be for boxing? What would happen if you happend to connect with the sunken knuckles?
Thanks
Hello I’ve got 2 sunken knuckles and recovering at the moment. How would your injured hand be for boxing? What would happen if you connected with the part of your hand where the knuckles were?
Hi James!
My hand would be absolutely fine for boxing now – once it’s healed, you’re pretty much good to go!
In the meantime if I were you I’d be focussing on things you can work on – your conditioning, road work, core work etc.
You’ll almost certainly be able to box again though, so don’t worry about it in the long term – just don’t rush back and risk hurting your hand even more. Wait until it’s fully healed.
Steve
Hi James!
My hand would be absolutely fine for boxing now – once it’s healed, you’re pretty much good to go!
In the meantime if I were you I’d be focussing on things you can work on – your conditioning, road work, core work etc.
You’ll almost certainly be able to box again though, so don’t worry about it in the long term – just don’t rush back and risk hurting your hand even more. Wait until it’s fully healed.
Steve
Broke mine in a fight over 30 years ago. Looks identical to yours. No pain or loss of range motion just looks odd. I was young so never even went to the Dr. I got lucky.
Sounds like you did get lucky, Noel!
To be honest once they’d established it was broken, the doctor didn’t do anything, they just checked it was healing OK.
Steve
I broke my 4th metacarpal hiking, embankment sunk under me, hand was behind and I sliced on it down holding my dogs leash. Now on week 7.
My issue has been continuous swelling (back and forth), and nerve pain / spasm / stabbing / tingling / burning / numbing at night.
I get physiotherapy and it is slowly easing down. Second night doing better after 3 weeks. I believe motion is lotion and excersize helps.
Do you have any other recommendation to nerve pain issues?
Good to hear that sunken knuckle is not a biggie. Have that too. Smallest of my worries. I see in Xrays the knuckles are fine.
To be honest Nina, I think you’re best speaking to your physio about that. It’s not really my area of expertise to be honest. I know you can have a nerve test done (may be worth exploring) which can see if there’s something interfering with the signals travelling down it.
Outside of that, I don’t really know the answer. Hopefully your physio will!
Best of luck
Steve
Hi, I punched a wall (stupid, yes) and broke my 5th metacarpal (pinky) last Friday and went to see an orthopedic doctor the next Monday. Doc mentioned reduction but eventually decided it wasn’t necessary (which I assume is because of the break being quite small). He then proceeded to check if pinky can move (made me open/close my hand) and decided is was doing pretty good, suggested I do some light exercises early on and referred me to a physical therapist. Physical therapist did the same checks and decided I don’t need to do actual therapy, instead suggested light exercises in the first month, also recommended soaking in hot water.
My main concern right now is will I be able to regain full (or at least almost full) strength and range of motion on my pinky, and when do you think should I start “challenging” my pinky a bit more?
Also thank you for making this post, reading this and the comments make me feel better, realizing that this injury is a lot more common that I thought it was
Hi Jeremiah!
Well it’s good to hear that the injury isn’t as bad as first thought… and the upside is that you’ll learn not to pick fight with a wall again!
In terms when you should start challenging the injury, I found that as long as I worked within pain thresholds (didn’t push it to the point that it was really painful), then I could start moving it from about 4 weeks or so. It more more to maintain range of movement than anything else.
You can relax knowing that the injury heals well. Although I don’t have a knuckle there any more, I have a fully-functioning hand!
Steve
Hi,
I broke my 4th metacarpal at the joint where the carpal and the metacarpal meets (they called it a CMC fracture) about 5 weeks and 2 days ago. Same as you, missing knuckle and stuff. It has absolutely improved since the night of the injury, I wasn’t even able to squeeze my toothpaste out of the tube. The weird thing is, now the only thing that seems to be tender at all is the 5th metacarpal. This week I started giving it a go with lifting and avoiding anything that makes it hurt. However, there are definitely things that are a little uncomfortable or make it feel a little sore during/after lifting.
My question is, did you feel any soreness during/after your workouts when you first started up training again? And if so did it just gradually go away?
Thanks
Hi Chase!
I did feel a little discomfort, but it went away in time. The important thing is to push it gradually – don’t go into full training straight away. Give it a chance to get used to movement again.
It’ll eventually be pain free!
Steve
Hi,
I broke my neck of 5th metacarpal a month ago and it took a surgery. But I am worried because knuckle of my 4 finger is hard to see. But in x ray there is no crack. Will it get normal with time?
It’ll probably be pain free and you’ll be able to fully use ut, but I doubt you’ll have a normal looking knuckle again!
Hi, what treatment was performed on your hand by Hilary Farrer to reduce swelling? Is it anything that can be performed at home please?
Hi Brook
It was called the Bowen technique. I can’t remember much about it, but it worked! Maybe look for a local practitioner. I don’t know much about what you could do at home to be honest, outside of what I suggested here.
Steve