Earlier today, I went for a long hike with my friend Matt and his 14-month-old son. I fed the young boy some pieces of cereal, and as I watched him grasp at the bits of food with the focus and lack of fine motor function of a child, I reflected on the wonder that is human motion. This has certainly been on my mind recently as I’ve slowly regained motion in my arm after two weeks of virtual immobility.

Most of us probably take movement for granted. We don’t think about it; we simply have an impulse, some vague flutter of a thought about the itch behind our ear, and scratch it. We see an apple on the table, and we grab it. We don’t consciously activate the parts of our brain that control movement; we don’t feel the electrical impulses leap across our synapses. We don’t tell the fibers composing an elaborate harmony of muscle groups to contract. We just move our arm, eat the apple.

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To be clear, most of my body is working great, and I have a daily goal to appreciate that good fortunate. But my right arm, on the other hand (an awkward manner of speech, I know), operates a bit more like that of the baby’s: uncoordinated, weak, and often ineffectual. I reach out for the apple and come up 5 inches short.

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Almost three weeks out from surgery, the broken wing is starting to mend. The bump just below my elbow is swelling from the incision.

I come up short because I still can’t straighten my arm. The good news is that I went for my two-week follow-up appointment six days ago. Dr. Millett said the surgery was very successful and had only minor concerns about some swelling. Because my tendon is now threaded through a hole in my bone, it is in fact a stronger attachment than the original. The only downside is that my tendon is 2-3 cm shorter than it was, so I’ll have to significantly stretch out my muscle to straighten my arm. Until my follow-up, my arm was in a brace and locked at 90 degrees. At two weeks, we reset my brace at 45 degrees from straight, and I’ve been cleared to begin active range of motion. This is fabulous. I can move my arm around a bit and do minor lightweight tasks, like tying my shoes (a task nearly impossible before). It’s also much more comfortable to go on hikes and generally be active since I don’t have my arm in a sling anymore. I’ve spent a good deal of time hiking in the Flatirons, watching Netflix videos while on the stationary bike, and doing core workouts. I’ve done some minor strengthening on my healthy arm because there is some evidence to suggest that it will improve the strengthening capacity of the injured arm.

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This is the face of a champion, sweaty and going nowhere fast.

As promised, here is my rehabilitation plan. But first, I want to qualify a few things. This plan is pretty aggressive and contingent on the quality of the fixation and the level of degeneration of the biceps tendon. I am pretty young for the injury (most patients are men in their fifties to sixties), and I got the operation eight days after the injury so my tendon was still in pretty good shape. In other words, this is the best-case scenario.

Weeks 0-2: This stage focuses on protecting the arm and allowing the basic healing responses (swelling, pain, etc) to run their course. I only performed light passive range of motion (PROM) and scar tissue mobilization work. My arm was locked between full flexion and 90 degrees.

Weeks 2-4 (Jan. 17-31): The stage begins to activate the muscles and initiate arm function. I’ve been continuing with PROM and have added active range of motion (AROM) work, both in arm flexion and in supination and pronation (bending my arm and turning my hand up and down, in layman’s terms). I can now move my arm from full flexion to 45 degrees from full extension.

Weeks 4-6 (Feb. 1-15): I continue with AROM and begin stretching the biceps. I will work toward full range of motion, both in terms of flexing my arm and supination and pronation. At this stage, I also hope to be able to begin strengthening work around my biceps, like fingers/forearms, shoulder, chest, and back.

Weeks 6-12 (Feb. 16-Mar. 29): At this point, I start strengthening my biceps, starting with very light, simple movements and progressing to heavier weight and more complex motions.

Week 12: I begin sport specific training. Yes, that’s right, I can train for climbing (and, accordingly, go rock climbing) again. Yay!

The wall, er, fridge, of rehab.

The wall, er, fridge, of rehab.

I’d be lying if I said I didn’t hope to climb sooner, and I don’t think that is totally crazy. At some point in the strengthening progression, I will start climbing in a very controlled way. I also have been scheming about how to maximize my overall fitness so that I return to climbing with the most things working for me possible. That means I have to find ways to strengthen climbing muscles other than my biceps. The obvious options are finger strength, core strength, and cardiovascular fitness.

So far, I’ve been working to build a base in each of these. The core workouts and cardio are fairly obvious. For finger strength maintenance, I’ve used a combination of putty and a bucket of rice. At this point, all I’m really doing is activating the muscles to keep the neurons firing and the fluids moving around (which also helps the inflammation from the surgery).

If all goes well, I should be back to climbing just in time for spring, which is really not so bad. The last time I took more than a few weeks off from climbing was in 2009, so I’m due for a longer sabbatical anyway to let the climbing muscles recover. I’ll check back in soon with my progress.

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