Elbow tendon tear repair, nerve surgery?

[Simkie]

I tore the crap out of an extensor tendon in my elbow this year and it’s looking like a surgical repair is in the cards.

I also developed pronator teres syndrome, which is a median nerve compression in the elbow…sort of like carpal tunnel syndrome, but in the elbow. And that probably needs to be fixed, too.

TBD is addressing the carpal tunnel syndrome I developed LAST year. Or the ulnar nerve compression.

The surgeon says I can expect 4 weeks braced with PT to follow and gradual return to work. Has anyone gone through any of this? Would love to hear how it went and how/when you were able to return to your horse stuff. I am just so tired of being busted

[RMJacobs]

I’ve had ulnar nerve compression in my left elbow for a very long time. I didn’t want to do surgery, so my rheumatologist sent me to PT. It was amazing how quickly I got back the feeling in my last two fingers once I started doing the exercises. Even though formal PT was back in 2003, I still do the exercises when those fingers start to tingle. It’s challenging now because of a torn rotator cuff (both shoulders, but the left bothers me the most), but I can still do the exercizes well enough to keep the nerve compression at bay.

Rebecca

[Simkie]

Thanks very much for sharing your experience! Yeah, the ulnar nerve issue honestly doesn’t bother me that much. I’ve been dealing with it for forever and mostly have it managed. Unless the EMG shows something surprising there, I’m inclined to leave that one alone.

But the tendon tear is pretty bad, and the pronatator teres thing just straight up sucked a lot this summer. I can’t do another summer like that and get done what I want to get done.

This whole getting older thing is dumb. (Although I guess preferable to the alternative!)

[Mango20]

No, but I’ll be following your case because I think I have something quite wrong in my elbow, too. The bulk of it appears to be a tendon problem where the bicep attaches to the elbow. It’s been going on for months - I try to use it less and it improves somewhat, but I still get a sharp pain when lifting heavy things. I’m sort of afraid to have it looked at because I know they’ll want to sideline me for a while.

[Simkie]

@Mango20

I’m sort of afraid to have it looked at because I know they’ll want to sideline me for a while.

Here’s a push to go check it out! Better to know than not. You don’t have to do anything about it until you’re ready.

But I’m also bad about that. My bicep at the elbow end historically spasms badly at night once I get going with my summer projects. Never got that worked up, either (just suffered, ugh) and it weirdly wasn’t a problem this year. Maybe because of these other issues. :-/

[hallie2]

I’ve always enjoyed reading your knowledgeable posts. Just wanted to say I’m sorry you have to be repaired. I’ve gone thru 5 big ortho surgeries myself so I know how depressing it is to hear you have to have surgery and then stop riding for however long. hope your recovery isn’t too long.

[Simkie]

Thank you, you are too kind!

I’m so sorry you’ve gone through a bunch of stuff, too. This isn’t my first rodeo, either, and ugh I’m just so tired of it. I don’t know how these things keep happening

[endlessclimb]

I’m sure there’s something wrong on me too. No doubt I’ve earned it, but several times a day it feels like I’ve touched the electric fence. BAM. Then I’m ok. Happens in the hand, and in the elbow several times a day. About once a week in the neck.

Another who is following along. The tendon stuff scares me worse than the nerve stuff, because tendons can be tricky to heal and easy to reinjure.

[hallie2]

the important thing is we keep bouncing back. indefatigable

[Simkie]

@endlessclimb

No doubt I’ve earned it, but several times a day it feels like I’ve touched the electric fence. BAM. Then I’m ok. Happens in the hand, and in the elbow several times a day. About once a week in the neck.

Eeeee. That sucks, I’m sorry. Here’s a push for you, too, to go get that worked up. Better to know, and be able to game plan (even if that’s just “when it gets to -x- point we look at -y-”) than be surprised by permanent function loss. You gotta take care of yourself so you can take care of everything else!

@endlessclimb

The tendon stuff scares me worse than the nerve stuff, because tendons can be tricky to heal and easy to reinjure.

I’m totally on the opposite track, lol. I’m not excited by the tendon stuff but nerve stuff? Goddamn, when that goes wrong, it may never be right again.

@hallie2

the important thing is we keep bouncing back. indefatigable

Damn straight

(Although right now? Right now, I’m tired, haha.)

My last summer project that’s still outstanding and HAS to be done is residing the run in shed. I wound up finding rot so it’s been a bigger project than expected. I’m finally almost to the actual siding point and realized…I can’t hammer. I hammered a wall back together yesterday and goddamn. Today does not feel good.

[IPEsq]

I have a tear at the lateral little bone (name escaping me at the moment)…aggravated tennis elbow. One of the triceps attachments is also angry. I decided to try PRP because I don’t have time for surgery right now. Wow. It aggravated every single nerve. Radial nerve was the worst but they were all lit up. I never have nerve pain with the actual injury. Still recovering from that and weeks to go to see if it will actually help.

Based on that experience, no way I’m doing surgery. I have read outcomes from surgery don’t tend to really result in full function or pain relief anyway. Supposedly typing is not weight bearing and would be allowed. Meaning I probably couldn’t take leave from work. But let me tell you how much your forearm muscles are engaged in just making your finger work. And then there’s the splinting. Ugh, no thank you.

Have you tried any other therapies? I had tried laser, PEMF, anti-inflammatories, some behavior modification though not full rest as it’s my dominant arm and, well, I have feed bags to carry. Honestly would ask my vet to shockwave it before considering surgery at this point. Narcotic type pain meds don’t do anything for pain for me and only make me vomit. I was only allowed Tylenol following the PRP. I literally almost passed out in my bathroom the first night from the pain of sleeping with it immobile (and still in a bandage) for 2 hours then moving it to get out of bed to pee. Can’t imagine that would be worse than actual surgery.

[Simkie]

I’m surprised you’ve had such a rough go with PRP! I’m sorry it’s been such a trial. I’ve done a lot of PRP, although not for this, and actually have an appt set up next week to PRP the hamstring I also tore this summer (we’re shockwaving it after that. My physiatrist didn’t want to shockwave it when it was pissed. Just fyi if you’re able to convince your vet to shockwave your elbow. Wait until it’s settled or apparently it’ll suck a lot.)

I don’t have time to PRP this to see if it improves and still get in surgery if it doesn’t before next spring. As it is now, it’s already really tight. I do wish I’d just gone forward with PRP when we initially got the imaging back (which shows a “severe, near full thickness tear of the extensor carpi radials brevis” with a 6 mm retraction) but we were waiting on the hamstring imaging and here we are now. Hindsight!

I hope you turn the corner soon! In my PRP experiences, the first week is hard, the second is back to baseline, and that two week mark is when improvement starts to kick in.

[IPEsq]

First week was very hard. But I think in the elbow it wasn’t the local pain so much (which wasn’t pleasant for sure in the beginning) but that every nerve in my entire arm lit up for at least 10 days, which is when it started to turn a corner on comfort. My wrist and thumb hurt. My shoulder hurt. I couldn’t squeeze my saline bottle for my contacts. The lack of sleep gave me migraines. Oh for sure wouldn’t shockwave it in that state. I’d throw up!

Tear is mild-moderate for me but of course could get worse if I continue to be a stubborn horse girl.

[Simkie]

Just curious, did you go see Centeno for your PRP? I’ve certainly had uncomfortable Regenexx PRP, but my worst experiences have been been tabletop PRP. Did both hips together once and I straight up could not walk and was so incredibly miserable.

I hope you’ll have a fab result and you get to the part where things just feel better soon.

[IPEsq]

My hand surgeon did it in my regular ortho clinic.

[Simkie]

Ah. Highly recommend hitting up the Regenexx peeps for PRP. It hurts a lot less! (And works a lot better, in my experience.)

[IPEsq]

Thanks will keep that in mind! Too bad we can’t just order a product like Renovo.

[Simkie]

Oh that’s out there. My regenerative med guy is veryyyyyyyyyy dismissive (Not something I’ve ever tried, so no personal experience.)

[IPEsq]

Well my horse just switched from autologous products to Renovo for some things due to supposedly not having a lot of the good stuff in his own blood due to EMS, and he says his hocks feel great!

[Simkie]

I can only report what I hear from him! Although there may be significantly more processing required on human products vs veterinary.