I incurred a Type II fracture of my left elbow a month ago. The surgeon I consulted a few days after going to the emergency room (where I was x-rayed) examined my left arm and told me I would not need surgery, and to proceed with physical therapy; and to see him again in 4 weeks (tomorrow).

The first therapist was a nice young woman who gave me the option of continuing my P/T at a hospital that was closer to me, but in the same health network as the first hospital (a top hospital, one of the best in the U.S., where I get most of my medical care). I thought that was a good idea; and was given the phone# to call, which I did. She also showed me some exercises and gave me a diagram. The second hospital didn't have anything available until 2 weeks (actually 13 days) after my first appointment, which in hindsight I think was too long a stretch without seeing a therapist, but I didn't realize it at the time and none of the medical personnel mentioned it.

When I started P/T in earnest at the second hospital on 12/30, my new therapist told me I had been doing the exercises improperly and went over the right way to do them. (I have never been good at remembering exercises unless I do them on a few separate occasions under supervision) I did them 4x a day for the next 8 days. When I returned to therapy on 12/7; the therapist took measurements during our session and said I had improved in extension and bending of the elbow. She also made me feel extreme pain with her manipulation of my arm; and told me she didn't understand why I was feeling such pain, there was no reason for it. My questions prompted her to tell me that after an injury such as mine, the patient has 6 weeks until the elbow stiffens up.

I returned two days later, having continued the exercises at home. Again, the therapist's maneuvers were painful (even though she wrapped my arm and elbow in layers that included a hot wet towel), so much so that I begged her to stop for a minute. She took measurements, and seemed displeased; and refused to answer when I asked her what the measurements showed. She wanted to get me to be able to touch my left hand to my left shoulder by pushing the left forearm down toward the elbow-to-shoulder part of the arm (I couldn't do it) and also my left hand to touch the back of my neck (managed a fingertip for about 2 seconds). It was terribly painful and I could not sustain my endurance. I'm pretty sure she did the painful pushing for longer than 10 seconds, but I don't know how long, it seemed much longer than that. She advised me not to do any more specific exercises, but to "move the elbow" during the weekend, and throw a ball around, as well as do a barely specified bend-the-forearm-up-from-elbow-and-turn-palm-back-and-front exercise (she wouldn't tell me for how long/how often).

The originally prescribed exercises have been two: one that combines Elbow Flexion with forarm Pronation, and then Forearm supination (which has become easier). I did them first for 5 seconds apiece, later 10 (and frequently more, on my own initiative), usually 4x a day, though a few times 3x a day.

So I returned today; having thrown the ball (using the elbow, not the shoulder) with my left arm a lot over the weekend, and trying to touch the back of my neck with my hand (reached the back of my head). The therapist said she was going to try a splint to keep the arm bent, but then proceeded to do more of the pushing-my-forearm-back-to-get-my-left-hand-to-left shoulder, only with my lying down. It was agonizing, as usual. I tried to be brave, but it just hurt too much. (I had taken Tylenol Extra Strength - well, a generic equivalent, an hour before; it didn't help) The only thing that distracted me slightly from the pain was when I bit my lip quite hard, but that interfered with my regular breathing so I had to stop. It went on for at least 3 or 4 minutes, possibly longer. We did get my left hand to touch my shoulder, though only briefly. My therapist was annoyed with me, or at least was frowning most of the time, and seemed particularly annoyed when she said she was moving my shoulder, not the arm, and I was still in pain (I told her that it wasn't the shoulder that hurt, it was the forearm). Someone pulled a curtain around the area I was in, possibly to try to prevent me from terrifying the other patients, I don't know.

Finally, the therapist released me, and told me that she could not continue; I was "too difficult". She wrote a letter explaining it all to the surgeon (who I will be seeing tomorrow) and advised me to continue to do the exercises and "move the elbow". She asked how bad the pain was at that moment; I told her truthfully that there wasn't any more pain now (at that moment) but during her work on me, it had been either 9 or 10.

Soooo. Am I a total wimp or just cursed with a heavy-handed physical therapist? If I can get my surgeon to authorize future P/T with a different therapist, should I expect more of the same? I had expected discomfort and a certain level of pain during my P/T sessions, but not pain so intense that I could not endure it for more than a minute or two (sometimes less, maybe). I am not a coward;having endured multiple operations and "aggressive" chemotherapy in the past; but this experience has been exhausting and I am scared and rather depressed. Will I have to put up with torture in order to regain more range of motion? Right now, the dexterity of my left hand and fingers has increased since the accident, but not the bending and extension of my elbow (except, briefly, in that one session on 1/7).

Will I have to choose between suffering extreme physical pain in P/T that has so far been unendurable and not regaining the range of motion I need to have a normal life back (be able to drive properly, walk my dog on-leash, lift something heavier than 5 lbs., etc.)?

Any insights or opinions would be welcome. Thank you for reading.


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