Tuesday, 20 December 2011

Arm Injury

I'm a fairly aggressive golfer with a big distance when i get it right.  Some of my shots resulted in hitting the ground, or not catching the call in the middle of the club, and this was bothering me a bit, causing some pain to run up the back of my wrist.  On a couple of occasions I was rubbing it for a minute or so because it hurt.  After the 3rd and final round of golf, it was giving me a bit of an ache throughout my forearm.

A couple of days later, when golf was left well behind and I was at the Ski resort, I chose not to ski on the first day due to my INR being 3.9.  I said to myself that 3.5 was the max to ski, not worth the risk.  My arm was bothering me a bit, but wasn't too bad.

The next day, day 2 of skiing, my arm was the reason not to ski.  It had progressively got worse, and was now keeping me awake.  Desperate to ski, i called a sports physiotherapist, who came to my hotel room.  He noticed the bruise and commented on it.... I hadn't even noticed anything up to this point.  There was indeed a very large bruise.  At this time I couldn't straighten my arm, and any slight jarring caused me to wince.  He diagnoses it as torn radialis muscle.  He can feel a 'golf ball' hematoma in the muscle at the joint, and that's what's stopping me straightening the arm.  A hematoma is a large pocket of blood that forms as a result of an injury, where it has nowhere else to run to.  I really can't straighten the arm, and the physio can't either - it's jammed at about 15 degrees open.

At this point my arm looked like this:


The next day, it was worse, and i went to hospital.  They X-Rayed it and confirmed it was not a fracture:



 Next day, its worse, and looks like this:


I then visited my usual sports physiotherapist at home who was quite shocked by the level of bruising and lack of mobility.  He was even more shocked when i could barely explain how it happened!  He decided to stick some physio tape to the bruised area to help it drain.  This seemed to work quite well, here's a picture of it after it was removed - the skin coloured areas where the tape was and the purple where it wasn't.  I'm almost liking it - tattoo style!

 
Its very clear this is warfarin at work, but to what extent was warfarin involved?  Clearly the warfarin made the bruise, but what about the actual injury?  I feel that the muscle pain would have happened anyway, but perhaps just brushed it off in a few days.  I think the warfarin made the problem a hundred times worse.  I barely did anything, i don't even recall any injury as such, just a number of little pains, nothing I haven't shaken off before.

I sit here writing this posting 14 days after the 'injury' and the bruising has mostly gone, but the rock hard hematoma is still alive and well.  Perhaps its gone down a bit, and perhaps i can get the arm open more, but the arm still won't straighten.  There's a ton less pain now, it only twinges when it gets close to straight.  I hope the hematoma will absorb back and behave, because the idea of having it surgically removed doesn't sound too nice at all.

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