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  1. #26
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    Quote Originally Posted by gillo
    hi dunnerorg
    have been reading your interesting information on r/h replacement.You seem pretty clued up about the procedure and I wondered if you had an opinion on my predicament.I had a radial head replaced about 6 years ago with a silicon replacement .My injury was classed as a terrible triad injury which is a comminuted fracture,dislocation and fracture of the coronoid process.Because the silicon was compressing and breaking down I was advised to have it replaced with a metal one.That was 3weeks ago.The first week and a half were great then after using the affected hand typing a few sentences on a keyboard problems began arising.The next day major sharpe pains in wrist, back of hand and lower forearm when attempting supination or any hint of minimal lifting with a supination angle.Unfortuntately it hasn't improved at all and I'm really peeved as I cant do the full on physio and I know how important it is at this stage.After some reading and various terms such as radiocapiteller contact,damage to condylar cartilidge,medial ligament,interosscus membrane etc cropping up I'm stumped.Still cant supinate more than about 60 degrees. Would be good to hear from you. I'm in oz

    Cheers gillo
    Sorry, to here that Gillo. If I were in your position I would go back to the surgeon and see exactly what is happening. I have to point out that I am not qualified to give out medical advice. However if you would like a lay persons opinion. Then based on the assumption that the silicon replacement did not give as much trouble and that things have deteriorated since the operation.
    Then a couple of things come to mind.
    Perhaps the new replacement head is not in the optimal position, or has moved.
    Or perhaps it has changed the length of the radius bone, putting undue strain on the tendons and causing slight misalignment at the wrist.
    Perhaps some of the nerves have become irritated due to the surgery and are now over-sensitive, resulting in pain.
    Perhaps the pronation muscles are restricted and this is causing the supination muscles to work harder to turn over the wrist. Or perhaps both sets of muscles are having to work harder if the new head is not rotating easily.
    I would think that it is still early days in terms of recovery. I agree with the importance of movement and physiotherapy but at the same time you have to work within the body's limits. So If you feel that it needs rest then I would rest it. I would recommend ice if the area is hot and inflamed and I would also recommend gentle massage to help calm the area. The massage should not be used at this stage to work deep into the tissue, but rather just to calm the nervous system, and also to remove fluid which is bound to be there following the operation. Do gentle strokes with light pressure towards the heart. But definitely ask your surgeon about the alignment and position of the new implant.
    Hope this helps
    Dunnerorg
    I sense injury - the data could be called pain.

  2. #27
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    Hi Phil,
    That sounds familiar! I am two years since my replacement. To be honest in terms of range it did not improve too much since the early months of recovery. I stretched the arm every day without fail for well over a year. Although I did gain close to full range it gradually has tightened back up to about 160 in extension for most of the time. I am still improving in terms of flexion though and I think that I will get that back fully. The thing about ligaments is that they do not have cells to regenerate properly so they tend to recover with scar tissue. This tends not to be elastic like a normal ligament, so the joint gets tight. One of the other things I found was that as I stretched to full range, the joint tended to click uncomfortably so I have kind of reached a happy medium now between range of movement and stability. I would suggest icing your arm if it is becoming swollen and maybe even do no exercise on it one or two days a week, to give it a chance to recover a little bit. Each person is different too so It's quite possible that you will get full range and no clicking so keep up the hard work, and best of luck - Dunnerorg
    I sense injury - the data could be called pain.

  3. #28
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    lifting

    First time on the forum...I to have had my radial head replaced. Way to fast on my longboard, a little over years ago. It is crazy to me that of all the places I would find info on this topic is a website I visit regularly. Should have done this a long time ago. My extension and flexion are excellent(very lucky) my pronation is close to normal but my supination is about half of what it should be. This is where my problem lies. I started weight training recently and have had much trouble working out my bicep. Hammer curls work fine with very little pain. Open handed curls are impossible. GRADUS you said you ran into a guy who could lift crazy weight. Did you get to see any exercise he might have done to compensate for the lack of mobility. Any information would be helpful. I feel extremely lucky when I crashed dislocated the arm, ripped my ligaments to shreds and had had 11 pieces of bone floating in my arm. Luckily I started riding about 6 months after surgery and now ride at least 6 days a week. thanks

  4. #29
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    Hey guys,

    This is a very informative thread, theres more in here than on half of the google searches i do!

    I came off my bike in my local woods, fractured my right radial head in 3 places with one of the peices depressing slightly, the doctors said it was a bad fracture although the peices have stayed relatively close together. They weighed up the risks vs. benefits and have decided not to operate.

    It has been just over 2 weeks now and im to start physiotherapy soon. my arm is majorly stiff at the moment although i am feeling an improvement in range of movement as time goes on, but its pretty poor!

    The stuff about returning to biking is great but im wondering about other activities because I also box. Im expecting to lose 20% of my overall elbow range and am wondering if ill be able to throw punches again

    I mean when you throw a punch and your elbow locks out, it feels fine on a healthy elbow. but what is it like on a fractured elbow 6 months down the line? does it hurt to snap your elbow straight? wont i be able to throw a punch again without feeling pain?

    Also, once i rebuild my bicep back up, do you guys think it will retain its size as it did naturally before, or will this mess up my muscles ability to remain normal?

    Cheers guys!

  5. #30
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    glad to find this forum. Nov 4 last smashed my elbow which resulted in radial head arthoplasty with a lateral ligament repair,. 10 months later I would say I am doing worse now because I get chronic pain between the wrist and elbow. After discharged from physio stated hearing clicking/grinding/sounds from my elbow but that at least seems normal by what all you guys are saying but my time I can ride is diminishing big time due to pain in forearm. type of handlbars don't seem to change the situation between my mtn bike and my hybrid, upright riding or normal positioning still causes forearm pain. Anyone else have this problem?

  6. #31
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    Hi mcleodja
    I stumbled on this looking for other peoples experience of this surgery, I'm not a serious mtb rider, ride occasionally for fun and bit of fitness.
    I got my injury from a motorcyle accident 2004. Dislocated elbow was put back in in A&E few hours after accident and put in back-slab cast then radial head replacement 6 days later, after I had my pelvis fixed.

    I had the radial head replaced, the new 'part' is called tornier-chevux floating radial head prosthesis which is cemented in. This was because the original replacement was wobbling around causing osteolysis around the stem. It shows up on x-rays, looking like a shadow in the bone and causes pain that feels like you want to put the bones and put them back in the right place, if you know what I mean. I also had pain at the elbow, down the forearm and into the wrist.
    If your pain continues/gets worse you should get it checked as the earlier they catch osteolysis the better

    Its over fives years now since the original surgery and 3 since the new bit all was going well until recently when I am getting pain into my wrist and hand especially around the thumb side. Longer motorbike rides are hurting through lots of pulling clutch in/out and elbow can lock if I'm not careful to remember to change position regularly.

    I think the grinding sounds are called crepitus, basically surfaces rubbing together which no doubt will cause arthritis. Normal in our cases I should think not much we can do about that except try glucosamine/cod liver oil supplements.

  7. #32
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    Sooo glad i found this thread and hope you all are recovering well from this injury.

    Well my story is that i dislocated my elbow and broke my radial head back in July 09.

    I luckily did not need a replacement radial head unlike most of yourselves on this thread and i cannot begin to imagine how hard it has been for you all as i needed two screws in my elbow which are going to stay with me for life now.

    Recovery for me has been very hard, painful and slow like you all. I am 30 degrees off full extension and it,s not improving much now no matter how much physio i do. Also i can,t turn my palm over and my arm gets fatigued very easily.

    I get the usual grinding and squelching noises and my physio says that won,t get any better so athritis he i come i suppose!

    I get very bad grinding when i lift any weight but no grinding without the weight...Does anyone else get this?

    Taking glucosamine and cod liver oil to help but not sure that,s helping or not.

    Got another hospital appointment to see the consultant in Feb and he said i may need to have more surgery if nothing improves.

    Sorry to sound like a moaner but this has been getting me really down and again i really hope your all recovering well.

  8. #33
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    WoW, I am quite suprised to see so much radial head replacement. And yep, Im a new member to the club. On December 11th 2009 my wife, my friend and i went out on a mt bike ride. Well, a couple minutes into the ride we encounter a sweet drop, my friend hit it, my wife photoged then I attempted it, of course with no doubt in my mind i would make it...you guessed it, I failed. The result was fractured femur where it meets the pelvis which in turn shattered, a fractured ulna at the wrist and a fractured radial head which they replaced. So, I have a stainless steel strap and 9 screws to replace the shattered area of my pelvis, a stainless steel plate and 10 screws on my ulna and wrist and a stainless steel radial head thing.
    My range of motion on my arm is coming along well except in supination, and bringing the arm to a close, which according to my visit with my physical therapist today is normal progression. I had surgery on my arm on the 12th, so i am three weeks into my recovery on it. I had surgery on my pelvis on the 15th, i am not to put any weight on that leg for 12 weeks. Therapy on that is going well and recovery looks good.
    I am looking forward to a proper recovery and getting back on the bike. BTW, im 40 years old. Good luck to ya'll on your road to recovery, and keep a positive outlook.

  9. #34
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    Another radial head fracture here. Although mine was about 10yrs ago. They pieced it together with a small metal plate and numerous screws. I have about 95% mobility out of it except for wrist rotation where Im about 80%. When I first started biking it was the first thing that came to mind. What if I fall and reinjure? The recovery was long and painful and I didnt want to go through it again. I will tell you over time you will worry less and less about it. I still have nerve issues on my left hand - namely my ring finger and pinky. After a long ride of 3 or more hours they tend to get a little numb. Possibly from the way the nerve runs through my elbow joint and the inability to fully rotate the wrist. It hasnt held me back much though. I still wonder if it would have been better to have been fitted with a new radial head instead. The surgery to repair lasted almost 4 hours. Anyway I am now 40 and moving on without much thought of it. I would recommend intense PT to get back as much range of motion as possible asap. I havent lost any ROM but also havent gained any either as the years have progressed. Good luck all.

  10. #35
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    Hey guys, as mentioned by many of the others on here, I'm glad to have stumbled across this thread to hear the various recovery stories from this operation.

    I've attached my initial xray and post op xray. I race a lot of 4x and bmx and had my accident during a training session, flipping over the bars mid-air and landing on my outstretched hand. That was back at the beginning of november and I had surgery in mid-november.

    I'm now 9 weeks since surgery and still have a very limited range of movement. I'm 40 degrees away from full extension and around 30 degrees away from full flexion. Pronation is fairly good but supination is still very poor. I'm pushing the physio as hard as I can, various exercises many times a day.

    I had an appointment with an orthopaedic surgeon that specialises in elbows two weeks ago and he said that if we don't get an acceptable range of movement back then the prosthesis will have to be removed, not sure on what time frame they give to judge this.
    Attached Thumbnails Attached Thumbnails Riding after radial head replacement-chris-xray.jpg  

    Riding after radial head replacement-post-op-xray-copy.jpg  


  11. #36
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    tighten those screws

    Thought I'd throw my 2 cents in here as well. Typical story, went over the handlbars and shattered my radial head. Lucky for me they were able to screw it back together with a plate and five screws and while I don't have full range of motion, riding is not an issue at all. The only thing I really can't do is throw hard without pain, but other than that all is good. The tough thing is that its just going to take a long time to recover, but persistance pays off.

    However, about a year after my surgery to repair the radial head, I began to notice something protruding from under where the incision was made. It didn't hurt at all, but it was really bizarre. At the time I didn't have insurance, so I had to live with it a few months until I could get an xray. When I did, it was pretty shocking to see one of the five original screws was backed almost completely out.

    In any event, I had another surgery and removed said screw. I was back to normal almost the next day after that one.

    So, make sure they tighen those things down!

  12. #37
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    To Chris Cumming- I am recovering from a radial head implant/ligament reattachment after ejection from a mountain bike (fall on one outstretched arm/hand) resulting in elbow dislocation/radial head smashed to bits episode- "The Terrible Triad of the Elbow". I had limited range early on but made incredible progress and you can too. I am 6 months from surgery now and have the essentially full pronation/supination of the forearm, I have extension to -4 and full flexion- I measure at 160 flexion and can touch my wrist to shoulder with pressure. I am flexible to begin with which probably hurt me in the crash but helped in recovery. I used aggressive PT- major pain, full time regimen of stretching and exercises, and also some progressive splinting that was very effective. At about 8 wks from surgery (about the time I started splinting) I was extension -40, flexion 140 and supination 0 and pronation 60 degrees. Of note I am a woman and I think all the other bloggers here are men so I don't know how much that changes things if at all....
    For everyone else....
    Does anyone know any women with this injury? I am wondering how mountain biking and specifically downhill went after this surgery. I am eager to ride again really soon and wondering how other people did....

  13. #38
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    To Chris Cummings- Your email is blocked so I'll post a response here. Good to know you are making good progress, it's a long haul. I used progressive static splinting- from a company in US called JAS, Joint Active Systems. My major issue was that I also had other fractures and dislocation with ligament repair done. My arm is making steady progress now in strength and I haven't regressed as far as range so I'm happy. My arm is still not strong enough to trust on a mountain bike but on the road its okay. Looking at your xray, did they try to reattach the radial head fracture or go straight to the implant? Do they use the same kind in the UK? Mine is Vitallium. From what I understand with the implant it shouldn't limit flexion, only extension as the pressure is on it in extension. I can tell you as far as PT is concerned, I went for almost 5 months 3 times a week and there was major stretching involved. All of this was very painful but likely the reason that I have such good range, I just told the PT to do whatever it took to get the range..... it probably also helps that I'm flexible, my good arm actually passes 0 in extension so that's a good place to start.
    One more thing on the splinting, as I understand it is most likely to work the earlier you use it, I started really early but it sounds like you are still in the window. From my research I would stay away from the dynamic splints that you wear for hours because you may lose range in the other directions from the limits on movement for long periods of time. The splinting I used is very different and better I think.
    Good luck with rehab and let me know how it goes over there on the other side of the pond- interesting to see the differences in approach. It sounds like you are doing quite well already....

  14. #39
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    riding after radial head excision

    This page is of great interest to me as I am contemplating a radial head replacement. I had an excision 23 years ago after a fracture dislocation, and in those days nobody was doing replacements except with silicone. I am getting increasing pain in the wrist, forearm and elbow as I get older and it's really interfering with my riding. I love my MTB and don't want to give it up. Does anybody have experience with a delayed replacement? I would love to know if it helped.

  15. #40
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    Smile dennis1

    Hi Guys Iam New To This Forum But Iam Glad I Have Found People To Talk To And To See If Things Will Get Better For Me.
    I Had My Fall On The 2nd Of June 2010 Where I Work On A Building Site I Fell Back And Shattered My Elbow. they had to do sugery to rebuild my Radial Head and pin it together again. In My Left Arm And I Also Have Nerve Palsy In My Fingers , I Can Bend My Fingers I Just Have Trouble Lifting Them Up.
    Is Anyone Having The Same Troubles As Me?
    I Do My Phiso At Home And At Hospial, Iam also On A Waiting List To Use The Pool At Hospital ( Hydrothearpy)
    Does Any Know If I Should Pay For My Own Phiso To Help Me? I Just Feel The Hospital Wont Tell Me Nothing I Just Want To Get Back In To Work Again.

  16. #41
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    newly shattered radial head.

    hello all. i apologize in adveance for typos and bad grammar, but i only have one good hand right now. thank you for all the helpful informtion! not a real aggressive mointainbiker (i have one/use it occasssionally) but i am very physically active. i got my injury while running and it seems to be the standard for this site: shattered head/dislopcation. im currently stationed in japan in the navy and awaiting med-evac to go to hawaii to get a titanium head put in.

    i was mostly wondering, because i am a bit worried, about post-op pain and full recovery. it seems a lot of the recovery stuff has to do with how agressively i approach my PT afterwards. how bad is the pain? ill be going in about a week for the procedure. how long should i expect to be back on my feet and at least running again? as far as surgical recovery, i have a physically demanding job, will i ever be able to do full pushups again?

    thanks in advance for your help.

    Nick

  17. #42
    JHW
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    Nick:

    Focus on regaining your range of motion and minimizing pain first. Get a good PT and do the exercises religiously. I'm 11 weeks out from radial head replacement and ligament reconstruction after flying over the handle bars of a mountain bike while on vacation (47 years old). I go to PT three times a week and replicate exercises on the off days. Talk to your PT about this, but the one exercise that really helped me turn a corner was an "upper body ergometer" (i.e. an arm cycle), which I started at about week 5. I have done it every day after I found one at my local YMCA. 5-7 minutes forward and 5-7minutes backward (in addition to my other daily exercises). At about the same time, I was taking a jacuzzi bath at home and discovered that one of the jets was positioned in the right place to massage my injured elbow/arm. I believe this has helped as well. Lastly, I wore a mesh cloth elbow sleeve beginning around week 4 to help reduce the swelling. It also tended to defuse the pain so that it was not so acute. I have good ROM: with assistance, 0% flex and 140%. Pain and general discomfort have diminished a great deal over the past few weeks. Not pleasant at all before that. Hoping that improvement continues and I don't go backwards. PT massage of the joint beginning around week 4 also has played a big role in my recovery, as well as daily icing. Go to the grocery store and get two bags of frozen peas for top and bottom of elbow. Throw them back in the freezer when you're finished in order to re-use. Talk to your Dr. and PT about all this to make sure it's right for you. All injuries and results are different. Hope this is helpful. Glad to relay my daily routine if that would be helpful as well. Good luck. JHW

  18. #43
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    JHW,

    Thanks for your info. I am about 6 weeks post-op right now, the surgeon was really hesitant to let my PT guy push the limits with flexibility in the early stage. He was nervous because the shearing of my radius went down pretty far and he almost couldn't get the implant to seat in the bone. Right now after warming up I'm getting about 20-25 degrees from full extension, and a couple days ago I was a centimeter away from touching my shoulder (with pain and assistance). Still haven't done any strength building exercise, and it will probably be a couple more weeks before that starts. Pain is down quite a bit (none through the mid-range of motion, and none at rest unless its the first couple hours after I leave PT). I have a little bit of clicking/cracking in my arm when I bend it now though I suppose that is a bit normal. Getting a little bit of wrist pain, but nothing horrible, and also have a little bit of hyper-sensitivity in my right hand with any sharp or hot sensation. But the numbness/tingling is gone, so I'm told its a part of the healing process.

    Good advice on the peas, for some reason I hadn't thought to use two at a time. Also, good call on having a good therapist. I lucked out on mine and my surgeon who both have a lot of experience with this kind of injury.

    Thanks again, I'll keep you up to date and ask if I have any more questions.

    How is it doing now, JHW? Are you able to put any weight on it (pushups/weight lifting)? I'm in the military and trying to gauge my odds for staying in.

  19. #44
    JHW
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    I'm about 16 weeks out now. Swelling has continued to go down. Elbow looks close to normal except for the two scars on top and bottom. Yes to clicking-cracking. Some occassional and lingering pain and discomfort above elbow (for some reason) and in wrist-hand. I'm continuing my PT excercises every other day, which includes bicep curls, triceps, and arm extenions (for shoulders) with 5 lb dumbells, along with basic isometrics. On alternative days, I do the ergometer (arm cycle) and stretching at my local Y. I massage my arm a couple of times each day with a hand held massager. To answer your question, at my age, I'm not really concerned about weight lifting -- just being as pain free as possible!

    At this stage, I'm trying to wean off of daily Aleve and Tylenol for swelling and pain, which tends to increase during the course of the day. I've now been off for about 4 days and doing good. Hope improvement continues!

    Make sure your PT is massaging your entire arm at the end of your session. That will help. Over the course of my PT sessions, I went from 29 to 19 to 17 to 9 to 5 to 0 on extension, so your progress sounds fairly consistent. I was a little slower on flexion. I can only now touch my shoulder with assistance.

    Hope your improvement continues. Any special tips from your PT? Let me know if you have any questions since I'm about 10 weeks ahead of you.

  20. #45
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    Just now at 16 weeks. Doing the arm cycle and some basic weights at PT. 3-4 lbs for bicep curls, no weight for tricep extensions as that motion of my arm still hurts quite a bit (when the arm is above my head). The clicking and cracking seem to primarily by on the flexion motion primarily, but the more I let it crack the worse it will hurt later. Currently able to get to 130/17 in flexion/extension. But my progress in extension seems to has stopped. Using dynasplints for pronation/supenation and different ones for flexion/extension. If you haven't heard of those I would recommend them. You can just google dynasplint for more info to find a rep near you. Those are likely the only reason I am as far as I am with extension (as I was stuck at 30 degrees for about 4 weeks). They are a passive stretching device that you wear while you sleep.

    How is it now at 26(ish) weeks for you JHW? Still off of pain meds? How has your strength come back?

    Thanks again, hope you are doing well.

  21. #46
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    I'm new to this forum. It's the only forum I've been able to find with recent responses regarding Radial Head Replacement post surgeries. I'm female and my injury wasn't caused by biking but by slipping on ice in mid Dec. 2010. I'm now in my 7th week post elbow replacement surgery. I'm trying to wean myself off from pain pills and am now only taking 1 a day, but may have to go back to 2 a day for the aching and pain is still a little much. At what point are you able to completely stop the pain pills? I'm probably going to have to have the DynaSplint to help with arm extension and pronation. After basic PT exercises, my supination is good. My wrist locks up occasionally. I'm unable to touch my shoulder yet. I massage my arm daily especially around the incision to help with buildup of scar tissue. This also helped with numbness which is now gone. I'm rubbing Vitamin E on the incision to help with scarring. My shoulder has been bothering me like it's out of place or something. I have a Drs. appt. this week so I hope to have more answers. At what point does the arm stop aching? How close to back to normal can you get with this type of injury? Is 6 months or more the norm for recovery? I wish I could turn back time and retract my steps! This appears to be a rare injury, so it's nice to see feedback from this forum.

  22. #47
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    Hi all. Some great information here from you all, I have bookmarked this page to refer back to for when my PT begins.

    Anyway, thought I'd share my story too. I'm a 28 bloke and I was riding to work when I collided with a car at a pedestrian crossing. I was doing about 20mph and not looking at an oncoming car but more concerned with the traffic that was stationary!! End result, a mashed up foot and elbow and a week in hospital! Thank god for my helmet otherwise I might not be here right now.

    Heres my x ray showing the damage to my elbow: (you need to be logged in to view it)



    My Ulna has a break in it and my Radius has broken and dislocated too.

    Heres my x ray showing how it was fixed:



    Nice new radial head for the Radius and some metal work and screws for the Ulna, job done!

    I'm now 2 weeks post op. I have been back to the hospital this week to have the staples removed (17) and i'm currently rocking a full cast which will be on for another 4 weeks.

    Then it'll be time for the PT

    I've noticed that currently some of my fingers aren't able to bend back so my doc has advised me to start PT on those now whilst theres scar tissue healing as it will be much harder to do it 4 weeks down the line when everythings healed a bit better. Has anybody else had this problem?
    Attached Thumbnails Attached Thumbnails Riding after radial head replacement-mtbr-xray1.jpg  

    Riding after radial head replacement-mtbr-xray2.jpg  


  23. #48
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    Hi Ryki! So glad you were wearing a helmet! You injured your arm pretty good! My fingers were fine, but I had problems with my wrist once my splint was removed. It hurt so bad I thought it was broken. I am about 13 weeks out now and with much PT I am doing better. I am now wearing a DynaSplint at night time, but I still can't extend my arm out fully nor can I touch my shoulder. It's still a work in progress. I did buy an upper body cycle and that is helping me with gaining strength...especially the triceps. My supination and pronation is almost back to normal. My shoulder still gives me fits even though I'm doing shoulder exercises to help. My next Drs. appointment is the first week of April so I'm anxious to hear what the Dr. thinks. Keep us posted on your recovery Ryki. The sooner you can start your PT the better.

  24. #49
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    Thanks for replying Purrsey. Now 6wks post op and my cast comes off today. The whole arm has been alot stronger over the last 2wks but I guess thats all going to change this afternoon once no longer have the support of the cast.

    The fingers are back to normal after some modifications to my cast as I couldnt bend them back far enough!

    I've tried to do some slight pronation/supernation movement within my cast, hurts a little but feels strong enough for me to atleast try. obviously the cast limits every movement I do so the PT has been miminal.

    Pain overall has been minor really, dunno whether thats because i have a high pain threshold though. Aches during night when im tossing and turning tryin to find a comfy spot, have been taking tramadol to help combat this but my supplies are low!

    I've looked into the dynasplint. looks like a good idea but how does it affect sleep pattern? is it comfy to wear?

  25. #50
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    16
    well 5 hours after writing my last msg and the cast is now off. Initially i was hugely cautious and it felt very strange but after coming home and having a good wash (which felt amazing!) my arm feels good.

    I've had a go at some ROM but not alots happening. All of my pain is in the wrist too?? Not sure how this degree stuff is measured so this is a guess but ive got a range of 15 degrees with supa/pronation and about 30 degrees range with flex/extension.

    Doc has signed me off for 6 wks (that will be a total of 12wks off work) and I will get my 1st PT appointment at some time this wk.

    i shall keep posted.

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