Post-Fracture Triceps Strength Recovery: Can Targeted Training Help?

Triceps strength after femoral fracture surgery?

Hello Doctor: In 2021, I suffered a comminuted fracture of the right humerus due to excessive wrist strength.
After evaluation, the doctor recommended surgery to implant a steel plate for stabilization and recovery (the surgery involved the radial nerve).
About a year after the plate was implanted, the bone fully healed (I started exercising four months post-surgery, but did not undergo specialized rehabilitation).
Considering my fitness goals and my relatively young age, I discussed with my doctor and agreed to remove the steel plate in February 2022, one year post-surgery (I refrained from exercising for over 10 months post-surgery to allow the holes from the screws in the bone to heal).
In February 2023, I began to truly return to fitness training; however, there is a significant difference in triceps strength between my right and left arms (according to body composition analysis, my right arm has 0.3 kg less muscle than my left).
In terms of performance, during isolated triceps training, the difference is approximately 13:4 (under the same weight conditions, my left arm can perform 13 repetitions to failure, while my right arm can only manage 4 repetitions to failure, and this is not due to muscle soreness but rather a feeling of being unable to effectively control the muscle, as if I can only engage part of the triceps).
Visually, the difference is not significant...
I would like to ask the doctor about the issue of muscle strength loss.
Is it possible for me to recover through subsequent specialized training? Is there a ceiling to this recovery (for example, will I only be able to reach a certain level of recovery no matter how hard I try)?

A-Hsun, 40~49 year old female. Ask Date: 2024/01/13

Dr. Shi Guozheng reply Orthopedics

Gradual training can help restore function to a certain extent, but it may be challenging to reach the level prior to the fracture.
One can only train as much as possible.

Reply Date: 2024/01/13

More Info

Post-fracture recovery, especially after a significant injury like a humeral fracture, can be a complex process. Your experience with a comminuted fracture and subsequent surgery, including the involvement of the radial nerve, adds layers to your recovery journey. It’s encouraging to hear that your bone has healed, but the challenges you face with triceps strength are not uncommon.

First, it’s essential to understand that muscle strength recovery after a fracture can be influenced by several factors, including the extent of the injury, the duration of immobilization, and the specific muscles involved. In your case, the triceps muscle may have experienced disuse atrophy due to the prolonged period of immobilization and the impact of the surgery on the radial nerve, which innervates the triceps.

The good news is that targeted training can indeed help in regaining strength. Muscle memory plays a significant role in recovery; your muscles have a remarkable ability to adapt and regain strength, especially if you are consistent with your training. Here are some strategies and considerations for your recovery:
1. Progressive Resistance Training: Start with light weights and gradually increase the resistance as your strength improves. Focus on exercises that specifically target the triceps, such as tricep dips, overhead tricep extensions, and push-ups. Ensure that you maintain proper form to avoid any additional strain.

2. Neuromuscular Re-education: Since you mentioned feeling a lack of control over your triceps, incorporating neuromuscular re-education exercises can be beneficial. These exercises help improve the communication between your brain and muscles, enhancing your ability to activate the triceps effectively. Simple isometric contractions (holding the muscle tight without movement) can help in this regard.

3. Physical Therapy: If you haven’t already, consider consulting a physical therapist who specializes in post-fracture rehabilitation. They can provide a tailored program that focuses on regaining strength, flexibility, and coordination in your triceps and overall arm function.

4. Consistency and Patience: Recovery takes time, and it’s crucial to be patient with yourself. Set realistic goals and track your progress. Celebrate small victories, such as increased repetitions or weights lifted.

5. Avoiding Plateaus: As you progress, you may encounter plateaus in your strength gains. To overcome this, vary your training routine by changing exercises, increasing weights, or altering the number of sets and repetitions. This variation can stimulate muscle growth and prevent stagnation.

6. Nutrition and Recovery: Ensure that you are consuming a balanced diet rich in protein, vitamins, and minerals to support muscle recovery and growth. Adequate hydration and sleep are also vital components of recovery.

Regarding your concern about a "ceiling" for recovery, while some individuals may experience limitations based on the severity of their injury or other factors, many can achieve significant improvements with dedicated training. It’s essential to listen to your body and adjust your training as needed. If you experience pain or discomfort beyond normal muscle fatigue, consult with a healthcare professional.

In summary, targeted training can significantly aid in the recovery of triceps strength post-fracture. With a structured approach, patience, and possibly the guidance of a physical therapist, you can work towards regaining strength and functionality in your arm. Remember, recovery is a journey, and every step you take towards improvement counts.

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