husband wrecked bike, hurt shoulder, does ALS patient's heal?

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papaw50

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My husband had a bike wreck yesterday. His als is in his hands, arms and speech but not in his legs. Much to my dismay, he was taking this bike ride but he is a fighter and the als has not stopped him from doing anything yet. Anyways, I took him to ER because he landed hard on his shoulder, head and ribs. They said nothing showed up on x-rays. They put his arm in a sling for 3 days. He is in a lot of pain! My question - in the back of my mind I remember Dr. Guttman saying something about not overdoing, etc. because if he would injure a muscle or damage his muscle, in an als patient it wouldn't rejuvenate, or something like that. He's unable to move his arm today - does this mean he might never be able to move it again? Thanks for anyone's help.
 
Hi, this post is very interesting to me, as I fractured my back last September while having ALS, although I didn't know at the time that I had it. My back has not healed, but I am not sure of the reason why. I know it wasn't treated right. Also, I sprained my ankle recently and it has never regained it's strength. I have had several falls lately due to my weakness, and after each one, I never seem to recover fully. I will be interested in reading the answers to your post. I hope your husband feels better soon. Good luck to you both
Linda
 
One thing I noticed before even thinking about ALS is that cuts and scrapes seemed to take a long time to heal, and scars last longer, but I've banged myself up pretty good several times recently and, while I didn't heal fast, I did heal. They also told me to not "over do" it, but I just cannot give up biking, and I feel a LOT better after a few hours on the bike.

As my arms and neck have weakened, I've had to switch to a recumbent, and then I had to get my bike shop to rig it up such that I could actuate both brakes with one lever, and shift both dérailleurs from the right.

I can't prove it, but I suspect the bike is the reason my legs are holding up so well while the arms waste away--probably good for the lungs too. Please don't try to stop him from biking, but you might want to get him started looking at recumbents, especially if he's crashing due to neck fatigue or if his ability to keep a tight grip on the handlebars is compromised. With an upright bike, you need to really wrestle with the handlebars on a steep climb and when you hit a rock or pavement crack it will try to wrench the bars away from you. With a recumbent, you don't need the tight grip on the bars, and if you fall you won't fall so far--you'll still get road rash, but not as much impact.
 
As Adrian says as we get older we don't heal as fast. I know this from experience. An injury to the muscle of an ALS patient probably won't heal back the way it was. I'd be surprised though if your husbands arm isn't moving in a couple of days. It should take a bigger injury than that to kill his movement permanently. If it's still not moving by weeks end he might need some physio.
AL.
 
not to scare you, because as you know ALS is VERY unpredictable, but to share a little about my fathers experience: My father was diagnosed with ALS after a fall he had at work. He had always been active prior to this and the fact that he wasnt getting better is how we found out he had the horrible desease. I dont know if this if very relivent to your situation, but my dads injury to his knee never did heal and he is now strictly wheelchair bound due to the deteriation of his other knee.

Again, I don't say this to alarm you, this may have been just how his symptoms came about, but I figured no info is bad info! :)

Hope this was helpful!

Christina
 
Good news or bad news it is good to hear it because then you at least have an idea of what COULD happen even if it doesn't.
AL.
 
Actually, I seem to heal faster than before I had ALS. Simple things like cuts and scrapes.
 
one more thing about recumbent bikes, then i'll leave it alone:
don't present it as "time to trade in your racing bike for a recumbent"--it makes sense to ride both. they exercise different leg muscles, so riding both is good cross-training. also, since its different muscles, it may take a little while to build up to a comfortable level on a recumbent.
 
I think it would be good for him to go see a physical therapist who is familiar with ALS. Rather than simply immobilize the muscles, they might be able to guide him in specific exercises to maintain range of motion and regain function while being careful not to over-stress and cause further damage.
 
husband

I appreciate each and every one of you for your responses. Someone at our church had mentioned they thought he should follow up with physical therapy and not keep the shoulder immobile. We thought it sounded like good advice and then I come on the forum today and see the same advice. I'm thinking we'll be calling his doctor to get the therapy set up. As of this morning, he's still unable to raise his arm without pain. He's not one to complain and he's always been able to tolerate pain, too. But - i can tell you he is ready to get back on his bike. BUT, we will be buying a helmet. That is a MUST! We went to Walmart last night and loaded up in the back of the truck. We also bought some porch furniture...loaded up in the back of the truck. Got in, turned the key - nothing. ha! Had to call a tow truck. I'm thinking "HMMMm - when it rains it pours!" Not my husband. He was like "oh well - things happen for a reason". He is my hero! Throughout this entire ordeal - ever since he was diagnosed in June '06 - he has had as awesome attitude. He has taught me a lot. A lot of people have been inspired by his attitude. And, we've learned to take one day at a time. Teaches one patience. A couple of years ago, if something like that would've happened (truck not starting) I would've been frustrated. I was tired - been a long day...but I stayed calm. ALS vs. truck not starting?! we just don't sweat the small stuff anymore.
Again - thanks to those who responded with advice. The PT sounds like a good thing. We will continue to keep all of you in our prayers and thoughts. I LOVE this forum.
 
My physical therapist told me that the main reason I want to avoid illness or injury at this stage is that once an ALS patient is "out of commission" for days or weeks most of the time they cannot make up for the lost time. The muscles cannot bounce back from the lack of activity like healthy muscles can. I know it can be difficult to figure out how much activity to do if you are still able. Exercise can make you feel better, but too much can make you feel worse, and then there's the chance of injury.
 
Sorry to hear about your husband papaw50.

one more thing about recumbent bikes, then i'll leave it alone:
don't present it as "time to trade in your racing bike for a recumbent"--it makes sense to ride both. they exercise different leg muscles, so riding both is good cross-training. also, since its different muscles, it may take a little while to build up to a comfortable level on a recumbent.

Of course there may come a time when you are no longer able to support yourself on a road bike.

I can no longer safely control my road bike - but can still tear up the trails on my recumbent.

I recommend under the seat handlebars with bar end shifters.
 
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