Ravi, strength athlete

Consultant: Mr Ali Noorani

Shoulder and elbow fractures

Following a misdiagnosis of a torn biceps, Mr Ali Noorani stepped in to successfully treat Ravi’s humerus fracture.

Strength athlete Ravi is now back in harness in daily life and in the gym.

Ravi, a 21-year-old student, suffered a spiral fracture of his right midshaft humerus (long bone in the upper arm) while lifting weights in the gym in Spring 2019. At hospital his injury was misdiagnosed as a torn biceps, a condition that needs surgery within weeks to avoid permanent weakening of the arm. Unable to get this treatment in this timeframe and coming from a medical family himself, as the son of a GP, Ravi had professional knowledge at his fingertips to help him research relevant specialists. This led him to the Wellington Hospital, where he met Mr Noorani, who having viewed a video showing the fracturing process occurring to Ravi’s arm, was immediately able to correctly diagnose the problem as a humerus fracture without even performing an X-ray.

Ravi was extremely impressed by Mr Noorani’s expertise. He had expected to have an MRI scan confirming a muscle tear and to have surgery, and although he was initially confused by the conflicting diagnoses, Mr Noorani’s knowledge convinced him, particularly when his diagnosis was reinforced by the X-ray results. Mr Noorani explained: “Lots of athletes don’t recognise that repeated lifting of heavy weights without taking the time to recover and rehab properly can result in stress to the tendons and in this case, stress fractures to the bone which can result in a bigger injury. Small stress fractures can accumulate and result in a large stress fracture.”

X-ray showing Ravi's right midshaft humerus fracture

X-ray showing Ravi’s right midshaft humerus fracture

X-ray showing Ravi's right arm post treatment

X-ray showing Ravi’s arm post conservative non op healing

Normally, Ravi’s injury would have been treated surgically, but owing to the delay in it being correctly diagnosed, Mr Noorani opted to take non-operative approach and harness the body’s natural healing ability; a positive outcome is probable using this method providing the bone alignment is correct. Following an X-ray, Mr Noorani put Ravi’s arm in a secure brace and sling which helped reduce discomfort. As a strength athlete, Ravi had found it very frustrating to lose muscle condition; and was unable to work out and even walking was problematic. He also had to miss his university exams and sleep in an upright position and normal daily tasks were too much for him.

By October 2019 Ravi’s pain levels had decreased enough for him to try to go to the gym again. He was still weak, and his fracture hadn’t healed, but he was able to do some light training. Ten months post-injury Ravi is back lifting weights in the gym five times a week, without discomfort and feels almost normal. However, because his arm is not fully healed, he is only lifting relatively light weights for now. He said: “I’m very confident I will make a full recovery. The initial rough timeline I was given was essentially this. I’m now able to function fully outside of the gym. My arm is feeling much better.”

Having been sling-bound for five months and unable to carry out everyday activities, since early September, Ravi has regained confidence in his arms functionality and can now carry out essential daily living tasks again. Ravi’s was an unusual injury, but he advises patients with related injuries, to trust their body’s healing power, eat well, stay active and mentally strong. Friends, family and favourite leisure activities are all vital for support and emotional wellbeing too. He particularly stresses the importance of finding a specialist you can trust and then following their advice.

Ravi said: “I am very lucky to have found myself under the care of a world leading expert in sports injuries. He was able to give me critical advice on whether to operate to fix the fracture when it had (finally, correctly) been diagnosed very late. I have had great care, every step of the process and every decision has been fully explained to me, and the advice I have had has been spot-on.”

Mr Noorani said: “At 5 months, clinically Ravi’s fracture has healed. He has a near enough full range of motion. He is no longer in pain and he is no longer restricted in his activities of daily living. The X-rays show good callous formation (healing bone), and with time the fracture site will go through a process of remodelling and the healed fracture will consolidate and become stronger.”

February 2020