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When can I start exercising?

Q: I am a 24 years boy. I am a body builder by profession. About 4 months back, I met with an accident and fractured my forearm. I got operated for this. A steel plate was put inside my arm. My problem is that my arm hasn't got back to its original shape and power. I would like to go back to the gym and work out the way I used to do. When can I start working out?

A:Fracture union for the forearm takes about 2-3 months in an adult patient, assuming everything has gone well. The X-ray evidence of union does not mean that the bone has regained full strength. This is because the mere formation of bone in its amorphous state does not provide the full strength. All the elements that constitute bone must be reconstituted in the right proportion and in the right alignment. This is a very slow process done by a process of bio-feedback wherein strengthening of the bone takes place in response to your muscle activity and joint function. This usually takes about one and half years. Normally therefore, you must start stressing your healed bones slowly to reach maximum loads only after a year and half. The worst forces are sudden impacts that happen with a jerk, wherein an acute transfer of energy can cause the weakest link in the bone at the fracture site to break. Therefore, once a plate implant is put you must only gradually increase the weights that you use for body building. But remember no jerks. Even after one and half years the wholes left by the screws especially at the ends of the plates will remain as weak points. Therefore, in your profession you may need to get off the plates as soon as possible. This is also important because the plate protects the bone from stresses and unless the bone is subject to stresses it does not regain its strength. Other than a normal diet that is balanced there is nothing in the diet that will change the rate or the total strength of your bony union.

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