Elbow Surgery: Why I Decided to Cancel and What I Learned
As I shared in an earlier post, I’ve been dealing with an acute elbow issue, and after careful consideration, I had decided to cancel a surgery I had scheduled for November 22. Looking back, this turned out to be a great decision. Here’s the full story of how I got to this point—and the lessons I learned along the way.
The Initial Injury
It all began on October 2, when I was exercising and something in my elbow popped. It was one of those moments where you ignore the usual red flags, push through the discomfort, and regret it later. I should have known better. It’s often the hardest to coach yourself, and that’s where my initial mistake was made. I assumed I would be fine and the voice in my head that I normally vocalize to others – be careful, let’s go slow – was drowned out by the other voice – don’t worry, you’ll be fine.
The panic and grief of the injury onset immediately – what the fuck did I just do to myself?! But after a few minutes, I put on my coach’s hat and started to evaluate what went wrong and what I was going to do about it. I started a basic rehab protocol, and within a few days, I noticed improvements—gaining back range of motion and some strength. But there was still a lingering “funkiness” in my elbow that wasn’t quite right, so I decided to see a professional.
Seeking Help at the Minor Injury Clinic
I went to a minor injury clinic where they couldn’t find any sign of the injury. The tissue I had ruptured seemed so small that it didn’t even cause swelling, which made it hard for the doctor to pinpoint anything. I was referred for an X-ray just to start the ball rolling on potential treatments – if anything was to be done at all.
That’s when things took an unexpected turn. Between the appointment and the X-ray, I noticed a small nodule starting to form on the end of my elbow. By the time I saw the Physician’s Assistant, this nodule had grown to the size of a jellybean and was freely floating around inside my elbow. It was causing some discomfort because it would get stuck as I moved my arm around or get pinned down when resting my arm on things and cause some pain.
The MRI and Potential Surgery
While my elbow’s overall function was improving, the floating body continued to grow. The PA recommended an MRI, and based on the results, it looked like I might need surgery to remove it. The position of the MRI aggravated the bursitis long present in my elbow and in swole up to a half a baseball within hours after the scan.
Then I met with the surgeon who saw my elbow in a pretty bad spot overall. The procedure would involve a 2–3 inch incision crossing the joint of my elbow, draining the fluid, and removing the floating body. The line item that bothered me the most was the indication that they would have to pin my surface tissue down to the muscle to create a “filled in space” to prevent the previous fluid-filled-void to accumulate more fluid and risk infection.
Recovery sounded like a hassle too: I’d have to keep my elbow in a fixed 90-degree position for two weeks, followed by several weeks of regaining full range of function. While I trusted the surgeon to complete the specifics of removal and drainage, the idea of going through all that recovery, when I wasn’t in significant pain to start with, gave me pause.
A Change of Heart
I initially accepted the surgery date, thinking it was the best course of action. It was an incredibly quick turn around – quite literally less than a week from my consult with the surgeon. I got cold feet and cancelled. My elbow function had improved significantly, and I wasn’t experiencing discomfort during daily activities. Plus, the floating body wasn’t hindering my movement all that much as I got used to what bugged it and used a compression sleeve to keep it in place. I decided to take some time to think it through.
Instead of rushing into surgery, I started experimenting with some more aggressive movement and blood flow activities. I doubled down on the elbow sleeve as was wearing it 24/7, taking it off only to shower. After about two weeks, I had noticed a bit of improvement but not enough to completely write off having surgery.
I then started using compression tape to press down on the fluid-filled area, encouraging it to be absorbed. Within about two weeks of this more aggressive approach, the swelling in my elbow had almost completely disappeared. The nodule was still there, but it was potentially reduced in size and less noticeable (it was hard to tell as I had it covered for so much of the day and lost a read on how big it actually was).
Why Surgery Might Not Be Necessary
Now, looking back, I can see how important it was to take the time to explore my options. My elbow feels better than it did before the injury, and I’m confident that if I continue this approach, the issue might resolve completely without surgery. There would simply be no fluid to drain. As for the floating body, if it can be incrementally reduced in size there would cease to be any reason to cut my elbow open to begin with. I am a bit irritated with the medical system and these series of doctors that didn’t have it within their tool kit to recommend exactly what I did – which all seems very sensible, basic and readily accomplished.
The key lesson here is that when it comes to surgery, patience is crucial. Being as transparent and self-reflective as possible, I understand that my elbow issue is likely a 1 out of 10 in terms of the severity of circumstances that someone might contemplate surgery. But I think it does serve as a helpful baseline to consider.
Just what might happen if you went all-in on fixing the issue that lead to your surgical circumstances? How much resolution could you get with your daily homework? What is the surgeon missing?
Surgery should be the last resort, not the first option. If you’re in pain that significantly impacts your daily life and there is no hope in sight, surgery may be necessary. But for most orthopedic issues, time is on your side, and with the right approach, you can often avoid the scalpel. Stuart McGill, often referred to as THE resource for lower back pain, often suggests that people go through “pretend surgery” to both redact the mechanical circumstances that lead to your pain (i.e. stop lifting weights) and undergo the rehab process (i.e. do the wimpy low back activities you would have to do to recover from surgery) that would occur if you got surgery. And in many cases the problem resolves with greater efficacy than the surgery itself!
Final Thoughts
This experience reinforced my belief that surgery should always be a last resort. You have more options than you might think, especially if your condition is the result of a specific, mechanical incident. For my clients and anyone reading this who’s considering surgery, my advice is simple: Ask a lot of questions, take your time, and explore all possibilities before making a decision. Even if it means waiting a bit longer, your body might surprise you.