By Professional Physical Therapy
Buddy Valastro is a well-known American celebrity master baker, entrepreneur, television personality and author with Italian roots. He is best known as the star of the reality television series Cake Boss, which premiered in 2009.
Two years ago, Buddy suffered a severe injury to his right hand in an accident at home and has undergone multiple surgeries. During his recovery he teamed up with Deana Swanson, MS, OTR/L, CHT at Professional Physical Therapy to help him return to work in his family business and get back to doing what he loves, baking!
The American Society of Hand Therapists covered the complete story in a recent podcast episode, and we would like to share some highlights from the interview with Buddy and Deana. On this episode they discuss details of the terrible injury, the therapy and how they worked together to get Buddy back to doing what he loves. The day of the injury, Buddy shares his initial thoughts.
“I am like a high-level athlete in what I do. If I could not make cakes to the level of being in the major leagues, a part of me would have died. I was scared. I’ll never forget driving to the hospital with the spike in me, I thought I might lose my hand.”
Buddy Valastro, Owner of Carlo’s Bakery
Tell us where you are from and what you do?
Deana: I work in Parsippany, New Jersey doing hand therapy for 13 years. I got certified 9 years ago and have worked with every type of injury you can think of. I started with a lot of trauma cases and then went on to work in areas with more repetitive injuries. I also train other students and I mentor a lot in my own company. I love to teach which is one of my passions as well.
Buddy: I am a baker and had a very traumatic hand injury. In September it will have been 2 years. I had 5 surgeries on my hand and Deana was my occupational therapist. I could not be here today without her. When we started out, I did not know how far I could go or what I could do. And I am now about 90-95% back to my hand functionality.
Can you explain what happened?
Buddy: I am the “Cake Boss” on television. We make crazy elaborate cakes and everything I do is with my hands. My hands are everything to me. On a Sunday afternoon, I was trying to fix the bowling alley pinsetter in my home which I fixed before. I turned my hand for a second, and I was impaled by the machine. It was bad, it went right through my hand, the mechanism rolled my hand over and shattered my thumb. The injury was between my middle finger and ring finger, I broke my ring finger and thumb. Then I went to HSS to see Dr. Michelle Carlson who is the best; she operated on me. I had a total of five surgeries; I have one more to do. The tendon healed in the scar tissue, so she needs to take out or release some scare tissue in January and then Deana and I will be back in action. It was horrific what happened. Deena helped me tremendously through the whole journey.
How far post surgery did you have to start therapy?
Buddy: I started therapy about three weeks after surgery. They wanted me to start quick. I only had 5-10% of my strength when we started.
Deana: You also had a lot of restrictions; the doctor was not allowing a lot of MP flexion because you had k-wires on your hand. All we could do is bend the IP of the thumb and get a little bit of flexion of the index finger. So, therapy started with having you pick up little pegs and doing a hand therapy exercise called hook fisting. Initially, the most important thing to do is to deal with the swelling. Your hand was like a balloon.
Buddy: My hand today, about 2 years later, the swelling is only now back to normal. My fingers were so swollen, it’s crazy how much it shrunk from what it was. I am right-handed; it was my dominant hand, which made it even worse. I was not able to do so many things like button my shirt, open a door, brush my teeth. But with therapy and surgeries I was able to get to where I am today. It was wild!
Did you ever find a point where you had to pull the reigns a bit, to slow down?
Deana: When I worked with Buddy, I felt I was working with an athlete. He was very determined, and I could not have asked for a better patient. The way Dr. Carlson released everything and the technique and skill she had coupled with Buddy’s motivation made all the difference. He would not have gotten here without that type of motivation and the care he received from the surgeon. But yes, sometimes I had to pull him in.
How soon after the initial surgery was your next procedure?
Buddy: I was in excruciating pain. I had a big metal spike through my hand. I was calm and my two sons were there. They called 911 but it was my sons that cut me off the machine. When we got to the emergency room, they were able to take out the metal spike. I went to New York the next day and went back into surgery with Dr. Carlson. I was in HSS for a few days and then started physical therapy. Then a month later I had my third surgery and a few months later my fourth surgery. The initial surgeries were very closely spaced.
How did you begin transition back to job tasks, trying to get both gross and fine motor skills back so Buddy could do what he needed to do?
Deana: One of the things he does which is so beautiful and incredible is that he can make pedals with fondant and make a beautiful rose to put on a cake. One of his favorite things to do was to play with the puddy and he would make those peddles for us in the clinic. It was beautiful.
We would also mimic the work he would do while baking like squeezing a piping bag and rolling things out. Piping is a very exhausting task; you must have strength and you need to have a lot of control to change the pressure constantly. He would practice a lot, once the restrictions came off.
Buddy: In one of my shows during the season, I worked on a cake that I piped for 15 hours straight, and it had the most meticulous lines, layers of just squeezing the perfect piping. It was one of the best cakes I ever did, and this was after the surgeries. The fact that I was able to do that is amazing. The flowers are very delicate touches, using very fine motor skills to sculp and mold. Endurance was very important.
Buddy, what was the hardest part of the rehab process?
Buddy: The toughest part was not knowing if I was going to be the same. I am like a high-level athlete in what I do. If I could not make cakes to the level of being in the major leagues, a part of me would have died. I still had the imagination to be able to dream it, but to go and physically make it happen is a whole other thing. I was scared. I’ll never forget driving to the hospital with the spike in me, I thought I might lose my hand. I had no idea what my functionality was going to be and what was going to happen. Without my hands in what I do, I am really nothing. It was tough. I pushed hard.
Deana, was there nerve damage?
Deana: Yes, there was numbness, but it was not the type of nerve damage where there was muscle atrophy.
Buddy: The nerve has grown back but I still have a slight tingle. I don’t think it will ever be the same. But it feels much better than it did, 2 years ago.
Knowing Buddy’s expectations and the caliber of cake decorating he needed to get back to, how did you approach therapy from the get-go?
Deana: I took things in steps as I always do. I knew how important everything was. But I wanted to focus on what was in front of me. I did not put a lot of emphasis on what he had to get back to at that moment because there was so much swelling that I wanted to take it day by day and work as much as I could at that given point of time.
The way that I saw Buddy’s injury was similar to a gunshot injury to the hand that I had seen multiple times before. When Buddy presented his injury to me, he presented some of the same gun-shot wounds through the hand and I was able to systematically pull from that kind of knowledge and pull that into Buddy’s issues. So even though I knew he needed to get to things like piping, make cakes, pull all this dough together and really be active with his hands that was on the back burner for me. It has always been my experience that with trauma to first address the swelling and scar tissue. I did not know the outcome. I took it day by day and tried to break it down and do what I could do to fix or improve his condition. Everything was systematically approached, day by day, what can I do to make this better. That’s how I approached it.
Buddy: For people that are not in the industry, people that get injured and say, “do I really need physical therapy?” You have to do it. It is so important, and it makes such a difference. I am such a believer of it now more than ever since I saw it. I will never forget those first couple of visits to the clinic and saw Deana. She was so great with all the patients, and I saw how advanced they were getting and all the different things that they were doing. I knew she was great!
“Deana was amazing; we bonded. We are like family. She made me feel informed and pushed me to work hard and I stuck to it. It was a great friendship and bond that I will never forget. I always thank Deana and Dr. Carlson because if it was not for them, I don’t know where I would be today.”
Buddy Valastro, Owner of Carlo’s Bakery
Buddy: I see the joy that you get in your profession. It must make you feel so good that you could help someone get to where they are today. We all touch people’s lives in our jobs, but there is nothing like helping to heal someone. That’s a whole other world. I could not do anything with my hands. And the fact that I can do cakes at the level I am and be fine. It’s amazing!
Deana: Buddy listened to everything I had to say. I try to educate my patients and I hope that helped. I’d tell you this is what’s going on in your hand, this is the muscle we are working with to do this, to fix that. I hope that helped.
Stephanie Strouse (moderator): As a therapist, we put passion in what we do. To see someone, walk out of clinic and be appreciative, even if they can do something little. We make a big deal about it. To us it is a big deal to know you can be more independent and do something you could not do before.
Deana: It’s no fun having to rely on other people, at the beginning you really had to. It is a painful process that all of our patients go through. They must give up the independence that they love and take for granted. It is amazing you were able to get it back and I was happy to be part of the journey. I really was. I am very proud of you!
Professional Physical Therapy has more than 60 hand specialists on our team, and we are the largest provider of certified hand therapy in the Northeast. If you’re experiencing hand pain or discomfort, contact us at one of our hand therapy locations, so we can customize a rehabilitation plan just for you.