Tag Archives: arm

Shoulder Surgery – 13 weeks in

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Arm Bike Physical Therapy

Arm Bike Physical Therapy helps overall strength - Courtesy of: Physiotherapy-treatment.com

Catching up since my last post, my recovery from Open Bankart Surgery on my right shoulder is progressing rather well. Our main focus for my physical therapy has been strength training. This means all exercises have added 3 lb. weights to their motion and my PT has introduced an outward/upward arm lift while lying on my stomach. Other than that there has been little to no change. The PT also introduced the hand bike on it’s lightest setting. I do two minutes and thirty seconds of forward rotation. Then I do another two minutes and thirty seconds of reverse rotation.

Overall this portion of therapy has been physically challenging because I’m going from doing nothing but motions to actually stressing my arm with extra weight. The hand walk while on the exercise ball continues to be my absolute least favorite exercises. The other exercises challenge my strength and range of motion, but that exercise in particular truly tests my arm (keep in mind though I have lost 10 lbs. since starting PT, I’m still a solid 235 lbs. at this point– that’s a lot of me to keep lifted in the air).

I now have 180 degrees of inward motion (full range of motion) with little to no pain. I also have 72 degrees of outward motion with serious discomfort. This outward range is above normal and the last area to return as far as muscle conditioning is concerned, but it is returning slowly and surely.

Finally, my left shoulder continues to exhibit minor discomfort. It is obviously has some residual damage from all the stress put on it, but it’s not a complete loss. I will clearly need minor PT on it to clear up issues, but I think long-term it should be okay.  There has been no dislocations in the left shoulder for a month now, but there is noticeable limitations in range of motion/ease of use and extra pain during full extensions at the limits of motion. Still– my orthopedic surgeon wants me to wait on rehabbing it until the right side is “normal” again.

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Shoulder Surgery – 10 weeks in

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Isometric Strength Training

Isometric Strength Training - Courtesy of summitmedicalgroup.com.

Catching up since last post on my recovery from Open Bankart Surgery on my right arm, things have been very good as we go into week ten of recovery and week eight of physical therapy (PT). My left arm has on and off been an issue, but overall has been better than weeks before. I have now, without too much issue, hit 180 degree reaching upwards. My arm starts to tremble after about 2 minutes of being in this 180 degree position unassisted on its own and I start to feel intense pain after about five minutes of sustained outstretched reach. This is considered normal range and because of strength issues is expected. Long term strengthening would address this issue, but I have not been cleared for actual physical strengthening with weights thus far. Either way, I’ve recovered 100% on internal motion.

This Monday (1/4/10) I will see my orthopedic surgeon. The expectation is that I will be cleared for full outward motion and inward strengthening. As such, the head PT therapist cleared me for “isometric” strengthening. As the surgeon said internal motions are safe there is no issue with these excercises. The two new isometric exercises added are done by using light resistance against a wall. The first involves pulling inward while holding against a wall and the second involves pushing forward against the wall. Again, these both activate the muscles in the upper shoulder and work towards actual strengthening of the upper bicep. These are both key to stabilizing my shoulder, which since I’ve hit my next milestone I’m ready for. This upper arm strengthening will be key to preventing future dislocation and also maintaining overall arm strength at normal levels.

Outward motion wise the head PT was able to get my arm to about 50 degrees. This was way beyond the 30 degrees expected and shows I’m ready for further outward stretching and conditioning. I’m also able to put my hand to the small of my back (the handcuff position) and across my chest to touch my opposite shoulder without issue. Again, this is done with minor discomfort and shows overall shoulder muscle healing has been achieved.

I’m 100% on target recovery wise and this is all good signs. We’ll see what the surgeon says, but I’m pretty hopeful at this point for being cleared for strengthening and outward motion.

I’ve also been told that once that happens I’ll be cleared for Nintendo Wii Bowling therapy. I’m not making this up. My ultimate goal will be Wii Golf or Tennis. Again, these are valid methods of rehabilitation. The idea is these video games simulate real world movement of active sports motions and if you can do them in simulation then you can do them in real life. Thus proving my ability to sustain normal activity and then some.

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Shoulder Surgery – 9 weeks in

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Shoulder Electrical Stimulation - For the record that isn't my shoulder.

Shoulder Electrical Stimulation - For the record that isn't my shoulder. I'm not that old (yet)!

Since last post my right shoulder has continued to be stable. Recovery wise there’s not much physical changes that take place during week nine. The important thing is the shoulder is becoming stronger. It’s easier to lift things. Easier to open doors and jars. Overall just easier to live life normally. My biggest example of recovery came with a large snow storm that rolled through on 12/19/09. The storm dumped about eight inches of snow on the ground. I managed to shovel my 10′ x 100′ driveway, as well as, the large area around my house where we park our cars without issue. It took me a bit over two hours, but aside from some soreness in my left shoulder there were no ill effects. I was careful with lifting and made sure to lift at the knees. I also bore most of the half shovel full loads of snow on my left arm. Still, even my physical therapist said this is an excellent sign. I do notice if my arm vibrates or it is shaken the bone is still sore, but I can say that it does take both force and sharp movement to make it happen. Again, normally it feels pretty good (less than a two out of ten in pain) 90% of the time.

My upward rotation is around 175 degrees and near full motion. Oddly I can lift my arm to this position laying down or standing up without issue. When the therapist does it though I seem to subconsciously tighten up and limit my motion to sub-160 degree levels. I talked with both the therapist and chiropractor about this– they agree it’s either a physiological thing (and believe me one I try to overcome it) or because of the angle they move it at (there may still be a rough spot in the humerus at that point where it rotates). Either way though, I’m around 98% recovered in the forward and back range of motion. We continue to work on outward motion as well.

The therapist has begun weaning me off both the heating pad warm up portion of PT and cool down electrical stimulation portion of PT. We still ice at the end for fifteen minutes though. The worry is that I obviously won’t be doing e-stim after PT ends and that you don’t normally warm up your arm with heat before using it. So every other session we skip heat or e-stim (rotating what we skip).

I continue to experience minor problems with my left arm though that even seems a bit better. I find doing my at home PT in the shower is helping to stretch out the joint and keep my shoulders balanced. Overall though I’d say even the left arm is about 10% better than last week.

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Shoulder Surgery – 8 weeks in

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Arm Pulley PT - Not as painful as it looks.

Arm Pulley PT - Not as painful as it looks. Trust me.

Last time I talked about the ever closer road of normalization as I continue my recovery from Open Bankart Surgery on my right shoulder. I would say this week has been much of the same. I am eight weeks away from surgery and six weeks into physical therapy (PT). There has been no major change in my physical condition overall since my last post. My left shoulder continues to experience minor dislocations and is now in more pain than my right. This is because right now my right shoulder has little to no pain 90% of the time.

My range of motion is still limited in that I cannot reach outward above my shoulder, lift or pull more than ten pounds, or partake in strenuous physical activity such as sports or heavy housework. Overall though I’m able to do about 80% of what I did living with my shoulder in constant danger of location. The difference is there has been no indication the right shoulder would dislocate and that is a major improvement. It’s in there pretty good indeed.

Otherwise the week has been pretty much plateau in nature. I made no more forward progress beyond 170 upward and 30 degrees outward. Nevertheless after being examined by the PT’s office chiropractor I was pronounced fit to proceed with light physical exercise and told that I’m recovering very well considering the extent of the surgery. He also altered my routine a bit. Now they do the shoulder massage, apply heat, and then let me do scapular crunches against a wall with a balled up towel in the middle of my back. I also so a free arm pulley to lift my right arm upward and perpendicular to my collar bone. Each of these is for ten times. I then walk the wall ten times with my arm again to stretch it upward. Then it is twenty circular pendulums in each direction, twenty side to side pendulums, ten shoulder shrugs, ten forward and reverse shoulder rolls, ten bicep curls, ten elbow circles in each direction, and then three 15 second neck stretches to each shoulder. I actually get done with the whole thing in about ten minutes. It’s actually pretty painless and I feel good afterward. They then ice me while applying electrical stimulation.

I also do this routine once a day at home while in the shower in the morning in addition to my three times per week during PT.

I am now through my second full week of work. There has been no issue with that. I do notice my shoulder does bother me in the extreme cold (sub-twenty degree temperatures) and my regular PT therapist says that is typical.

Otherwise no news for once is good news.

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Shoulder Surgery – 5 1/2 weeks in

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Shouler and Upper Torso Muscles

Shouler and Upper Torso Muscles

Last time I talked about the significant strides I was making in recovery from Open Bankart Shoulder surgery on my right arm. Those strides only continued through week four into week five. Week five proved to be one of some major accomplishments. I recovered from my previous set backs and just before my five week visit to my orthopedist was able to move my arm to 128 degrees. With that, I visited my orthopedic surgeon who was pleased with my progress. The exam was fairly quick. He checked my forward and back rotation (he was pretty shocked when I reach upward and backward without pain). He checked my external rotation (about 1 degree, which is good without pain at five weeks).

The surgeon than issued my updated physical therapy (PT) prescription and sent me on my way. He’s going to see me in another six weeks on 1/4/10 for my twelve week visit. That should be my final post operation visit if all goes well. The new PT prescription added external rotation (think making a chicken wing flapping motion with your arm or reaching out to your side to grab a drink– both are external rotations) along with strength training that is to commence on this Wednesday (12/2/09). Three weeks after that point (9 weeks or 12/16/09) additional stretching and strength training are added to intensify the final stages of healing and muscle regeneration.

With that I went off to therapy where after intense massages on the shoulder I was able to reach upward while laying down to 140. This is near full rotation and I had to fight through pain to pull it off, but I did pull it off.

PT Performing 140 Plus Rotation Upward

PT Performing 140 Plus Rotation Upward

The next three sessions including today’s built on continued upward stretching past 140 degrees. The PT session after my five week post op also introduced a change to my exercise routine. I now do two minutes and thirty seconds of circular pendulum swings (clockwise and counter clock wise each direction), two minutes and thirty seconds of side to side pendulum swing, and finally two minutes and thirty seconds of forward/back pendulum swings. This was to allow more rotation of my still irritated humerus head and add more range of motion to my work out. I still continue to do the shoulder shrugs, shoulder circles, bicep curl, neck stretches, and external elbow rotations.

The following PT sessions (11/18 and 11/20) continued those excercises. I noticed that on 11/20 I was starting to feel stiffer than normal. That stiffness increased until 11/23 where the PT treated it with electric stimulation of the arm while being iced. This seemed at first to only irate the situation, but about an hour later when I thawed I noticed I did feel better and had near normal range of painless motion with no external reaching.

The subsequent 11/25 PT session also involved light stretching and more e-stim while icing. Again, about an hour later my stiffness was nearly 100% gone.  I felt so good in fact I was able to go out and sit through dinner without issue (sans sling) or pain. Thanksgiving weekend also went without a hitch and I was even able to put up Christmas decorations.

I had one minor instance this past Friday (11/27) where standing up I pulled my back out slightly. The following day I fought through my PT sessions and took some Aleve to mitigate the pain. By 11/29 though I felt nearly 90% better. Today I notice no lingering issues from that pull.

I noticed this morning I could wash my hair almost normally with my right arm though at an arguably slower pace than normal. Driving is also easier as is eating. I’m also seeing noticeable increase in right arm bicep strength as I continue to use the arm.

Today’s PT session rotated me to about 145 degrees (my limit where pain sets in) where I had to grimace through the grade six plus pain to allow the muscles to stretch. We’re trying to overcome that final upper limit and remove the pain. Only by stretching through the pain can that happen. So you basically just have to deal with it. My back muscles were less sore than in the past and the scar tissue only when really pressed upon exhibits soreness. The swelling is completely gone and there is no bruising anywhere any more.

All-in-all I feel about 45% better and seemingly continue to get better everyday. This Wednesday will be my six week mark where the chance of dislocation and infection drops significantly. Once I breach that point I can then begin strength training and that’s where the real work will begin. For now though, I’m enjoying painless and near normal living.

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