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Shoulder Surgery – 17 weeks in

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Light barbell weights

Light bar bell weights - For shoulder surgery patients you should be staying under 5 lbs during aerobics to avoid injury.

Last time I updated you on my shoulder surgery (recovery from right shoulder Open Bankart Surgery), I told you my insurance company cut off my physical therapy visits citing near complete relief of symptoms. I checked with my surgeon and he told me to wait until my visit today when we could evaluate the situation. He ran me through a range of motion test (upward reach, behind back reach, outward reach, and outward rotation). He agreed my outward motion was about only 90% recovered, but because there was no pain in full assisted extension he let me know that is okay. He thus told me that my shoulder was both stabilized and 100% healed from surgery.

My surgeon told I can come back if I have any other issues, but otherwise no follow up visit is needed. He also noted since my left arm had gone without dislocation for over two months it too was healed. He did check my left arm’s range motion and let me know surgery would not help in that situation as there was no actual loss of stability or permanent tear in the tissue.

Instead he recommended I join a gym or start doing light aerobics with light weight lifting on both arms. He noted that using the same exercises at PT on both shoulders would long term strengthen and stabilize the joint. Motions should be inward in nature and kept under five pounds during work outs. He advised against heavy weight training and any exercises that would increase elasticity in the muscle. He said my condition was genetic in nature and quite common as far as joint structure defects go. Other than that, I am officially recovered. I’m about ten weeks ahead of schedule and more fully healed than was expected. Both items are good news and it looks like in the long term I made the right decision– though I won’t lie that first month was horrible.

This ends my log of shoulder surgery recovery. I know many of you have been checking in and reading. I hope for those of you going through shoulder surgery this helped you understand what to both expect and what you have to look forward to. Many Open Bankart surgery patients need up to six months to fully heal (that’s 27 weeks) and in my case I had a quick recovery. If you’re not healing as quickly as I did do not get discouraged. You will see the same results, but I will tell you my secret was never giving up on PT and always working through intense pain. This is the only way you will ever recover.

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Shoulder Surgery – 13 weeks in

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Don't be fooled... healthcare is far from a non-profit industry!

Don't be fooled... healthcare is far from a non-profit industry!

Last post I talked about how my recovery from Open Bankart Surgery on my right shoulder had begun to focus on pure strength training and continued development of my outward flexibility. This routine was exactly the same for week thirteen except that my physical therapist (PT) increased my weight by one pound on each exercise. This made it overall much harder to do, but I got through it. I also cut back to two visits for the week. The pure intensity of the work outs require at least a day to recover and I find with the long weekend in between the sessions I recover more fully so as not impede forward progress. When I went to return for my second two visits to head into week fourteen I was told that my insurance company said my progress was adequate for the treatment and that I no longer needed PT. As such, they would pay for no more PT sessions.

With that I’m waiting to talk with my orthopedic surgery (hopefully tomorrow) to discuss this further. I’m not so sure this is the case. While I have regained about 75% of my capabilities I’m nowhere near being able to perform high impact sports or able to lift over thirty pounds. I also managed to get to an external rotation of 72 degrees. This is still short of 90% of the full 90 degrees that we wanted and thus there is no way I don’t need further treatment.

We’ll see how the appeal process goes, but with cost consolidation being the way of modern corporate America courtesy of the never ending recession none of this surprises me. Of course, it is disheartening to see one’s health care now comes under such scrutiny where close enough is considered fully recovered– not good news. Glad I didn’t get open heart surgery… I can only imagine how that would have been. It’s beating so that’s close enough for us!

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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 – 11 weeks in

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Upward Strength Training - Courtesy CommercialAppeal.com

Upward Strength Training - Courtesy CommercialAppeal.com

In my last post I recounted my continued progress towards being allowed to begin strength training some ten weeks away from Open Bankart Surgery on my right shoulder. This past week started off continuing those efforts and climaxed with my visit to my orthopedic surgeon yesterday afternoon (1/4/10). During that visit he checked both my upward and outward ranged. He was pleased I met both my goals (180 degrees inward and 30 degrees outward). With that, he lifted all previous limitations on my physical therapy with an updated prescription.

When I went to the my PT session later that day I was told we would begin strength training. I was told to drop the inward movement exercises (the pendulums and isometrics), as well as, the shoulder shrugs in favor of more intense exercise. With that we began with the normal massages. Since I could now (as of this week) lay on my stomach we also did a lot of back work on my right shoulder blade. The therapist was finally able to get to a spot along the inner ridge of my right shoulder blade that has been sore for sometime, but unable to be treated with full force. That of course changed with my ability to lay face down. We then had me lay flat on my back. I had to with both arms reach upward over my head holding a cane with both hands. This worked my upward motion and strength. We then stretched my arm upward to its limit. We then did upward and outward stretching. The therapist also ran me through a battery of outward motion stretches that literally pushed my arms to its limits. I then did the pulley with an outward motion. I then did scapular crunches against the wall with a towel between my shoulder blades. Finally I laid on my left side and did arm lifts away from body outward. I was pretty fatigued by the end of it, but not as sore as I thought I might be. I did not get either heat or ice. Again, we’re weaning me off those comforts.

I’ve been told the next six weeks will focus on additional outward flexibility and overall strengthening of my arm. I’m pretty excited to move forward onto new exercises and ultimately even closer to normality.

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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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