Tag Archives: external rotation

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 – 7 1/2 weeks in

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Scapular Strengthing w/weights (Courtesy: http://grantpierce.wordpress.com/)

Scapular Strengthing w/weights (Courtesy: http://grantpierce.wordpress.com/)

Last post I talked about how I was returning to a normal life. At 7 1/2 weeks away from Open Bankart Surgery on my right shoulder normality seems closer and closer. Shortly after my last blog post I had my follow up visit on 12/4 at physical therapy (PT) where I was able to reach an all time upward amount of 170 degrees. If you recall, 180 degrees is full rotation. It was very painful to go past 160 degrees, but I did it.

With that I continued my normal at home PT routine over the weekend and returned to work on 12/7. I was able to work both my PT in that day, as well as, my 3 at home (or work) PT sessions. Again, I was able to hit 170 degrees at PT and did so with less pain. We also continued external rotation (moving my arm away from my body) towards 30 degrees. Again, 180 degrees outward is your maximum, but for now this is the limit my orthopedic surgeon wants me working at.

I had to miss my 12/9 PT session because they closed their office for snow and to top it all off I came down with a cold that same day. This laid me up the whole week and stopped me from doing my at home PT work. When I returned to PT on 12/11 the effect was I reached upward to only 165 degrees, but was still able to go outward to 30 degrees. In short, my muscles though stronger overall from the rest are also tighter. We worked through a brutal upward stretching session that left my bicep feeling like chopped meat.

At that same PT visit the therapist added a scapular stretch, which is the motion you would do if you were standing straight up and pulled out a draw from a dresser while bending your elbows. Over the course of this coming week they will actually start me on scapular weight training to start building the strength back into my lower arms back up to normal, as well as, my shoulder blades and back.

The good news is that I’m noticing less and less daily pain. Sitting still there is normally little to no pain. Driving is minor discomfort when I get around 10 miles and I can finally sit through dinner while out to eat without having one of my arms pop out of the socket. This is all very good news. I also notice my upward reach in my protected zone (150 degrees or lower) is painless as well. I was able to get through four hours of mall shopping yesterday and over 50 hours of work this week. All with little to no discomfort. So there have been good gains overall. I plan now that my cold is letting up to get back to my at home PT starting today so I can catch up and restore any range of motion that I’ve lost over the last week or so.

As always, I let you know how it all goes by the end of this week.

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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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