PT – the real deal

The good news first – I am making progress already with my ROM and this after only one PT!

Yesterday I was at the supermarket, grabbed a can from a higher shelf, put it in the basket and stopped in my tracks, thinking…. “what just happened??” 

 

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And then I realized, I had just reached for something higher with my frozen shoulder (!) and did it without a problem and no agonizing pain was shooting through my arm either. I literally had the above dogs look on my face!

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I also had my first real full session of physical therapy now. It lasted a good hour and my PT was nice, attentive and very hands on.

Of course I met some interesting characters as well. The receptionist acted like she has never seen me before, one lady told me the entire biography of her purple Mickey Mouse socks while another older guy stood half naked in the corner, massaging his back on the wall and felt obligated to give nonstop commentary to my exercises. Ugh.

 

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My PT wanted to see a demonstration of my homework and I was measured. I already improved 10 degrees on flexion…

 

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…and 14 degrees on this. Good stuff!!

 

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I made friends with the pulley and he stretched me a few different ways as well. Some went well, others not so much. I am not a fan of having my arm stretched across my chest and I was seriously not thrilled having my arm lifted up, so it’s almost parallel to my ear and held down, to “get a good stretch”.

The stretch was definetly there but it was pretty rough. At some point I heard a loud crack coming from my shoulder. I guess those were adhesions breaking. (I remember recovering from hip surgery No. 1 and No. 2, I had a ton of scar tissue and adhesions and getting up from a chair sounded like popcorn cracking in there.)

He did this 10 times and I was so glad when it was over; only to hear “and now another ten.”

 

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My PT said I have to stretch till I feel discomfort otherwise it does not stretch the capsule. Makes sense. At the moment my shoulder capsule is tight as tight can be and has adhesions.

He assumes I am in the “frozen stage” already but he also said I am responding well to PT.  Now I have one day off from PT and then twice PT, back to back.

No rest for the weary.

 

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And the show must go on…

 

Financial report

 

When I was at  PT  I was also asked what my goals are from PT. That was easy –  I want my  ROM  back and better quality of sleep. Simple as that.

Sleeping is becoming more and more difficult for me.

My R shoulder gets sore if I lay on it for too long, laying on the back I need to prop up the shoulder & my R arm gets stuck in midair; on the tummy is not ideal either and of course my arm is throbbing too. I am not digging this.

 

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More motions that are becoming challenging are giving a hug, shaving arm pits (maybe TMI but I am just being real) and reaching for the backseat while sitting in the drivers seat is monstrous.

Doing a pedicure on my R foot is also not a piece of cake. Having screws in my hip limits my reach down there as it is and combining it off with a frozen shoulder now really tops it off. I guess it’s time to have my twinkle toes done by a professional.

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On the bright side of things – I actually had a pretty good nights sleep after visiting the  PT  office. I think my  PT  releasing the muscle, which I now even know what it’s called…

 

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…actually helped already. My shoulder felt more relaxed and I was able to sleep through. Rare these days.

I also was not hurting too much after PT  BUT… I also did not have a full PT session yet. My first therapy was mostly talking about medical history, measuring and “some” PT. Might be a whole different story once somebody cranks my shoulder around for over a full hour.

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Started my new exercises too. So far I got 9 exercises, each 15x, 3x/ day. My first round was not good. I rotated my shoulder a tiny bit too much – it left me in tears during that exercise. I hope not to experience thay any time soon again.

 

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Evaluation day

 

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You know you have spent too much time in your PT office when you are greeted by the receptionist with the words… “oh, you are back!”

It was strange for me to be back since I spent last year five months in this office and worked by butt off after my hip fracture. Brought back a lot of memories.

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I was evaluated by the head guy of the office who has over 40 years of experience in this field. We first went over the anatomy of the shoulder, which tendons lead where, which muscles pull which direction, etc., how it’s all “supposed” to work.

 

He asked me to demonstrate my  ROM  and I was measured. Extension was 90 degrees of 175 degrees. Not great.

I was told all other degrees as well but at some point they became too many to remember. Basically, ROM is quite limited but the good news is, I am still early in this journey and he actually thinks with proper PT, I will respond well to it and it won’t take too long to recover from. Music to my ears.

 

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Exercises I did, were the pendulum in all four directions and several stretching exercises while holding an about two feet long stick for balance. Some exercises I did on my own, on some stretches he stretched me further than I would have chosen to go.

He was happy with it, while I was having a tough time and seriously thought “another second and my shoulder WILL  pop out of the socket!!!”

 

I actually did increase my degrees of  ROM  already within one visit  BUT  it was not pretty.

He was gentle and careful but some of those “let’s see if we can go a little further”-exercises were rather tough. I felt like somewhere else entirely, hearing “push, push, push, push!” next to my ear.

 

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I was also told some muscles connect to the ribs in front and mine were  SUPER,  SUPER  EXTRA tight. So tight it pulled the shoulder out of position, my R shoulder sat higher than the L and the shoulder blade was not gliding correctly anymore either. It’s all connected and if one thing is off, it affects everything else.

This was not the reason why I have adhesive capsulitis but it’s not helping either.

(Makes sense now why I have to prop up that shoulder at night even when on my back. He went ahead and “released” the muscle and told me I am making a good effort.)

The previously mentioned neck muscles he also took a look at and were commented with “this whole area is hard as cement.” (I know.)

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For the upcoming weeks he wants me to come in 3x a week. He was pretty confident that he will get a good grip on the situation.

After icing my shoulder I left with instructions on homework. Which exercises to do how many times, how many overall reps and the whole fun 3x a day.

 

Looks like I have my work cut out for me.

 

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Lessons learnt so far

This whole shoulder disorder is new to me, so naturally I am making mistakes but the learning curve is steep.

 

I have learnt to:

  • NOT  do an exercise I saw on youtube on my own. Granted, it was only wall walking but the payback pain was enormous.
  • NOT  try to reach for something that is higher than I can at the moment.
  • NOT  try vaccuum clean under the bed with that arm. Really bad position.
  • NOT  have your OS crank up your arm beyond where it should go.
  • NOT  assume people know what a frozen shoulder is and what all comes with it. They don’t.

 

For now I am nursing my aching shoulder and hope it calms down soon. Ever since my OS did his thing with my shoulder, it feels bruised on the inside.

 

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I guess it’s a little pre-taste for PT which I am starting in a few days.

 

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I also have issues with my Trapezius muscle. It’s stiff and hard as a rock. I am sure that’s not helping. Maybe my PT can take a look at it, since he is at it.

 

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I had to redo my pillow arrangements in bed, yet again, to make sure my shoulder is comfortable and gets support at night. With all the pillows I have by now I feel like I am turning into “princess with a pea”.

 

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MRI and results

I finally found the right combination of pillows, to prop up my arm at night. It was pure heaven, to let go of the arm (within my limits of movement) and feel rested. Sleep is so not overrated.

 

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I also had my R shoulder  MRI  this week. I have been many times to this office and people know me well there.

Since I am not doing too good in normal MRI’s I was lucky to get into an open MRI but even the “open” one needed additional love. They pushed me in several times, as test runs, so I can get used to it and even suggested I can come back another day, but I figure “I am claustrophobic today, I will be claustropobic tomorrow”. No difference, so I sucked it up and 20 minutes later I was done.

 

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I saw my  OS  and the verdict of the  MRI  is in. It is official now – it is adhesive capsulitis, in the early stages. Lovely.

So, I guess 2019 is the dedicated year of the shoulder. 2013 – 2018 my hips kept me busy, now it’s the shoulder. I like to keep things fresh.

 

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He wants me to do “aggressive” PT, 3x a week/ 6 weeks, to really work on range of motion, so my joint won’t lock up aka gets “frozen”. Sounds ouch but I trust him. In six weeks we see where I am at. Good or bad.

 

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Restricted ROM

 

Here are the promised pictures of my R shoulders restricted movement, 3 months in. Date is March 4th 2019, so I can compare it to next month and see if I progress, get worse or stay the same.

I don’t think it takes much explanation, as one can see clearly the free range of motion of my L, versus the R.

And yes, this is it. It just is not possible to go much further.

 

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Reaching behind my back. And this was on “a good day”.

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My R shoulder is stuck and won’t go down as the left.

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Sleeping is becoming more difficult since I can not relax my R arm, it’s aching and often keeping me awake; side sleeping on my R is not fun (even less fun since this is my go-to side to fall asleep) and sleeping on the tummy is challenging because of the position my shoulder is in. Basically – good times.

Every night I experiment with a different variety of orthopedic pillows, pile pillows up next me and hope “this is it”. So far I have not found the ideal combination.

Another night – another try.

 

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What actually is “frozen shoulder”?

 

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Here is what I know so far about frozen shoulders.

 

  • the majority of people getting it are woman
  • age wise it happens most likely between 40 and 60
  • it’s still considered a mystery in the orthopedic world
  • it can happen if you experienced trauma or surgery to the shoulder, have an autoimmune disease, hormonal changes, problems with your thyroid or you suffer from diabetes. Or just because.

 

In my case – all I am guilty of is the age and the sex. Nothing else. I have two operated hips but otherwise – healthy as a horse. I guessed I lucked out…

 

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My assumption is, there was inflammation going on, I rested the shoulder and in that time, adhesions formed. (As I said, nobody knows, I am just assuming.)

 

I also think my hormones are playing a joke on me again. I already get menstrual migraines every month because of hormone changes, so maybe they also influenced the lining of the capsule?

With my body anything is possible. I never pick the obvious, I always go for the funky stuff.

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Frozen shoulder in a nutshell:

From what I understand there was inflammation in and around the joint going on and eventually the capsule got thicker, swelled, scarred, adhesions formed and shrunk. The combination of it all hinders the shoulder from moving smoothly and freely and it comes to pain and restricted movement. The perfect storm.

 

 

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I got myself already a shoulder icepack and a shoulder heating pad. I looked what else is available for frozen shoulder, to make life a little easier, and came upon this…. frozen  BOAR (!)  for sale. Not quite what I had in mind…

 

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