New Exercies Added Tonight - By Far The Most Painful

Now that surgery is done and I have almost 4 weeks of physical therapy under my belt I can pretty much move my arm with some mobility to the left, right, up and down.  The only place I cannot move it is behind my back.  To give you an example of how far I can move it imagine you are wearing a pair of jeans.  Now picture your belt loops on those jeans.  Looking at the left side of your jeans you probably have one loop in the front, the next one is on the left side then the next one is probably on the back side of your left hip.  That belt loop on the back side of your hip is how far I can reach behind my back...and that is with quite a bit of pain.

Well tonight was the night that that I was introduced to the first exercise / stretch designed to improve my range of motion in that direction and let me tell you it was not fun.  It is a pulley exercise where I grab one pulley with my left arm and place that hand by the "back belt loop" area and grab the other pulley with my right hand in front of me and pull down with that hand.  What this does is cause the left hand to move up and back.  Let me just say that I was able to pull the pulley a couple of inches max.  The pain wasn't as bad as it could have been if I decided to really push it.  I took it easy because I have accidentally moved my arm in that direction before and the pain was excruciating.  That being said it was still a sharp pain with a certain tightness about it.  I did one set of 10 of these and each time I pulled down I would have to hold it for 3 seconds.  This is by far the toughest of all of the exercises I do on my own but not as tough as some of the stretches that Beth has to do to me.

Here is a photo of the exercise

 

Trying To Get Motivated

I am sitting here trying to get motivated to do my PT.  I didn't do it yesterday because I was very sore and it was hurting pretty good during Friday nights exercises.  So that means I really should do it today but it is still a little sore, I am tired and the Bears lost today.  Someone needs to give me a swift kick in the a$$.

Back To The Recliner

Well, it is 1am of night 4 of no immobilizer and I have decided to move back to the recliner.  I think I will be more inclined to get some sleep on here.  The shoulder is just to annoying to sleep on in the bed so hopefully I will be able to get a few hours down here.

Sleeping After Immobilizer Removal

On Wednesday I was so excited to finally get my immobilizer off...I mean I would be able to sleep in my bed for the first time in over a month.  Who wouldn't be excited?  Well that excitement ended after the first 5 minutes in bed.  Just because the immobilizer is gone doesn't mean I am going to be without pain and did I ever feel that pain.  The first trouble for me was trying to get comfortable.  I sleep on my left side which is the shoulder I had the operation on.  I decided to try and test it to see how much pressure I could put on it and it wasn't that much.  So after some manuvering I finally got comfortable...for 5-10 minutes at least.  Then every time I tried to shift positions my shoulder would feel it.  It wasn't really that painful but I noticed it enough to make it uncomfortable and hard to fall asleep.  A few times I did tweak it pretty bad though.  Last night was my 3rd night without the immobilizer and each night it has become just a little easier to fall asleep.  Hopefully withing a week or so it should be a lot better.

On a side note I am in therapy with a patient how had her surgery almost 7 months ago and she said just the other night she tweaked in pretty good in bed.  So it seems like the "tweaking" won't be ending anytime soon.

E-Stim...The Pleasure At The End Of Therapy

At the end of each therapy session I get hooked up to a machine and get Electrical Stimulation Therapy.  What is E-stim you ask?  Electrical stimulation units use an electrical current to simulate the same electrical impulses that are activated during normal exercise. By passively activating the muscle, the body responds in much the same way as during normal exercise. By placing a pair of electrodes (or 4 in my case) on the target muscle or muscle group, the unit can send electrical impulses through the skin to underlying nerves, stimulating the contraction and relaxation of the muscle in a rhythm similar to daily exercise. Electrical Stimulation can be used for two primary functions; strength training and muscle tone or pain control.

So basically E-stim is a nice pulsating massage on the muscles that were just stretched to hell by exercises and stretching by my physical therapist.  Combine this with a nice ice pack on the shoulder and it is a nice relaxing way to end a productive therapy session.

Tonight's Home Therapy

Tonight was the first night that I did the 2 new exercises plus the 9 others I have been doing and all told it took 50 minutes.  That includes 10 minutes of heating pad before and 10 minutes of ice after. 

Overall it went pretty smooth but there were two exercises that stood out as pretty painful.  The worst by far was the External Rotation In Abduction exercise. This one was so painful at times that I felt like stopping but I kept pushing through because stopping would not do any good.  A majority of the pain was centered in th etop front portion of my shoulder with some pain along the bicep tendon.

The second one that was pretty painful was the Sleeper Stretch which surprised me because that one is not usually that bad.  During these two exercises I started to really feel the muscle guarding again which has been pretty much in check since 2 Thursday's ago.  We will see how tomorrow's home stretching session goes.

Home Therapy Exercises Part II

Since I have my home exercises spread over several posts I am going to go ahead and compile them all here in one post.

CODMAN CURCUMDUCTION EXERCISES
Rest my right arm on a table, let my left arm hang down and rotate my hips clockwise 20 times and then counterclockwise 20 times

PULLEY EXERCISES - PASSIVE RANGE OF MOTION EXERCISES

The graphic to the left only shows two exercises but there are three I actually do.

 1.  With my elbows at my side and my palms turned in I pull up and down on the pulleys for 4 minutes.  This exercise puts some pressure on my shoulder but it isn't too bad.

 2.  With my arms extended out in front of me I pull up and down on the pulleys for 4 minutes (image not pictured).  This is the easiest of all 3 of these exercises.

 3.  With my arms out to my side I pull up and down on the pulleys for 4 minutes.  This exercise it the toughest of all three.  It could actually be quite painful sometimes.  

4.  SHOULDER INTERNAL ROTATION - Stand with your back toward the pulleys. Reach over your head with your good arm and grasp the handle.  Reach behind your back with your injured arm (as if trying to touch your spine with your thumb) and grasp the other handle. Pull down with your good arm. This should pull your injured arm farther up your back. I do 1 set of 10 and hold each one n place for 3 seconds.  This is the most painful of all of my home exercises by far. (Exercise added to my regime on 1/24 at the beginning of my 4th week of PT)

CANE EXERCISE ONE - EXTERNAL ROTATION IN ABDUCTION
While lying on my back I use the good arm to push the affected arm out the the side with the help of a cane. The affected arm stays relaxed all the time.  This is done in 3 sets of 10.  This exercise puts a lot of pressure on my shoulder and cause some pain every time I do this exercise.

CANE EXERCISE TWO - PASSIVE RANGE OF MOTION
While lying on my back I bend my arms 90 degrees, hold a cane over my chest and bring my arms back and to the left.  I do 3 sets of 10.  This is a pretty tame exercise and causes very little pain or tension in the shoulder.

CANE EXERCISE THREE - PASSIVE RANGE OF MOTION
Lying on my back I hold the cane straight out above my chest and bring it back as far as I can.  I do 3 sets of 10 for this exercise as well.  This is the easiest of all 3 cane exercises.

SLEEPER STRETCH - POSTERIOR CAPSULE / INTERNAL ROTATION STRETCHING
Lie directly on affected shoulder with head well supported by pillows.  Slide your arm up to 90 (level with collar bone) and bend your elbow to 90.  Bend your knees up to keep you stable lying on your side.
Place the hand of the unaffected side just below wrist of affected side and slowly push the forearm down towards the bed/ floor.  Make sure that you keep the elbow bent at 90 and you keep the upper arm level with the collar bone throughout the stretch.  Maintain the stretch for at least 30 seconds and it should be held at an intensity that you find mildly uncomfortable.

SHOULDER SLIDES
In this exercise I stand in front of a wall with the palm of my left hand against the wall and slide the left hand up until all the way extended.  While the arm is extended all the way I lean forward and hold for a few seconds.  I do 2 sets of ten each day at therapy and at home on days when I don't have therapy.

ISOMETRIC SHOULDER INTERNAL ROTATION
I stand with my left palm flat against a wall, push and hold for 3 seconds and release.  I do 3 sets of 10 for this exercise.  This is a pretty harmless exercise.

ISOMETRIC SHOULDER EXTERNAL ROTATION 
I stand with the back side of my left hand flat against a wall, push and hold for 3 seconds and release.  I do 3 sets of 10 for this exercise.  Again, this is a pretty harmless exercise.

STANDING RESISTANCE BAND ROW
With my arms extended I grab the red resistance band with each hand and pull back in a rowing motion until my elbows are even with my side.  I do not go past neutral with this exercise.  I do 2 sets of 10 for this.

ISOMETRIC SHOULDER EXTERNAL ROTATION
I first grab the exercise band with my left hand as shown to the left and then take two side steps out to the left and then back.  I do 1 set of 10 for this exercise.

ISOMETRIC SHOULDER INTERNAL ROTATION 
I first grab the exercise band with my left hand as shown to the left and then take two side steps out to the right and then back.  I do 1 set of 10 for this exercise.