The Shoulder Puzzle
Putting the pieces in place to get back in the game
The shoulder is one of the most dynamic and complex collections of bone, connective tissue and muscle in the human body. It allows an extensive range of movements incorporating five different joints. Yes, friends, five joints, all which have to perform consistently to provide us with the comfort and control we demand without giving it much thought. When the shoulder begins to cause us problems, we assume that just giving it a rest or maybe a shot of steroids will be the quick and easy cure. Many times this is the case. “I’ll be OK. Let me call my doctor for a quick shot.” But when that shot no longer does the trick, we can be faced with the fact medical attention should be explored and can include an orthopedic surgeon, physical therapist or occupational therapist.
Conservative care (rehabilitation, steroids and activity limitation) versus surgical intervention should be a careful consideration. Letting a mild to moderate shoulder injury or nagging pain go unaddressed for days or weeks can respond positively to therapy. However, allowing a nagging injury go for months or years without proper care can make the joints of the shoulder degrade, causing a delay in recovery and alter the normal function and strength of the shoulder. When you can’t reach a plate on a shelf, throw a ball or push up from bed because it hurts or feels weak and unpredictable, it’s time to ask yourself: Is it really worth gutting your way through it or missing out on the activities that make a good life? Make the right choice and see someone that is specialized in helping you get back to what you really want to do.
Surgery, if necessary and timed well for moderate to severe injuries or those not responding to conservative options, can be a successful and beneficial outcome. Complications from surgery and unrealistic expectations can make for a disappointing result. In the thousands of clients we have rehabilitated using both physical and occupational therapy, there is a common response we get for postsurgical shoulder recovery: “I didn’t think it was going to take this long” and “This is so much harder than I thought it would be.” No preparation is adequate to understand what it takes to get from the surgery to the outcome you desire. Motivation and good support from the surgeon and your therapy team will make the journey more enjoyable and fulfilling, but seeing it through to the end of your rehabilitation is critical to reaching your goals.
Your rehabilitation, with or without surgery, should always involve either your physical or occupational therapist or both. These are the specialists on your medical team that are integral to minimizing your symptoms of pain, weakness and loss of normal joint motion. We work with you to restore your trust and control that the shoulder will once again respond to our demands without failing you. Communication with your doctors on your progress is essential, and they should always be involved in your therapy progress.
Shoulder recoveries can vary from sports injuries, age-related arthritis, injuries resulting from a stroke, falls that affect the shoulder, dislocations, traumas from auto accidents, and many other possibilities. All plans don’t have a perfect start and end since the outcome also depends on the other 23 hours a day and what you do with that time. All rehabilitation is not the same, which is a great thing! You and Aunt Sally will not have the same rehabilitation program (and if you do, run away, run fast and do not collect $200). Trust me, don’t bother getting in an argument with Uncle Billy over Thanksgiving dinner since his rehabilitation only lasted six weeks and yours lasted 12. Seek out an experienced team that has a good track record with shoulder recovery and rehabilitation. Ask questions such as: • Will you develop a plan to get me back to (desired activities)?
• I had a setback, how will you help me get past it?
• Have you worked with my surgeon before?
• Are you familiar with his/her protocols for recovery?
• Will you come to my home for rehab to … clean house/dress/bathe/cook?
I love getting phone calls from individuals asking these questions; I already know they have reasonable goals in mind.
Snap, crackle, pop may make for a great cereal, but should not be associated with your shoulder.
Dr. Gregory Redmond is the owner of Eberhardt Physical Therapy, Nutrition and Wellness Clinic. He is a retired USAF veteran with nearly 20 years of experience as a physical therapist and is also a specialist in wound care and balance disorders. He and his wife and co-owner, Shelly Redmond, a registered dietitian, bring their unique approach to rehabilitation with integrated wellness, nutrition, weight loss, physical and occupational therapy.