Wednesday, August 10, 2005

Rotator cuff and physiotherapy

I've noticed a lot of people stop here after searching for information about rotator cuff injuries. So i am going to post about the saga of my shoulder to give some idea of what people can expect when they get a diagnosis of torn rotator cuff.
If you don't have a rotator cuff problem, just skip this.

The first thing i noticed was a snapping sound and extreme pain - i thought I had managed to break my collar bone and i was worried that i had somehow managed to have severe osteoporosis without being aware of it.

I could feel and hear a crepitus noise [a sort of grating sound] when my arm moved and i thought this was the broken bones rubbing together.
It turned out that this was the badly positioned bones rubbing since the tendons are torn and not holding the bones in place properly.
My case was complicated by having pinched nerves in my neck and frozen muscles in my neck due to my enlarged thyroid as i hadn't been able to move my neck properly.

After seeing the Dr, I was x-rayed in many different poisitions - this was both difficult and painful as it was really hard to move my arm or shoulder and even walking jarred my shoulder tremendously.

After the x-rays my Dr gave me some cortisone injections as the whole shoulder was frozen due to the pain and inflammation. I had several injections in different places and these were repeated on the next two days.
The cortisone helped a lot - i wasn't expecting it to do much but after the second lot of injections i noticed it was slightly less painful.

I also had anti inflammatories to take and also some pain medicine, Additionally i had some dressings to wear on my shoulder which were a sort of slimy gel backed by felt like material [Flector Tissugel] -these contained an anti-inflammatory and they seemed to help a lot.

The Dr recommened i start physiotherapy 2 or three days after my last set of cortisone injections and gave me a presctirption for 12 sessions.

The physiotherapist examined the x-rays , took a case history and medical history and did a phsyical exam of my shoulder, neck and back.

I have fairly long hair - mid back length, and i found that putting it in a plait before the sessions made things easier for me and the physio.

The physiotherapy treatment on my shoulder and neck has consisted of massage, manipulation of the joints and light traction. Also supervised excersises and electrostimulation with antiinflammatory perfusion, ultrasound tretament, infra red treatment, and another kind of electrostimulation that i forgot the name of immediately.

The massage was mostly relaxing , the manipulation was at times painful - although i was told to tell the physio if he was causing pain and he would change the pressure/movement. Slight discomfort was ok but not pain.

The light traction felt strange but wasn't too bad- though it seemed to cause my joints to ache afterwards and be physically tiring - like doing a workout.

The electrostimulation -with and without the anti-inflammatory perfusion wasn't painful though it stung slightly in a rhythmic way. It was easy to ignore it and read for the 20 minutes that it lasted for.

The ultrasound treatment did not seem to be painful in itself -although having to press down on the inflammed shoulder was painful and it was awkward to do - however this only lasted about 5 minutes so it wasn't too bad.

The infra red treatment was quite relaxing - it felt like being lghtly toasted in a pleasantly warm toaster.

The excercises -

After a few sessions of physio , i was given the first excercise to do at home. This involved sitting on a stool, bending over and allowing the arm and shoulder to relax and swing freely - this was a bit more difficult tahn it sounds due to the pain and inflammation , but after about 10 days it felt relaxing and painless.

The next excercise was to allow the arm to drop down from the shoulder and lift the arm up as far as it would go with the palm facing upwards. This was difficult to do at first as the bones would click and cause pain. I had to adjust the angle slightly to make sure there were no clicks.
After about a week of doing this excercise at home , I was told to bring swimming clothes to do excercises in the pool.

The second excercise was continued in the pool and an additional movement using a small float was added. I had to grasp the float with my arm level with my shoulder [supported by the water] and bring the float down as quickly as possible and then allow the float's bouyancy to bring my arm back up.

I had to do both of these each session 10 in each set and 10 sets.
Around this time i was told i had to do as much as i could with the affected arm as long as it wasn't prolonged painful actions. Discomfort was ok.

I found being in the water relaxing and i started going swimming on non physio days though i found my shoulder movement was restricted so i tended to mainly use my legs. I continued with these excersises on non physio days too.

The last excercise involves holding a stick in both hands, behind the back and raising it as far as it will comfortably go - all the while allowing the arms to relax downwards to prevent the bones rubbing. This was also done in the water and added to the previous 2 excerccises.

I have now had 11 sessions and will be going back in 2 weeks for the final session. I may need further treatment on my neck but the physio expects my shoulder will be completely healed by then. Currently my shoulder is only pinful when the tendon is directly pressed or when i pull something sharply - eg tieing a knot or occasionally when pulling on a drawer.
This has been nearly 7 weeks since the start of the saga with the cortisone injections.
I hope this helps.



Anonymous said...

Your information was helpful, I'm going to try doing the exercises on my own. [Recently unemployed after 13yrs, no medical insurance now.] I was wondering how you managed to sleep though? My shoulder wakes me up, if I do manage to get to sleep. Thanks.

Alison Ashwell said...

Anti inflammatories and herbal sleep aids - valerian, skull cap, lemon balm etc- I got it as a single sleep supplement ready mixed and it helped relax me.
I hope your shoulder heals quickly