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Old 07-10-2012, 11:13 AM   #281
Gravel Brown
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Re: My SLAP Journey...

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Originally Posted by Selina McFall View Post
I had physio again today, and the PT suggested doing my passive exercises in the pool would be helpful. They don't do hydrotherapy, but I have a swimming pool in my building so could do it every day twice a day if it would help.

Gravel, I know you're a big fan of hydrotherapy. What exactly did it involve? Was it as simple as just doing the passive movements in the water?
Id strongly recommend it Selina, it was the big difference in my recovery and really sped up my ROM and strength gains.

My hydro involved the following movements in the water with the arm fully submerged, i was basically neck deep in the pool when doing these:
  • Moving the arm forwards to chest level and then down to hip level with the arm locked straight. Basically a semi circle sort of movement.
  • Moving the arm laterally from hip level to shoulder level with the arm locked straight.
  • Slow punching movements underwater - straight punching in front of the body.
  • External rotations with the elbow locked into the side of the body, these were, and still are very stiff.
  • Going underwater and sitting on the bottom on my knees and slowly letting my arm float above my head.
Basically id do 3 sets of 10-20 reps of the above movements 2 times per week. Start off very slow though and be careful as the water takes gravity out of the equation so makes everything feel really loose and normal. If you over-do it youll be sore afterwards so start off real slow, maybe 1 set of each exercise for 10 reps and build from there.

As i became stronger my PT made me wear a big plastic paddle on my hand to increase the resistance.

As i said, it was a major player in my recovery and id recommend it to anyone.

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Old 07-11-2012, 03:35 AM   #282
Selina McFall
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Re: My SLAP Journey...

Gravel
*
Thanks, I’ve had it cleared by the doctor today so plan to start straightaway, excluding the punching exercise, which I haven’t started yet.
*
My external rotation is also very stiff, in fact it’s gone backwards from 30 degrees to 20 degrees since I last saw the doctor and I’m behind where he wants me to be.* He has told me it must be up to 60 degrees by the next time I see him in a fortnight – I am allowed to take it to 45 degrees on my own and 60 degrees with the physio.* Out of interest, where was your external rotation at this point post surgery (4 weeks)?*
*
My forward flexion and abduction are fine (145 and 150 degrees respectively).
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Old 07-12-2012, 07:29 PM   #283
Gravel Brown
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Re: My SLAP Journey...

Selina,

My external rotation was extremely stiff all the way through and it still is. My surgeon and PT have both said that it isn't a bad thing. The stiffness tells you that the repair is still tight, which I a good thing. Better off stiff than all sloppy IMO.
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Old 07-13-2012, 10:30 AM   #284
Carline Saintilien
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Re: My SLAP Journey...

Gravel, I am freaking out.

I had my 5.5 months post-op visit with my surgeon and he is concerned about the pain and discomfort that I am still experiencing. Currently, I would rate the pain between a 2-3 on the pain scale because I am conscious of it.

My surgeon and PT always assured me that I could experience pain with increased activity and for up to a year.

Between May through June Iíve taken a couple of business trips and long weekend leisure trips. After each event/trip, Iíve felt increased pain to the point I am guarded. However, after a few days the intense pain dissipates and Iím back to about a 2/3 on the pain scale. Its more soreness than extreme pain.

During my visit I got the impression that I shouldnít be experiencing any pain/discomfort/soreness because it has been 5.5 months since my surgery and I had only a grade 2/3 anterior labrum tear.

So he gave me the option to go and get an MRI to confirm all is well now; or to continue with PT for about 1-2 months and if there is no change in my pain rate, then go and get an MRI. To be quite honest, I am freaking out.

As they say, ignorance is BLISS. And what I don't know won't hurt me.

In the event, I am still having issues where surgical intervention is warranted, wouldn't that cause more problems in the future?

I was fine before, just knowing that it may take up to year feel next to normal.
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Old 07-13-2012, 06:49 PM   #285
Gravel Brown
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Re: My SLAP Journey...

Hey Carline,

Try not to stress too much. When I was at 5.5 months I could definitely still feel pain. Much the same as you, a dull ache about 3/10 but sometimes up to 6/10 when it was aggravated.

I don't think that I was completely pain free until 8-10 month mark.

Now I'm at 13 months and again feeling some pain. My shoulder still flares up easily if I'm not careful. I've completely dropped overhead weights all together, not worth the risk.

If I were you I'd wait 8 weeks and see if the pain subsides. In the meantime load up on fish oils and glucosamine. I've heard great things about glucosamine so have just started this.

Keep us posted on how its going. I know the paranoia that comes with the pain all too well. Even here at 13 months I'm paranoid about the pain I'm having.
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Old 07-13-2012, 10:09 PM   #286
Carline Saintilien
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Re: My SLAP Journey...

Thanks Gravel. I sure will keep you posted.

How long did you have supervised physical therapy vs. home exercises only.

My doc also gave me the option to continue exercises at home. But with life being so busy, I chose to continue with supervised PT.

But at the same time, I kind of want to be done with this whole thing.

Also, with being out of commission for so long, I was thinking about doing crossfit.

Dr. Rockett,

How long do you recommend supervised PT for labrum tear repairs?
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Old 07-14-2012, 06:29 AM   #287
Gravel Brown
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Re: My SLAP Journey...

My PT was pretty much supervised the whole way through. Here's how it went:

0-4 months: hydrotherapy 2 x per week plus a separate physiotherapy session 1 x per week.

4-8 months: hydrotherapy 2 x per week plus a separate physiotherapy session 1 x every 2 weeks.

8-10 months: this is when I was done with hydro and PT so essentially unsupervised from here.

I'd stick with PT for as long as you can. It gives you a good chance to ask any questions etc which can play on your mind from time to time, plus obviously getting continual benefits from the pt itself... so it's kind of a security blanket before you're set free into the big wide world.

Once you do get back to lifting weights just be super careful. I think I jumped the gun a bit with mine, ie doing heavy loaded overhead stuff etc, and now I'm paying the price with ongoing inflammation. Just err on the side of caution, it's not worth pushing it too hard.

I have a big focus on just body weight exercises now, kettlebells, double unders, rowing etc... as opposed to heavy weights. I think it just makes more sense for my long term recovery and shoulder health.

Hope your pain goes away soon mate... it's a frustrating journey huh..
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Old 07-14-2012, 07:10 AM   #288
Selina McFall
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Re: My SLAP Journey...

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Originally Posted by Carline Saintilien View Post
Gravel, I am freaking out.

Between May through June Iíve taken a couple of business trips and long weekend leisure trips. After each event/trip, Iíve felt increased pain to the point I am guarded.
Hi Carline, just curious - why do you think the pain has flared up after your trips?

I flew long haul economy 2 weeks post surgery (12 hours). That was fun! Actually, it wasn't so bad - luckily i had someone fairly small next to me both ways who didn't object to the arm rest being up for the whole flight - with the sling i didn't fit into the seat width-wise, and the arm rest was just too high to be comfortable. I got help with my baggage, and the doctor had written me a note to confirm I was safe to fly etc.
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Old 07-14-2012, 08:38 AM   #289
Carline Saintilien
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Re: My SLAP Journey...

Thanks Gravel. My PT says the same thing regarding continuing supervised PT for as long as my surgeon prescribes it. Also, as long as my insurance doesn't object as well. Thats always important.

I understand that everyone will have different experiences post surgery. But its interesting that you had physiotherapy through 8 months. It hasn't even been 6 months yet for me. So I guess I just need to be patient.

With regards to crossfit, I understand there is lots of upper body work but if possible, I want to focus more on lower body fitness. I think I do enough upper body strengthening exercises in PT already.

Selina,

Before I travelled, my pain level was about a 2-3. But on my first business trip after surgery (about 4 mos post-op), I was in a lot of pain. Just opening up a door sent a shock of pain all up and down my arm. Then after a few days my pain level decreased. Then I went on another international trip two weeks later. After the trip, again my pain was at a 6. Those two trips were the only "new" activities that I engaged in so....I felt that could only explain my pain.

You know what's interesting, my PT said out the gate, my recovery would only be about 4 wks, 8 wks tops. Yet, I'm still at that "decrease the pain" in my treatment plan. And two weeks post-op, I was sooooooooo exhausted, home-bound and virtually dependent.

I'm glad to hear you are well on your way. Please continue to share your progress. It really does help many of us who are about to have surgery or has had surgery already.
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Old 07-15-2012, 03:07 AM   #290
Selina McFall
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Re: My SLAP Journey...

Wow, sounds tough. 4 - 8wks sounds ambitious for full recovery though! I was always told 6wks in the sling, after that I could do CV exercise and most normal activity, excluding strengthening and sports which I could start at 3mths (though obviously introducing weights slowly from that point). I was also told I could go back to work straight away, and have my arm out the sling from the start to type etc. I actually think that assisted in my recovery in the early stages, as I noticed rapid improvements when I went back to work and was using my forearm most of the day.

Reading other people's updates I think i've been pretty lucky with minimal pain so far. I get "twinges" at the top of my ROM when I'm doing exercises, and physio is tough, but otherwise it's been okay bar a couple of days when it was aching a lot. The worst so far was without a doubt the rest of the day following my second physio session when I had to take painkillers again. But when I woke up the next morning it was fine (I assume it was inflammation caused by the physio pushing me).

I don't think I have a high pain threshold - when my shoulder was dislocated, believe me, I felt incredible pain! To the extent that I was unable to move, even to assist the paramedics getting me on the stretcher, they had to give me gas before they could move me. The pain I'm feeling as a result of this surgery is so different I'd say it is maybe a 2 / 3 on the bad days, compared to a 10+ with the dislocations. However, almost immediately after the dislocations the pain went away, and I was able to return to my previous activities pain free (literally 2 or 3 days later I felt 100%). You'd think I hadn't done much damage, but I had - SLAP tear with a partial tear to the biceps tendon, anterior and posterior labrum tears - required 6 anchors to fix!

There's an interesting report on a research paper here, which says one of the factors that can influence how people experience pain is previous experience with pain.

http://www.sciencedaily.com/releases...0624090043.htm

My own, completely un-scientific theory on why I'm not experiencing much pain now, is that my body remembers the acute pain of the dislocations "something's seriously wrong", compared to now "healing pain", and has influenced the pain receptors in my brain to tell me that this pain is minimal. Who knows! The article also says your emotional state at the time you experience pain is an influencing factor - how did you feel on the business trips, were you nervous about being on your own, feeling vulnerable maybe?

If I were you though, I think I'd want to get the MRI now if it's an option. At least then you know if something is wrong, or if the pain you're feeling is just part of the healing process.

If it's the latter, have you been cleared to do things like yoga and pilates?

http://www.shoulderdoc.co.uk/article.asp?article=1406

My surgeon has said he will let me start yoga again at 3mths, and although he personally isn't a big fan (done incorrectly, it can cause labrum tears), I'm really looking forward to it, as I just feel it will help me return to normal. I have an excellent instructor, and pre-surgery when I was at risk of dislocations from doing something as simple as stretching, I was able to fully participate in the class without anything bad happening, as the instructor helped me ensure my form was correct.
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