Your goal as the patient is to create an optimal environment of healing in and around the shoulder; 24 hours a day.
Unlike cutting your skin (which bleeds and subsequently provides the region with all it needs to heal), structures about an injured shoulder classically have a poor blood/oxygen/nutrient supply and thus the healing process is slower than expected. That, in conjunction with a lifetime of wear and tear makes for a process that can be prolonged. Be patient and listen to your symptoms.
Pain tells you that you are doing something wrong.
Pain Scale: 0/10 no pain perceived, 3-4/10 irritable pain, 10/10 worse pain conceivable
- GOOD PAIN: A deep massage
- BAD PAIN: a brick landing on your toe
YOU ARE ADVISED TO CREATE NO GREATER THAN 2-3/10 “GOOD PAIN” WITH EXERCISE.
Do not be tempted to do too much. Your initial home exercises will seem simplistic, yet go about them at 50% of maximal assumed capacity to ensure that there will not be tissue irritation. (Note for our surgical patients) Even though surgical intervention has vastly improved and residual pain thereafter can quickly stabilize, underlying tissue healing constraints are still the same.
It still takes the same amount of time for tissue to heal.
THINGS TO DO
- Use ice often: 10-15 minutes as desired during the day and usually helpful just before bed if night pain is still an issue.
- As applicable, do daily activities with the palm up: ie pushing a door open, lifting a teapot, grabbing a bag of groceries, driving (pillows supporting forearms)
- With all lifting, take advantage of shoulder blade musculature by first pulling the shoulder blades back and down to your pockets. You will be stronger and distribute loads away from the shoulder joint
- Have your personal trainer consult with us regarding proper progressions with your exercise once you have completed your physical therapy
- Practice good posture in both seated and standing positions: Thumbs forward and sternum elevated in standing. Cushioning support just below the shoulder blades to help sit tall
THINGS TO AVOID
- Pushing/lifting loads to the front, side and overhead; especially with the palms down
- Prolonged carrying of a heavy bag or bag with shoulder strap
- Advanced exercises: pushups, front and lateral raises (with palms down), triceps dips, bench and overhead pressing; all can be safely modified.
- Bearing weight on the shoulder at night.
Twin Cities Shoulder is a specialty shoulder care practice under the umbrella of OrthoRehabSpecialists Inc. ORSI is an outpatient orthopedic and neurologic private practice that has provided physical therapy care for over 30 years in the Twin Cities metro. Terry Buisman PT is the co-owner of ORSI and heads TCS. His specialty is adult shoulder (non/post-surgical/adhesive capsulitis) as well as combined shoulder and spinal based pathology. We greatly appreciate the opportunity to play a role in your return to health.
