I passed a major milestone last Thursday as I hit the 6 week post-op mark. I have been transitioning out of the sling since week four (at home) while continuing to use the sling out in public. I officially quit using it last week. Things have been progressing, but two words really define the recovery so far: slow and incremental.

Being patient is no easy task when I am so used to working in the clinic, lifting weights and playing sports with my boys. Sleeping has still been a bit of a challenge as the shoulder aches after a few hours in one position, but I am now sleeping in my bed for 6-7 hours with only 2 disturbances per night. My mobility with dressing, shaving, showering and getting dressed is steadily improving. With respect to pain, it is absent at rest. However, it still strikes when I move the wrong way or happen to lift the arm against gravity due to weakness and stiffness.

Rehab

I have been going twice per week, but missed last week due to a summer vacation. I was diligent with my exercises 2x/day while away. Prior to leaving, my latest passive range of motion was equal to 117 degrees of flexion and 38 degrees of external rotation at 5 weeks post-op. As far as guidelines for the next 2-4 weeks, the goals are to restore ROM, resolve pain and begin light strengthening with rehab activities such as:

  • Begin active assistive range of motion (AAROM) progressing to active range of motion (AROM)
  • Continue with deltoid and rotator cuff isometric strengthening
  • Begin light scapular strengthening – retraction (light rows), protraction (serratus anterior work), scapular depression and gentle ball stabilization work in a dependent position
  • AAROM exercises with a dowel rod or cane (external rotation, extension, scaption, flexion, horizontal adduction/abduction)
  • Joint mobilization, continued passive stretching to restore full range of motion and addition of shoulder pulley in this phase
  • Light biceps and triceps strengthening (elbow at side)
  • Scar massage

One important note: I have found the continued use of ice helpful in reducing daily soreness and discomfort following my home program. As such, I would highly recommend its daily use this late into the rehab.

Fitness

I have been walking 4-5 days per week for aerobic exercise, as well as doing lower body and right-sided upper body strengthening 2-3x/week in the gym the past 2 weeks. The atrophy and weakness in my left shoulder and arm is unreal. With that said, I am certain that movement (aka getting off the couch) is very helpful mentally and physically during this lengthy recovery. Working out the other parts of my body will only help my overall health and keep me mentally sane until I can use the left arm again. For those going through this or contemplating this surgery, be sure to establish a safe exercise plan based on your surgeon’s guidelines that will help prevent any potential depression, excessive weight gain or loss of strength in the other areas of your body, especially for those accustomed to working out a lot.

Work

As a physical therapist, I use my hands and arms a lot to lift weight, demonstrate exercises, adjust setting on exercise equipment, and perform manual therapy. As such, I have not et returned to work. For those with more manual labor type jobs, this surgery will keep you off work for a minimum of 3-4 months in most cases. I see the doctor this Wednesday and plan to discuss my return to work plan. Realistically, I hope to be able to go back to work around the 10 week mark, knowing I will have to make some modifications and ask my co-workers for some help.

Personal reflection

This process has been humbling in a number of ways. First, relying on others to drive, dress you and perform even the most basic tasks forces you to realize how much you need two good arms to navigate life. Secondly, I have so much more empathy and respect for all my patients that have undergone this procedure. It is a challenging recovery that requires patience, perseverance, pain tolerance and compliance with the home exercises to see small improvements each day and/or week. Third, not being able to work has only heightened my awareness for how much I enjoy helping others through my profession. I really do miss working as it serves as a purpose and passion. Finally, this surgery has made me feel really vulnerable and helpless at times. While that may seem a bit depressing, I have tried to embrace it, slow down and appreciate my family and friends who are here to support me. I have accepted the fact it is okay to ask for help and try to work on practicing patience (which I have very little).

This surgery has given me a chance to reflect on my personal and progression life the last several weeks. I have been able to recharge the battery, read for pleasure and spend more quality time with my family than ever before. So, while the pain, lack of sleep and physical limitations really do suck, I have been afforded new opportunities through this recovery process. The surgery also offers a new challenge and goals for me to meet, and I always like a good challenge! Thanks for following along with my rehab ramblings and cheers to what the next 6 weeks brings!