The last two weeks I have continued to see progress with my strength. My “shrug sign” lifting up my left arm is improving and now most noticeable when lifting my arm out to the side at 80 degrees and beyond. I have seen a steady increase in lifting capacity for my biceps and triceps but am still down more than 50% compared to my right side overall in strength.

New accomplishments 

  • Able to reach behind my head and wash my hair
  • Able to drive and turn the steering wheel with just my left arm
  • Begin wall push-ups and single arm rows

Remaining limitations 

  • Reaching up behind my back
  • Unable to lay/sleep on left side
  • Decreased elevation and external rotation

I have learned that the shoulder is still vulnerable if I do too much activity or push it too hard with the stretching. Generally, I stick to no more than 4/10 pain when doing passive stretching myself. In therapy, I have been just trying to block out the pain and endure the stretching even when it goes beyond that level. Last week, I had difficulty sleeping the same night following both of my PT sessions. I felt as if the PROM performed by the PT was more intense than it has been. While I was able to tolerate it during the session, the shoulder was increasingly sore and tight the same day after both sessions.

Key takeaway -> While some soreness might be expected, sleep disruption is NOT a good thing. I feel as if my shoulder has gotten stiffer and more inflamed internally this week. I am not blaming the PT per se, but it is incumbent upon me (or any patient) to make notes of the body’s response to treatment and if something is not working make an adjustment. Pushing too hard and experiencing this pain is a sign that the shoulder is becoming more inflamed. This in turn causes more tissue resistance, guarding and a sense of stiffness in the joint. It is time to adjust the intensity of the stretching in my case.

Rehab reflections

Rehab following this surgery is fluid and has ups/downs and plateaus. I have rehabbed hundreds of patients with this condition, but going through it firsthand has taught me how difficult it can be for a patient to know how much is enough or even too much when it comes to stretching, activity and pain.

In the end, our bodies crave homeostasis. At this phase of the recovery, the repair is getting stronger and much less likely to re-tear. However, increasing stiffness, pain spikes and interrupted sleep should not be commonplace. I continue to tweak my home program (reps, sets, time of day, etc.) along with the PT routine to find the best fit. I will admit it has been challenging at times to find the right blend.

Honestly, I have not had the smoothest recovery in terms of getting my motion back quickly or easily. I have also had moderate discomfort intermittently the past 3-4 weeks. As I head back to work this week, I plan to work independently and forgo the manual therapy for the next 3-5 days. I want to see how my shoulder feels in order to better assess if and how much the manual therapy may be contributing to my ongoing stiffness/soreness.  My intuition tells me that I need to calm the shoulder back down in order to regain the mobility, but the next few weeks will provide more concrete answers.

5 core things I believe about physical therapy:

  1. Use the pain response (during and after treatment) to assess the efficacy of your current rehab plan
  2. No 2 rehabs are alike. Don’t compare yourself to others, as some progress faster and others slower.
  3. Be patient and take it 1 day at a time to preserve your mental health as it does eventually get better
  4. Little things really matter so celebrate the small functional victories in your recovery
  5. It’s easy to do too much or too little exercise. Work diligently to find the right dosage for you.

All of these things have held true for me the past 12 weeks. I am a self proclaimed perfectionist. I am flat out OCD when it comes to my work and profession. I am a tough critic. With all that said, I will be an even better clinician this week as I return given the ups and downs of my own recovery. My hope is that by being direct and sharing my thoughts and experiences at least one patient, clinician, friend, or family member will benefit in the future.