Today I had my appointment with the specialist physio, Marty, who is consulting on my case. He hasn't seen me since November so he gets a bit of perspective which can be a good thing - it's hard to see improvements when I'm plodding along day by day; he sees me every few weeks, so the improvements are more noticeable to him. Today he was pleased with some increased motion - more of my arm than my scapula - but my measurements have improved a bit; and with some "spontaneous movement" - i.e. that I can do naturally now, like my super shoulder shrugs, although in all respects he is still very clear that I have a long way to go (it's ok... I know that). When he compares me today to how I was in September, he is optimistic. There's a bit of me that feels kind of reassured when I see him because he does notice the improvement, measures it, compares it with the last visit and is calm and measured and honest about everything. Each time he's been pleased with several things, although his main concern is still the level of pain I have constantly and everyone still thinks the solution is getting back natural movement, but I have to get there without overexacerbating the pain. (I'm not entirely sure that's a word, but everything exacerbates it, so I'm going with the hyperbolic neologism.)
I am however, kind of excited about trying a couple of new things... I'm not sure if excited is exactly the right word to use, but I feel like they could have the potential to be really helpful.
First, one of my little exercises I have been doing is a kind of semi-demi-port-de-bra-thing (my own, completely modified, ballet arms exercise for the non-dancers reading) and it seems to give me much more flowing, natural feeling movement than the other exercises I have. (Confession: I started doing it because I went to see the Nutcracker ballet before xmas and was trying to see what position I could get my arm into. Nothing much more than second position, but enough to play about with. And more than a few months ago.) Within a small range, the movement has increased in fluidity pretty quickly, relative to other exercises. It feels nice and flow-y, instead of like I'm trying to lift a dead weight, which is really how my arm feels with a lot of the other exercises, simple as they are.
Today, Marty said he felt I should try to get creative with my exercises. He told me a story about an 80 year-old Chinese patient he had, she had suffered a bad shoulder fracture and her movement was terrible. He was trying very hard to get her to do exercises but she was really struggling with the movement and then after 3 or 4 appointments she asked him if she could do Tai Chi, which she had practised for years. He asked her to show him and said that "she turned from a caterpillar to a butterfly" right in front of him. Her movement was fluid and smooth and completely different from attempting the 'normal' exercises. He said this was only three years ago and she taught him the importance of muscle memory in a situation like that. (As an aside, I have so much respect for someone so highly qualified, experienced and esteemed in his profession who can say they are still learning. For me it is the very definition of confidence versus arrogance. It's pretty rare, it seems.)
Watching me do a few "ballerina-type" moves, he said that I should try to think about what moves would work for me - obviously nothing extreme in relation to shoulder movement (which would be impossible anyway), but movement that feels natural to my body, rather than movement that is fighting it. It makes sense to me. I have already tried it with a couple of things so I think I'll have to get on YouTube and do some searching for some ballet fusion exercises, or something similar.
Nothing about this has been normal - the extent of the injury in the first place was likely due to the flexibility of my shoulder; then all the damage combined made it quite unique; then the length of time added further complexity; and then I needed the incredibly rare surgery... so it really fits that everything about the recovery is going to be outside the box - and designed to work with my body - too. My muscles really developed from age 3 to age 22 with dance and gymnastics moves, so it also makes sense to me that my muscles/ muscle memory will respond to that. At least it might make it a bit interesting coming up with some different exercises... just what Angelo (my regular physio) wants from me: another challenge!
The other thing I am going to try is something called the Feldenkrais method which is 'somatic re-education' and works on the neuromuscular movements. I stumbled across it a couple of days ago (very weirdly on a piano discussion forum in which a frozen scapula was mentioned), thought it sounded interesting and Marty has fully endorsed the idea. I hope to start that in the next couple of weeks, so more info coming up when I learn more about it.
And I've to try to play the piano more too - right hand scales and finger exercises. I tried to play last week and I was dreadful, plus, my newly ambidextrous brain, that has been reading music since I was 7 and piano music since I was 10, was trying very very hard to read the bass clef as the treble and I kept hitting the wrong notes. It's really weird, I've never been strongly right-sided, although I do have a slight preference for my right hand but have always done some things left-handed (I put mascara on my left eye with my left hand and my right eye with my right hand... stuff like that) but my left hand has been my dominant hand for 18 months now (I can even use a knife AND scissors with it - big achievement! The world is created for right-handed people.... over 5 feet 2, I am fighting on many fronts right now.) Anyway, I am SO mixed up over left and right at the moment. I get it wrong constantly.... Who wants to fMRI my brain??
So generally it was a good appointment because it definitely had some positive aspects, but I also completed the shoulder function questionnaire that I complete each visit and I'd improved from 15 points to 18 points (out of about 60) on functionality which kind of put things back into perspective. So, I have some good things to focus on and some new things to try, but I think "one step at a time" seems like the perfect (only!) perspective to have right now.
"One Step At A Time"
Jordin Sparks
Hurry up and wait
So close, but so far away
Everything that you've always dreamed of
Close enough for you to taste
But you just can't touch
You wanna show the world, but no one knows your
name yet
Wonder when and where and how you're gonna make
it
You know you can if you get the chance
In your face as the door keeps slamming
Now you're feeling more and more frustrated
And you're getting all kind of impatient waiting
[Chorus:]
We live and we learn to take
One step at a time
There's no need to rush
It's like learning to fly
Or falling in love
It's gonna happen when it's
Supposed to happen and we
Find the reasons why
One step at a time
You believe and you doubt
You're confused, you got it all figured out
Everything that you always wished for
Could be yours, should be yours, would be yours
If they only knew
You wanna show the world, but no one knows your
name yet
Wonder when and where and how you're gonna make
it
You know you can if you get the chance
In your face as the door keeps slamming
Now you're feeling more and more frustrated
And you're getting all kind of impatient waiting
[Chorus]
When you can't wait any longer
But there's no end in sight
when you need to find the strength
It's your faith that makes you stronger
The only way you get there
Is one step at a time
(Again: I don't own any music/ videos etc. All linked to Youtube and artists accredited)
I've used this quote before, but not for a while and it is definitely the perfect quote for today, and for these lyrics:
"A journey of a thousand miles begins with
a single step."
~ Lao Tzu
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