Last week I saw one
physiotherapist and two doctors who had not seen me for a few weeks. Every one of them was very positive and
enthusiastic about my newfound (re-found?) ability to shrug my shoulder.
"I think that's excellent" and "I'm so excited about this!"
were a couple of the comments I received which led me to realise that this
shoulder shrug is not just a shoulder
shrug.
The last month has
been a little better. I have been
deliberately cautious with my exercises, taking the advice that I had not to do
anything that was going to aggravate my pain.
When I saw the physio at UPenn in September, his recommendation was to
focus on calming the pain because I would never make progress functionally
unless my pain was under control. Initially it felt a bit like I was letting the pain beat me. My shoulder
felt tighter and I had a lot of burning pain in my hand (possibly from nerve
compression). I felt that not increasing
my exercises was a step backwards instead of going forward. At the same time I felt like listening to my
body also made sense; it was like I had been fighting it for over a year,
especially since my surgery, and now I really had to let it guide me. It took a few weeks to really get my head
around this and I certainly didn't get instant results (given up on those!) but
now I do feel like it is beginning to work.
I've also been
tolerating more manual manipulation by taking Valium when I go to physio. It seems to be increasing my range of motion
now and my scapula has gone from feeling solid and 'stuck' to feeling more like
it is pulling against sticky toffee when I try to move it. It's really just more torture, but it does
seem to be helping!
My pain is still
high, but less aggressive and angry pain.
It is more constant, steady, and just about controlled by my painkillers
now rather than feeling like it is attacking me all the time. I have stuck with the very basic exercises -
small movements, no pushing anything and taking a day off when I need it - and
I am very slowly beginning to see results.
Such as shoulder
shrugs… Last year after I fell I was
completely unable to shrug my shoulder.
Every medical person I saw would try to get me to do it and ask me why I
wasn't doing it: was it too sore? Not with that movement. Was it too tight? Nope. Was something blocking it? Nope. No-one even considered that the muscles that
did that job were no longer even there. (My surgeon says this is because there
is a gap in the "medical encyclopaedia" and taps his head as he says
that. The injury is so rare that most
medical professionals have never encountered it. In fact, our friend who is a top neurologist,
and who really helped me a lot this year, told me he had "never seen a
scapula not move before".) I didn't
even know I wasn't moving it unless I was looking in a mirror. I simply couldn't tell. After my surgery, my surgeon said that there
was now a 'gap' in my brain - it didn't know how to do certain movements
anymore because the muscles had been detached for so long.
Learning to do the
movements again is strange. It seems
like I should just be able to move the way I always have but every time I get a
new exercise, or a new movement to try, it's like my brain is thinking really hard
and concentrating on making the muscle move and it's just not working. When I was younger I loved Matilda by Roald
Dahl and was convinced that if I tried hard enough I would also make objects
move with my eyes. I concentrated really
hard and tried and tried and tried, but it never worked(!) - it feels a little bit like
that, although I think I have a better chance of achieving success this
time…. For me, doing around 40 shoulder shrugs a day for months
just to get a really basic movement back doesn't really feel like something to
get super excited about. But seeing it
from a few different perspectives this week has made me realise it's not just
the shoulder shrugs, it's really what they represent.
It is a tiny
movement, a tiny achievement, but it means that I have managed to get that
movement back - to rebuild the neuromuscular connections to the extent that I
can now do this movement (relatively) easily, quickly and sometimes even
subconsciously now. I really hope that
suggests I will manage to do that with all the other movements too. I know it's going to take a lot more time and
lots of hard work, and I was told this week to expect a bumpy road ahead. So right now, I am going to enjoy feeling a little bit excited about my shoulder
shrugs!!
"Success is falling nine times and getting up ten."
~ Jon Bon Jovi
