An Unexpected Journey

"Health is the condition of wisdom, and the sign is cheerfulness — an open and noble temper." – Ralph Waldo Emerson

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Physical Therapy: A (Long) Description

pulleyI’ve mentioned physical therapy in previous posts, but I realized while going through my session today that I never actually described just what I was doing in physical therapy.  To recap, after some unspecified injury, I developed Adhesive capsulitis (aka “Frozen Shoulder”).  It’s a condition where your range of motion becomes limited and there is pain when you attempt certain movements.  Certain daily activities as mundane as reaching for something on a shelf or putting on your shirt can suddenly become difficult or even painful.

At first, my routine only consisted of a couple exercises and then my physical therapist would stretch out my arm and shoulder beyond what I could do on my own.  However, over time I’ve been given more and more exercises.  My routine now takes me about forty minutes and that’s before I see the physical therapist!  Here’s that part of the routine:

Hand Bike
This piece of cardio equipment has two grips that you hold and rotate around, just like the pedals on a bicycle.  I use this for five minutes to “warm up” the joint.

Arm Pendulums
Bent over, using one arm to support yourself on a bench, you rotate your arm clockwise and counter-clockwise.  What’s important is to keep your shoulder blade back, you don’t just let the entire section of your back/shoulder/arm hang down.  You move your whole body to move the arm in the circular motion, twenty five times in each direction.  This is done five times in between the other exercises.

Finger Walks
This can be done with or without equipment.  At my PT center we have the equipment for this.  Imagine using your pointer and middle fingers to “walk” up slowly on a wall until you’re stretching the joint.  At the PT center they have a wooden piece on the wall with little “steps” to go up the wall.  At home or in the gym, I just use any old wall.  You go up, hold for five to ten seconds then “walk” your fingers back down for a total of ten times.

Cable Pull (Arms)
With the arm at a right angle (upper arm straight, forearm out to the side) you pull the cable (or exercise band) in across your body and then out, fifteen times for each.  Two sets total.

Back Row
This too can be done with a cable or exercise band.  This is your standard back row, with an emphasis on getting the shoulder blades together.  There is only one set of these, but thirty reps total.

Dumbbel Lateral Lift
I’m currently on 8lbs, but started with 5lbs.  This sounds mundane, but it’s a challenge for an injured shoulder.  Each rep involves lifting the arms, holding it for five seconds and then coming back down.  This is done ten times for two sets.  There is a secondary lift where you invert your forearms and lift the weights wide in a “V” shape in front of you slightly (not all the way up).  That too is done ten times for two sets.

Pull Up Assist Machine Hang
Generally when you go to a pull up machine with weight assist, the idea is to well, do pull ups.  In my case however I put the weight at the bottom so it will support my full weight.  I then hold on to the two grips that are parallel to each other and lower myself slowly.  Then I push my chest forward, the idea is forcing my shoulder/arm to stretch using gravity to pull the joint.

Using a pulley with two grips, I pull down using my right arm which pulls the left arm up.  This stretch is done for ten seconds for a total of ten reps.  It is often one of the more painful parts of my exercises along with the pull up assist hang.  You’ll see a picture in this article of the one I wound up buying to use at home.

Bar Exercises
Imagine a metal bar about three feet long with a handle set at a right angle on one side and a grip on the other end.  Using this with a weight tied on, I swing it over head slowly to give my arm another stretch.  This is also used to stretch my arm out laterally and at a right angle, all with the purpose of getting my range of motion back.  This too is quite painful.

Behind Back Stretches
This is exactly what it sounds like.  Imagine you’re using your thumb to scratch your back so you reach back and your arm is at a rough right angle.  That’s what I have to do, except the frozen shoulder keeps it form happening naturally so I use my other arm to force it up.  This is painful but worthwhile.  When I started I could barely get to my belt line.  Now I’m getting towards the top of my lower back.

After all that, my physical therapist then performs stretches on me, taking the arm farther than I can get it on my own.  This usually means laterally, overhead and at an angle.  She really knows how to lean into it and make the joint hurt!  There have been times I’ve coughed in pain or my body temperature shot up and I started sweating because it hurt so much, but it’s absolutely necessary.

This routine repeats itself twice a week, though I want to aim for three soon.  it has been frustrating, but at the sam etime I know it’s working.  My range of motion is better and I’ve had much less pain in the shoulder during sleep and work than I had say three weeks ago.  Let’s just say I really look forward to the ice pack afterwards!