Just over one year ago, I fell in the kitchen and thought the extent of my injury was a bruised forearm. Six months later, I began to feel intense pain in my shoulder following my weekends at work. It developed into a chronic pain forcing me to visit my doctor who diagnosed it as possible bursitis. After two Cortisone shots the pain did not go away, growing worse. He eventually gave in and sent me to an orthopedic specialist. After X-Rays and an MRI, we finally discovered I had a tear in the back of my labrum. This tear is known as a Bankhart lesion, caused by a shoulder dislocation that occurred during the fall. It came time to discuss pain management techniques.
After speaking to my doctor, we chose to avoid surgery for now. The reason for rejecting this procedure is the incredibly difficult and painful rehabilitation following the surgery to repair the labrum. With a newborn baby, I was both unable to take a paid leave of absence from my job and would be unable to properly care for my child with one arm incapacitated for anywhere from three to six months.
Instead we chose to go with alternative modes of pain management for my shoulder, including more Cortisone shots and extensive physical therapy. As someone who wants to limit the amount of Cortisone I have pumped into my body, I am focusing on the physical therapy work to strengthen my shoulder and help me completely avoid surgery in the future. This work is supposed to help with pain relief and we hope my shoulder will return to normal after 6 to 12 months.
Most of the workout is stretching and strengthening exercises. While a physical therapist is recommended, the exercises can also be done at home. One advantage to using a physical therapist is the opportunity to have your shoulder stretched and manipulated following your exercises. The therapy center also has access to ultrasound equipment to provide deep heating to your shoulder.
If you can’t afford to see a therapist, here are exercises you can do at home to improve your mobility and alleviate the chronic pain. It is very important to do these exercises twice a day, every day. Start off each exercise session with 15-minutes of heat applied to the shoulder. Some of the minor exercises can be performed with the heat wrap on your shoulder.
Here is a list of some items that need to be purchased to perform the described exercises:
* Exercise pulley set ($14.99 at amazon.com)
* Resistance Band with door strap ($11.99 at amazon.com)
* Exercise Ball ($14.85 at amazon.com)
Isometric Flexion: Stand facing a wall and place a pillow against the wall. Hold your arm at a 90 degree angle with your elbow by your side. Press your fist into the pillow with light moderate, maximal resistance. Hold for 5 seconds and repeat 30 times.
Isometric Extension: Stand with your back to the wall. Keep your arm at the 90 degree angle with your elbow by your side. Press the back of your arm into a pillow against the wall using light moderate, maximal resistance. Hold for 5 seconds and repeat 30 times.
Isometric Internal Rotation: Use a door frame to provide resistance. Standing inside the door frame, press the palm of your hand into the side of the door frame (still using the pillow for comfort) using light moderate, maximal resistance. Make sure you keep your elbow at your side. Hold for 5 seconds and repeat 30 times.
Isometric External Rotation: This is the same as the previous exercise, using an opposite motion with your arm. Using the door frame to provide resistance, keep your arm tucked in at the side and press the back of your hand into the wall using light moderate, maximal resistance. Hold for 5 seconds and repeat 30 times.
The Exercise Ball: Sit on a chair with the ball on the floor in front of you. Place the hand of your weak shoulder on the ball, palm down. Use the fingers from your strong hand to move the ball forward slowly, hold for 5 seconds and then pull the ball back to you. Repeat 30 times.
Weight Extension: Use a can of vegetables that you are able to palm. With your palm down lift the can directly in front of you, elbow locked as high as you comfortably can. Hold for 5 seconds and then lower it back to your side. Then lift the can to the side of your body, elbow remaining locked. Hold 5 seconds and lower it. Do 3 reps of 10.
Resistance Band: Hook one end of the band to the outside of a doorknob and then go into the room and close the door. Back up until the band gives moderate resistance.
1. Stand facing the door, with your arm held out in front of you, elbow locked. Lower your arm to your side and hold for 5 seconds then return arm to the starting position. Do 3 reps of 10.
2. Turn with your back to the door and once again hold your arm hanging to your side, elbow locked. Raise your arm in front of you and hold for 5 seconds before returning to the starting position. Do 3 reps of 10.
3. Turn to the side and hold your arm across your chest at a 90 degree angle. Rotate your forearm straight into your body and hold for 5 seconds before returning to the starting position. Do 3 reps of 10.
4. Face the opposite direction and hold your arm at a 90 degree angle, facing forward. Rotate your forearm away from your body and hold for 5 seconds before returning to the starting position. Do 3 reps of 10.
Exercise Pulley: Set up the pulley wherever is most convenient. You can either sit in a chair or on the floor depending on the height of the pulley. Using your good arm, pull one side of the pulley to lift your bad arm into the air, stretching it. Let your bad arm lower and continue the back-and-forth motion for 5-minutes.
There are also numerous exercises that can be done at a physical therapy center using machines but these eight exercises are a good alternative if you can only work out from home.
The number one form of pain control is to eliminate whatever it is that causes the pain to flare up. For me, that was impossible because my pain is caused by shoulder repetition at my job. There is also the possibility of monthly Cortisone shots but there is a chance too many Cortisone injections will weaken the joints. My doctor explained that by eliminating the causes of the pain, it only takes one or two Cortisone shots to almost completely eliminate the pain, with the exercises fixing the problem over time.
However, it is important to know how to deal with pain management if you are unable to eliminate the causes. Anti-inflammatory medications such as aspirin and ibuprofen are often recommended to deal with this pain. Make sure to speak with your physician before talking these. Pain medications can also be prescribed to help. This is something to be careful of as well, as these drugs can be highly addictive and should only be used as directed.
Through experimentation, I have found that stretching my arm while I have breaks at work is a good way to alleviate the chronic pain on a limited basis. I also find when it is hurting the most, keeping it resting on something solid is another way to keep the pain from becoming overwhelming. After a strenuous day, it is also a good idea to use cold to reduce inflammation. A cold pack used for 10 to 15 minutes every 2 to 3 hours after any activity that causes pain usually eases the inflammation and makes life more bearable.
At the end of the day, the best possible way to deal with the chronic pain of an injury like this is to rehabilitate it through exercise. Pain medication is only a temporary solution and, if I want to avoid surgery, I have to continue to exercise and stretch my injured shoulder to strengthen it. With the exception of surgery, this is the only way to improve the stability of your shoulder and help it run smoothly during everyday activities.