It was 10 years ago and I was working at my clinic. The pain came on suddenly while reaching overhead and felt like a squiggle of spaghetti moving in my left armpit. From that point on I have dealt with shoulder pain on a daily basis.
I want to talk about the challenges I faced and how I have managed to maintain a level of activity and exercise despite the injury, as well as some lessons I learnt along the way.
I had been lucky to avoid injury in my youth playing cricket, squash, and footy competitively plus loads of social sport with friends. I’d seen the cost of injuries in my nine years as an AFL physiotherapist. We had a brilliant rover at the Bulldogs called Brian Royal. He represented Victoria many times, but during his 199th game against Essendon at the MCG in 1992, he tore his Achilles tendon. At his age, it was career over.
The first thing I realised about my own injury was that, although it was limiting and painful, there were no signs of serious injury or red flags. However, there were times when I was severely incapacitated by the pain. At one stage I lost power in my triceps and I couldn’t even lift a 2 kg dumbbell overhead. Later I got excited about chin-ups. After a session of preparation work (not even doing a full chin up), the resultant pain stopped me from sleeping for 2 nights. I tossed and turned and would maybe get some slight relief before a deep shoulder ache came back with a vengeance.
Working with a team of physios was a great opportunity for me to have treatment and work through a prescribed rehabilitation program. I was a living case study. However, I wasn’t consistent with my treatment, only seeking help when the shoulder became particularly painful. Most of the time, I could get on with my life and put up with the discomfort. There weren’t signs of serious pathology, so we decided not to go down the path of further investigation and scans.
I had a chronic annoying shoulder injury that only episodically became severe. I think this is a story that many people can relate to. As Ridgway Method practitioners, we recognise the importance of finding the main drivers of your pain and restriction. These can be addressed by changing movement patterns and habitual postures, and improving tolerance to load with strength and mobility exercises.
Using the Ridgway problem solving approach, Nicole identified my left biceps and anterior deltoid muscle as the main contributors to my shoulder pain. I also have a nerve component to my pain with increased nerve tension in the upper and lower limbs. Now I have treatment on a regular basis with Nicole and have seen consistent improvement in my pain levels, range of movement, and strength.
When she treats these structures, this always improves my shoulder movement by reducing pain and guarding. More importantly, I have an exercise program to build on the improvements made during the treatment sessions. At the beginning, I couldn’t do a push up with proper technique with my left shoulder – but now I can do 3 sets of 15 push ups with good form.
With consistent treatment, specific exercise, and Nicole’s guidance, the movement control of my shoulder has steadily improved and with that, the level of chronic pain and tightness in the shoulder has also reduced to the point where I’m not even aware of my shoulder most of the time. Now I continue with the strength and motor control exercises on a daily basis.
My take-aways:
1. Recovery from injury is never a smooth linear process. There will always be setbacks and obstacles to overcome.
2. Persistence trumps all. To move forward you can’t give up. Always try to find the best pathway forward. Ask questions and get the best understanding you can.
3. You may not get 100% recovery and that may be an unrealistic expectation. You want to be as independent as possible but also know your limitations so you don’t overdo it. I look at my pain as a reminder. It keeps me on track.
4. Always look for guidance and assistance. This can come from your therapist, supportive friend, or family member who can check on your exercises and keep you accountable.
5. There is a difference between pain and suffering. One does not automatically lead to the other. We can get caught up in the emotions, and the negativity of pain does not help our recovery. We always have a choice.
