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Physical Therapy: Consultation and Fun Treatments

My first physical therapy session yesterday was pretty cool, albeit painful.

The PT put my shoulder–which was already hurting from busing/backpacking through town–through the usual contortions (*tear*). By the end, she would raise my arm in such a way, push lightly on it, look at my face, and go, “Hmm, I’m not going to put you through that.” Her conclusion was the same as the sports doc: decently likely it’s a small cuff tear.

What followed was far more interesting than my usual pain, though. First, I got a therapeutic ultrasound. And the gel was warm! (Quite the novelty in my experience.) I didn’t feel any warmth or hum from the ultrasound, and it didn’t provide immediate relief, but I’m doing better today. Not sure what all to ascribe that to, because this has definitely become a day-by-day injury in terms of pain levels.

Next up was a lesson on posture. Mine’s terrible, and it turns out that slumpy posture can put extra pressure on the cuff, resulting in a predisposition to injury and a worsening of my symptoms. I’ve been practicing good posture yesterday and today–much easier when sitting than when walking with a backpack–and it takes quite a bit of conscious thought at the moment.

She gave me a doorway chest stretch to do to help with my posture. In short, if my pecs are tight, then my shoulders will pull forward, resulting in slumpiness.

Along with this was an upper back exercise: a prone row of sorts called a “prone lying scapular exercise“, although with arms by my side.

The posture lesson was accompanied by a very good discussion of the muscles involved in the rotator cuff, which I’m ashamed to say I hadn’t researched up to that point.

Then we ran through a list of exercises to not do. I’ve been doing some leg work (weight-lifting), but didn’t want to risk any upper body work until seeing the PT. Looking at the weight machine I have access to, I was astonished at how many exercises require stabilization or rotation of the shoulders. Everything upper body.

A lot was prohibited by the PT: no overhead press (*shudder*), no push-ups/bench press, no rows, no chin-ups. I can try a lat pull-down (my usual, which is close grip and underhanded) with light weights and see if it hurts. Triceps and biceps are in if I can maintain good form (rigid upper arms).

The final interesting bit was the electrical muscle stimulation she did on my shoulder. Four relatively large (1.5 inch square?) sticky pads were placed around my shoulder, then a ice pack laid over that and bandaged to me. Then I was lightly shocked for 15 minutes.

Kinda cool, sans the ice.

That also didn’t provide immediate relief, and I suspect the ice made the pain worse. I’ve yet to have icing this injury make it do anything better. A heating pad, now… Ah. Not the best for the swelling they imagine going on in there, though.

I go back on Monday at the bright and early hour of 07:00, then again on Thursday. If this isn’t better in about 3 weeks, they’ll recommend an MRI, it sounds like.

On this upcoming Monday, I’ll have had this injury–and this pain–for a full month. Even on a good day, it hurts and I’m limited. Not cool. Shoo, fly.