In the beginning I struggled mightily, slept very little, and was largely uncomfortable nearly all of the first month. Each step forward seemed huge - first rehab session just 48hrs after surgery, stitches out after two weeks, sling off in less than a month. I also progressed rapidly through my first 10 weeks of physical therapy, quickly moving from passive to assisted to active range of motion. Those sessions were painful and difficult, but I was motivated by the thought of returning to strength and health, and I was driven by my own desire to stay ahead of the rehabilitation timeline. There were low moments and frustrations, but the progress always kept me mentally afloat.
The past month since I posted my last update has been frustrating for different reasons. It was not so much pain, or stiffness, but what appeared, for about two weeks or more, to be a complete stall in any progress. I could move my arms above my head, but the shoulder sat awkwardly above the socket, as if it were frozen in a right shoulder shrug. Beyond this, I was still very weak from the time in the sling, and had lost 5-7 pounds of muscle, mostly from my right arm, and the right side of my back. My scapula, teres, and other back muscles weren't firing normally, as if I couldn't make the connection from my brain to make them go when I needed. As a result, my shoulder blade was 'winging' badly, flying outside of its normal plane of motion in a strange compensatory way. I was running and doing agility workouts pain-free, but when I went to throw a frisbee, all my forehands were blading straight into the ground about 10 yards in front of me. I had gained back so much flexibility and range of motion, but the last 10-20% I was missing was completely destroying my form. For the first time since the surgery I worried that I would never regain my ability to play high level Ultimate, again.
Despite my fears, Lita remained encouraging and kept pushing me. She is a therapist not only skilled with her hands, and knowledgable about the body, but adept at reading emotions and understanding the psychology of an injury and the recovery from it. With her help, I made it through the last four weeks.
I'm not sure if stalling in my recovery was a normal part of my healing, or if perhaps I went too hard on strengthening (once I was cleared for it) while falling away from the stretching and range of motion activities. Either way, it became clear at my three month follow up with my surgeon (nearly two weeks ago) that both range of motion and strength were good, enough so for a normal day-to-day life, but not so to again be 100% as an athlete. To achieve this I needed to work even more diligently to regain the last bits of my function and power. Interestingly, my internal rotation ROM was about 30 degrees behind my external rotation, but my external rotation was the far weaker of the two. Although this is to be expected since external rotation puts the most strain on the repair site for the supra- and infraspinatus tendons, there was too large of a gap between the ROM and strength in each direction. Interesting physiological note, as you gain motion in one direction, you usually lose some in another, which is especially true of baseball pitchers. Typically the total ROM is 180-190 degrees.
External (ER) vs Internal (IR) ROM
My new regiment, since the three-month follow-up has brought in a few new exercises and modifications of old ones with the aim of increasing both flexibility and strength in all planes of motion. I've been very diligent, and I have seen the returns on my time investment. My internal rotation ROM has improved and is nearing equality with my left side. Also, last night I got my supine overhead ROM to where I can put the inside of my elbow joint up against my ear AND have my forearm touch the ground. Try it, you can do it, but think about not being able to for 100 days!
I've also noticed increases in strength, particularly in the problematic ER plane. Combined with my IR ROM, these two factors will be critical for generating power and achieving proper form on my forehands when I return to Ultimate. I'm working through some eccentric training (negatives) using Therabands, which have proved highly beneficial. Also worth noting, I've been cleared to do all weight training except overhead lifting (maybe another month on that), and although I've avoided it, I am cleared to do some roped climbing, too.
With the adjustments I've mentioned, it's clear I'm back on track. I may have written this before, but I can actually feel the end coming, now. I'll be cleared to play Ultimate again in the next 4-6 weeks, by which time I will be about 20 weeks out from surgery (half a pregnancy!), though full strength won't return for probably another month after that. Unreal. The shoulder really is complicated and while hard work is important, so too is patience. Lesson learned.
Can't wait to see you on the field!
