Ep. 2 'Resetting and stabilising'-Rehabbing shoulder injury
Disclaimer: This is to be used as a guide only. If you are suffering from shoulder pain please seek a proper assessment for your situation
From acute pain to integrating back to movement and activity
Reduce inflammation, reset, restore and reprogram
Day 3-6 post surfing incident:
For the next few days I focused on resetting movement patterns, to help engage the right muscles through shoulder movements and regain that neuromuscular control. It goes without saying, I still hadn't surfed or done anything extensive outside of daily activities.
My shoulder had released from that initial acute phase where almost every movement and any kind of load would irritate it, up in the joint and into the common deltoid referral area (deltoid attachment on humerus). My movement had increased, flexion at about 170 degrees, abduction at 160-170 and external rotation to about 35-40 degrees. All of these movements (in end range) had a slight grab in the posterior-lateral part of the shoulder joint, with a slight referral into the anterior deltoid. It was feeling relatively pain free, just a sense of vulnerability and unsteadiness.
Still working heavily on thoracic mobility, I progressed into some more stabilising work, which mainly consisted of quadruped (on hands and knees) position- engaging the scapular and taking my body through different movements such as rock backs, rotations and scapular push ups. As the pain reduced and my mobility increase, I was ability to take it through a more open chain warm up with a resistance band.
Using a dowel stick to work on resetting my overhead movement patterns (particularly in flexion) by taking the dowel to my end range overhead, then doing a slight overhead shrug to engage the upper traps, as a came back down I did a squeeze of my lower traps.
DO NOT KEEP YOUR SHOULDER BLADES ENGAGED BACK AND DOWN AS YOU GO OVERHEAD!
Despite what you may have been told from your trainer or therapist, your shoulders must release from that retracted and depressed position in order to properly rotate upwards! This is a common mistake it rehabbing/training shoulders. Yes! Engage your shoulder back and down if you're performing push or pull sequences, but going overhead with this movement pattern will reduce you ability and could lead to shoulder impingement.
Towards days 5-6 (which is when I filmed the video), I began introducing some isometric exercises for my shoulder in external rotation and cross body flexion (sword pull). I was using almost the lightest weight on the cable machine but it felt great to engage those muscles in this isometric way (isometric means holding the engagement for a period rather than taking to through the range of motion consecutively).
Note: After each session of loading the shoulder it increased pain symptoms by 5-10%, which is expected and they subsided within a few hours. This trend continued but with each session, less pain was present.... PERFECT!
Again, I don’t recommend taking pain medications, particularly when you get into the corrective exercise phase.This is reduce your ability to feel what's really going on with he injury as you exercise it. However, they can be okay in initial 24-72 hours to reduce pain symptoms.
Lastly, I just wanted to quickly mention that the left side of my next started getting that 'kinked' feeling towards days 4-6. This is common with same side shoulder injuries as the upper trap over engages to support the other muscles/ and joint. It's important to maintain releasing this to avoid having a long term neck problem once the shoulder is rehabbed.
In the next video I will talk about using articular movements and press ions to loading the shoulder up again!