physical therapy

I've been trying to create my blog posts in an orderly fashion, but I'm skipping ahead with this one.

Yesterday was my fourth physical therapy session. The whole session lasted about two hours.

By now they have me doing a regular series of exercises. In the first one, I spend eight minutes on the "hand cycle", which is essentially a stationary bike which you pedal with your hands. (The machine is way overbuilt for what it does, IMHO). I'm nearly convinced that it's doing more harm than good, since it's impossible to pedal without the feeling that pins are stabbing into my left shoulder.

Since that's first, it sets me up for pain and crackling during the entire session. I try to avoid crackling by easing into and out of positions slowly. Before I developed this condition, it was unusual for me to experience clicking or crackling in my shoulders, and I don't want to develop it in the long-term.

As is often the case with medical offices, my physical therapist was delayed, so I wound up doing all of my exercises, and more, before he could get to me. When he got to me, I was already in quite a lot of pain. Then, as usual, he started with a deep tissue massage, and ended by doing lots of extremely painful manipulations of the arm which are intended to get the shoulder rotating correctly again.

I've been concerned about the manipulations because, in addition to the frozen shoulder, I've also been diagnosed with tendinitis, bursitis, and a partial tear of the infraspinatus. I'm willing to put up with pain, but not if the pain is an indication that I'm doing excessive damage to the other constituents of my shoulder. I want my shoulder back to 100% when this whole episode is over. I fear that excessive pulling and tugging might worsen the existing tear, or produce new injuries in previously healthy tissue. This is speculation, based on a few points that are extremely painful.

I think of my frozen shoulder as if the joint is encased in a ball of cement. The tendons and muscles are coming out of that ball. Usually, they slide around efficiently and cleanly when the shoulder rotates, but my view is that now they are getting stretched with much more force than is natural, and probably in strange directions, too. Surely this is just aggravating the whole joint more?

I'm particularly concerned about the biceps tendon because it inserts into the shoulder capsule and can develop adhesions in frozen shoulder. If the biceps tendon is torn, it won't heal on its own, and I'll need surgery.

I brought up my concerns with the physical therapist once again - I've continued to mention them, because I feel the amount of pain I'm experiencing is unreasonable. Yesterday, he cautiously admitted that the pain I'm feeling may be due to stress on some tendons, in particular the biceps tendon, and suggested that I shouldn't push myself to the point of extreme pain. However, he still seems convinced that it will be necessary to go through a lot of pain to get my shoulder rotating again.

At the end of yesterday's session, he asked me to lift my arm in a couple of directions. He thought that my shoulder had improved marginally - that it was rotating just a little as opposed to being completely stuck. He didn't seem to be saying that to make me feel better, either.

He then offered some ice. I haven't used it so far, but I decided to try it. It seemed to help quite a lot. I kept it on for 30 minutes or so, and after that the pain had subsided quite a lot.

When I got a chance, I took a look in the mirror, and I think he's right. The shoulder does seem to be rotating very slightly now. But it has a lot further to go.