stretching the coracohumeral ligament

This afternoon, I finished reading the article Positional Stretching of the Coracohumeral Ligament on a Patient with Adhesive Capsulitis: A Case Report, by Jose Orlando Ruiz. It sounded interesting and simple enough, so I decided to try it. The article can be summed up with one quote:

The primary purpose of this single-patient case report is to describe outcomes of a positional stretching technique following the anatomical orientation of the two bands of the CHL and rotator interval capsule in a patient with [adhesive capsulitis].

Of course, the case study was done on one person, so in some sense it's meaningless. On the other hand, I doubt it could hurt. In fact, my physical therapist has encouraged me to do general stretching exercises, even allowing weight-lifting, as long as I avoid painful movements (although in point of fact, the physical therapy exercises that were prescribed to me always cause the largest degree of pain). I've already been doing an exercise which is very similar to the one described, only I didn't go so far as to bring my affected arm behind my back for additional stretching.

The article describes pretty clearly the stretching exercise, and also shows a photo of the action (Fig 2). I didn't want to lie down, so I tried to emulate this position while standing. I brought my left arm behind my back as shown in the figure, and used my right arm to help keep it pinned back, meanwhile extending my chest out and focusing on bringing my scapula together in the back. I could feel a decent stretch in the front of the shoulder, and only a very minor amount of pain.

Actually, there's a bodybuilding pose called the side triceps which is quite similar to this move. However, in my case, I kept my hand supinated as described in the article and shown in the figure.

In addition, the article says the stretch is done with ice applied ("cryotherapy"), but I did not try that. The idea is that the cold helps to "contract the tissues in the new lengthened position". Hm, I don't know about that, but I might try that later, if the stretching alone seems to help.

At the moment, though, I'm wondering if this didn't cause me some excess pain later in the evening.

I should probably mention that I'm not a doctor and should you try this yourself, don't blame me if something goes wrong! I encourage you to consult your own physical therapist or doctor before trying it.

some improvement

I went for a little hike today. Adhesive capsulitis seems to get irritated by hiking, probably because of the way your arms swing when you walk.

The swing of my left arm is somewhat inhibited compared to my right. I'm not sure if that's an unconscious attempt at avoiding pain, or if the stiffness prevents it from swinging normally. I can force it to swing more if I try, and that does cause some pain.

In any case, the last time I went hiking, I was bothered by pain at the end of the hike, and a clicking feeling when the shoulder moved (bursitis?). Today, it went better. I was out for about 2 hours, and my arm didn't bother me much.

I can't tell if this was a fluke; this disease is quite tricky and sometimes gets worse when you don't expect it, or, on the other hand, the pain lessens for no discernible reason.

Everything was mostly okay today soon after I woke up, and I was feeling pretty good and optimistic, until after I did my physical therapy exercises this afternoon. A while after doing those, the shoulder began to feel clicky and aggravated. Maybe I didn't apply ice long enough after doing the exercises. Right now it's feeling sore, so the ice is back on.

another insurance snafu

I opened some mail from my insurance company today. Turns out they'll pay for no more than 8 physical therapy sessions (and according to the verbiage in the notice, they may not even pay for that - thanks for the warning, guys!). So my next one may be my last.

There's certainly been some progress, but it's a mixed bag. I might be willing to pay for a couple more sessions on my own, but it won't be more than one a week. If I'd known beforehand, I probably would have rationed out the sessions more slowly. Bummer.

The next time I hear someone complain about how the government will decide whether or not I get medical care under the public option, I'm going to bop them. There's already a large, bureaucratic, money-grubbing institution standing between me and my medical treatment - my insurance company.