Sunday, March 1, 2015

Ream and run: rehabilitation tips from the super stars #16 and 17

We've invited some of the folks who have done a great job of their rehabilitation after a ream and run to share their tips.

Here's #16:

The success for me in being able to use my shoulders without restrictions is due to many factors. The following are my opinions on what makes for success:

-The surgeon in charge of the procedure
-The team (dedicated and motivated to make the surgery successful)
-Beginning physical therapy while coming out of anesthesia
-The motivation and determination of the patient
-The team's analysis of the situation before the event to determine if the patient is up to the challenge to do what it takes to make the procedure successful
- For me, I had to endure discomfort and to know that was part of the process; -My belief in what I needed to do and my desire to make that happen was a motivating factor to keep going -- I knew there would be a silver lining.
- Consistency and repetition. Every day keep the body parts going and religiously go through the therapy and exercises and never stop.
-I feel when you take this surgery on, fitness, movement and the motivation to use your shoulders without pain means to do what it takes to keep that going for as long as you live. This is not a short time commitment. In order to make that happen, I was more than willing to practice my shoulder therapy exercises every day - which I continue to do and believe is what has helped make this successful.
- To this day, I keep pushing the envelope because I feel stronger and my shoulders are handling the load. I always ask on my return visits if I'm doing too much and how far can I go.
- I do practice some levels of scrutiny regarding how much weight I am lifting.
- I just keep doing the fundamental therapy every day, and stay active working out. My saying "monotonous repetition of fundamental skills makes champions of us all."
- I am constantly thankful for the life this procedure has given back to me.
- Bottom line is the incredible team inspiring confidence in the patient, believing in the surgeon, and having a strong desire to make it work.


and #17

I didn't know if you or any fellow ream and runners might find helpful a few personal rehabilitation observations.

ICE...To reduce inflammation and discomfort, I kept 4-5 small reusable ice packs (5/9in) in the freezer, at all times.
For the first three months they were used for pain, after stretching, and when going to bed. After that, they were used after strengthening routines as well as after visiting the physical therapist.

ROPES VS FLOOR FOR STRETCHING....Initially, I found it very beneficial to do both. After I had pretty decent range of motion, with the ropes I found it difficult to improve without creating a pulling motion. At this point, I switched entirely to the floor. After floor stretching, my shoulder was less sore and recovered quicker.

ROTATOR CUFF PRECAUTIONS.....What I've learned about rotator cuff muscles has come at the expense of an injury during rehabilitation. Before surgery, I had routinely done bar dips in the weight room. At 15 months, my shoulder was doing great and it felt pretty much 'bullet proof'......or so I thought. Unfortunately, all it took was one simple bar dip to change things. Although not a complete tear, it was a major setback. If one looks at the recovery time chart (, it is very understandable why -  from disuse and surgery -  the cuff muscles are the last muscles to become strong again. Maximum recovery is not reached until the 30th month or 2 1/2 years. I didn't believe it then, but I do now. Be aware of exercises prone to cause rotator cuff injury: 
   1. With cuff muscles, it is also important for many months not to make any quick movements. The affected arm is weak and it is easy to drop something, accidentally. Don't instinctively reach to catch anything or you'll know it in a hurry.
2. Be careful too, getting in and out of cars. Wearing the sling is a good idea for the first 6 weeks.
3. FALLS...Be careful walking, jogging, going out after dark, climbing stairs, etc. At 4 months, I was looking for a workout and was slowly running stairs for exercise. I slipped and automatically started to catch myself on the steps. For a brief moment my shoulder lit up like 4th of July. End of workout. I dodged a bullet...just barely.

All of us feel a great debt of gratitude for this procedure. The surgery has helped us regain our active and pain free lifestyles. We all know the importance of daily stretching and maintenance. With all the time and effort that we have invested, it is our responsibility to keep our shoulders healthy. With this in mind, and with a good physical therapist, it is imperative to develop a personal maintenance program that one can stick with for the rest of our lives and most importantly, injury free. It's a small price to pay. During rehabilitation it's often hard to be patient, but now I've learned that it's not a race, either.



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