Did my rehab work?

by Daniel Heazlewood-Ross
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In 2020 I had shoulder surgery. If we are going to be specific it was a R) shoulder Bankart repair and stabilisation. Now this isn’t something I went into lightly, as a physiotherapist I threw every rehabilitation approach I could at my shoulder to try and manage it without needing surgery. Unfortunately for me it didn’t yield the results I was after and once I felt I had exhausted all of the conservative approaches I opted for surgical management.
 
I’m choosing to see the silver lining in this experience and use it as a learning tool to be a better clinician. I have rehabilitated many clients following this exact surgery so I was quite familiar with the timelines and what to expect. All of that knowledge and experience prepared me but it was quite challenging being on the other side of the rehab process. Please read on for a few reflections on my experience and hopefully it will help you on your rehabilitation journey.

​1. Be patient. You are not special. You’re not going to have some superhuman healing potential. In my case the first 6 weeks following the surgery we just need to let the tissues settle and let the body do its thing and heal. Once it was clinically appropriate to get moving the improvements came really slowly. Sometimes it seemed like weeks before I even noticed the littlest change. There were numerous times when I felt a bit defeated as the improvements were so slow. Now this doesn’t mean I wasn’t constantly improving. The more likely scenario is that the improvements were slow and gradual (what we want and expect) and it was only once it reached a certain point that I noticed.

2. Be consistent. I can’t stress this point enough. We all work differently, for me I needed a bit of structure. What this looked like was getting into a gym at certain times on certain days to fit in with my life. This eventually turned into a habit and made the process a lot easier. Personally I’m a big believer in going somewhere with a purpose - i.e. gym to do rehab. For others this may mean setting up a space in their garage to perform their rehab. The important thing is finding what works for you and sticking to it. 

3. Know when to push and when to go easy. This isn’t always obvious and this is where some professional help is invaluable. For instance I didn’t mind that my shoulder range of motion had not returned to normal 3 months post op. In my situation I was happy to wait an entire year for it to return as the goal is a stable shoulder. On the other hand I did need to push somewhat when it came to shoulder strength. Sometimes this was a little uncomfortable but I knew what was safe and that consistency was the key.   

4. Know when you can return to sport. This will look different depending on your chosen activity. Lawn bowls may be quite safe and reasonable - downhill mountain biking not so much. This decision is a collaborative approach between your surgeon, your physio and most importantly yourself.I like to take the guesswork out of things. This means getting the shoulder assessed. If you’re not measuring you’re guessing.  

How do you know if your rehab has worked?
Here at Articulate we are incredibly fortunate to have the AXIT system. This clinical instrument suite allowed us to assess my shoulder for both shoulder power and strength (strength being the maximal amount of force I can generate whilst power refers to how quickly I can generate force). The flexibility of the system allows testing in a multitude of directions and positions. We were able to identify a few areas on which I was still lacking and using the data put together a tailored plan to specifically target my deficiencies.
 
I am happy to report that my shoulder has made a complete recovery. I’m back to doing everything I wanted to be able to do. The decision to have surgery whilst being a significant inconvenience was well worth doing. In saying that surgery should always be the last resort and exhausting conservative management should always be the first option. The benefits of the AXIT system is that we can identify if there is some strength component to work on in improving an issue or alternatively it can confirm that the strength for a particular body part is adequate and that there are other aspects that need addressing for rehabilitation. 
 
Whilst the AXIT system is wonderful and gives us a lot of information it is only a tool. The art in rehabilitation is the interpretation of the data, understanding the experience of the client and applying the correct management program.
 
If you have any questions about testing or rehabilitation don’t hesitate to reach out to us in clinic.
 
Dan