In my last post I outlined that I had some issues with my diagnosis of frozen shoulder. Yesterday was Monday, and that meant it was the day for my first cortisone shot and my first physio treatment with the new physio.
While visiting my doctor he took the time to cover some of the questions I e-mailed him the previous day, the questions from my previous post. What he said was that back when I first came in, the very restricted range of motion immediately suggested frozen shoulder. The next step was to get an MRI, which we did. While the MRI did not provide any evidence of serious injury in the shoulder it was clear that something was wrong because of the limited range of motion. What he thinks is that it is possible that I am at an early stage of frozen shoulder, and if left untreated at some point in the future I will have full blown Frozen Shoulder.
The cortisone shot was fairly straightforward. He didn’t use any x-rays or ultrasound so the injection wasn’t into the joint itself but rather into the affected tendons which he did take the time to feel out and locate as the target for the injection.
The injection itself didn’t hurt any more than normal needle would hurt – a bit of a pinch as doctors like to say and a bit of burning but otherwise it was over rather quickly. After that it was often a physio.
My new physio, José, knows my doctor and knew about my history and injury, so we didn’t waste very much time talking. He had me lay down my back on the bed and proceeded to relax my shoulder. He made a point of indicating that my shoulder was quite limited. After he relaxed shoulder he started poking around and digging into some the muscles and tendons in my pectoral and my shoulder. One of the first things that he found was that the insertion points of the pectoral muscle near the shoulder were very contracted. To be honest I have been told about this by a massage therapist about 11 years ago and clearly I should have heeded her warnings.
He accessed the pectoral insertion points via my arm pit and worked both insertion points very hard. This was quite painful but I must say it wasn’t as painful as the massage sessions I had to recover a groin injury a few years ago. That pain was ridiculous, so ridiculous all I could do was laugh as I was getting a massage. Yesterday’s massage was painful however at the same time I could feel a renewed sense of blood flow in certain parts of my pectoral, my shoulder and my forearm as he gave me the massage. After working the pectoral insertion points we took a little rest at which point I noticed that my shoulder felt less tight and more mobile.
Next he worked a few other points – I can’t remember exactly what they were – and after that he pursued a spot in the back of my shoulder which has been tender for some time. I asked him what muscle it was and it turns out it was the infraspinosis, the very muscle that I have trouble with when doing my shoulder exercises.
After working a few more muscles he popped me onto a machine that provided heat to my shoulder, then hooked me up for some electro-stimulus after which we were done.
Two hours in total.
I have to say that as I write this post on the Tuesday after all of this work, I a’m quite satisfied with the physio. I not sure how much the cortisone shot affected the workout; I will have a chance to judge this as I am going to be receiving shots every second week, so for the physio sessions in between, well, my ability to endure the pain and range of motion should give me a good hint.
As for my shoulder the range of motion actually seems to have increased today and remarkably I do not have any pain when moving my arm to the extremes of my range of motion which has been the case for the last few months.
As for my injury as a whole, the physio agreed with the doctor in saying that if this wasn’t treated I would likely have worsened to the point where I would be experiencing proper adhesive capsulitis. It is quite likely that the muscle contractions that he encountered had worsened over time and then some event, most likely in the gym (I can think of at least two incidences in the last year), caused the onset of frozen shoulder, or to be accurate, my decreasing range of motion.
The next appointment is Thursday morning. Hopefully the pain from the massage has worn off by then so that the physio can begin for another productive session.
