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Stopped Physical Therapy and rapid decline in ROM

Posted , 18 users are following.

Aly204
Aly204

Hi all!

I'm new here, but had the luck of recently finding this forum. It is so helpful to read about others' experiences and know that I am not alone, and am NOT crazy!

A bit of my story before I get to my question... I cannot pinpoint exactly when I started having issues with my shoulder - my best guess is that it started June 2013, but could have been earlier than that. Like many people here, it was a gradual worsening of an annoying ache/pain in my right (dominant) shoulder. In October, I was walking a dog at an animal shelter where I volunteer, and I slight tug on the leash sent me to the moon. The pain in my arm about dropped me to my knees, and was then followed by numbness.

I saw an orthopedic doctor who specializes in shoulder issues November 25. ( I live in the US) He did xrays and an exam and diagnosed frozen shoulder. He recommended physical therapy for 3 weeks, and wanted to see me again in three weeks time. He advised me to take one vicodin 30 minutes prior to therapy so that I could tolerate more. I followed the prescribed course of treatment - PT 3 times a week and followed my home program twice daily. At the end of those 3 weeks, I had great improvement - 40 degrees improvement in moving my arm straight forward. I measured 165 degrees ( normal is 180). He was happy with the results (as was I) and prescribed 4 more weeks of physical therapy.

This is where everything went wrong. That following week ( Dec.16), I could tell that my arm was getting more and more stiff. It took more and more reps to stretch my arm to get to the same ROM I had been before. It also started causing more pain. This is when my physical therapist started to increase the intensity of mobilizations she was doing. Beginning the week of Dec 30, I was in tears during/following almost every physical therapy session. I was making no more gains in ROM , and had started to actually lose ROM. I discussed my concern with the pain and stiffening and loss of ROM motion repeatedly with my therapist. She assured me that this is just part of the condition, and that you have to push through the pain to gain ROM.

This did not seem right to me, but I have no experience with this condition and i was relying on the "experts". I should have listened to my body!!! At the next appointment with my doctor, I expressed all of this to him, and he offered me a cortisone shot - I declined this because I have Type 1 diabetes and know that this can cause problems with blood sugars for weeks. The only other option he gave was to continue physical therapy for 3 more weeks. I agreed to do this - asked if she should cut back on the intensity of stretches/mobilizations. He said not to cut back on intensity - "she needs to push you until you grimace - and then push some more."

I went one more week, and by the end of that week, I had reached an absolute low and breaking point. I feel that all of this over aggressive therapy caused more inflammation, and in turn excruciating pain and a drastic decrease in ROM. My last physical therapy session was 10 days ago, and while the pain has lessened (some) in that time, my ROM has decreased significantly. While I had 165 degrees 4 weeks ago, now I can barely raise my arm in the front to shoulder height. I have been attempting to do non painful stretches because I am frightened as to how limited my ROM will get.

My question for all of those experienced with this - is this rapid of a decline ( I'm guessing 50 degrees ) in 10 days time completely out of line? I am wondering if I may have some additional injury/issue resulting from the over aggressive therapy. I have not been offered an MRI, and do not intend to see my original doctor, as I feel he is part of what got me in this current situation. I am pondering seeing another orthopedic surgeon to get a second opinion, but suspect he will push the same mantra as the original : physical therapy, cortisone and/or MUA.

My desire is to get the pain under control and attempt to work through this on my own with stretches. I am not interested in MUA or arthroscopic surgery - these do not have great outcomes in insulin dependent diabetics. I saw an orthopedic pain management specialist last week. I do not want to stay on narcotics long term, and had read about some doctors using a nerve block for frozen shoulder pain. This "professional" actually laughed at my suggestion and told me that the only way to "cure" a frozen shoulder is through physical therapy. My primary doctor is pushing cortisone ( regardless of the issues with blood sugar control). I have gotten to the point where I am completely disgusted with the medical community ( and I am actually a nurse!). None of them understand or acknowledge the way the pain with this condition completely alter your life.

Any insight is welcome!

0 likes, 23 replies

23 Replies

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  • katie78501
    katie78501

    Posted

    Hi I've had FS since Dec 2013 so I think I've a fair way to go ,I cannot believe how it effects daily life

    showering drying hair getting dressed driving etc and while I have come to terms with it being a long haul tp

    Recovery I really don't know wether to have PT or just push on doing daily chores etc,one of annoying things

    Is the skin under my arm is starting to get sore I can't lift my arm up enough and I think it's lack of air ?

    Has anyone got any tips on what to put onto the skin ?

  • Browner64
    Browner64

    Posted

    Hi Katie

    Yes it is a very frustrating process. I have been struggling since last Aug but frozen

    Since Nov. While PT helps some, others have found it made it worse. I have found it

    Quite painful but have managed to keep my range of motion because of it. Unfortunately

    I have so much referred pain in biceps and elbow that I am in more agony from that

    Than the actual shoulder. I also likely have a tear so I am going to be many months.

    I am being forced into going on long term disability and people can't see why that makes

    Me so angry. But it's like you said your daily life is impacted. I can't sit and read or knit or

    Even clean my house because it is so painful. So what makes LTD so appealing I would

    Like to know. Especially when I live my job. Oh well.

    As for armpit. I have used deodorant sticks although it is hard to get it in there. Lady Speed

    Stick does not irritate. You might also try Gold Bond medicated powder. The irritation is def

    Due to lack of air.

    I wish you all the best. They say the only cure for FS is rest so try not to use it too

    Much or it will just get worse

    Take care

    Sandy

  • Shaina
    Shaina

    Posted

    Hi Aly204-

    I've just recently been diagnosed with Frozen Shoulder and I've actually been told the complete opposite of you...DO NOT push through the pain, but instead stretch until the point where you feel a little resistance and stop. I'm trying to keep my treatment pretty conservative at this point - free of shots and lots of drugs and pushing through pain, though I've only been dealing with it for a month so far...so we'll see! Good luck!

    ~Shaina

  • katie78501
    katie78501

    Posted

    Hi ,I have had FS for 4 months now ,dreadful to say the least but I have had very conflicting advice,I think because you are only 20 your blood supply to your shoulder will be very good ,I don't think it will take as long to heal as in an older person.

    My Consultant told me to push through the pain, my Physio told me just to go as far with excersise without pushing through pain so there we are .

    I just keep trying to do normal things and some days are much better than others,I have had to buy an automatic car as I can't change gear yet however I can drive !

    You have to compromise but bear with it ! I have been told it will get better wether with treatment or not ,good luck .

  • Piscinelace
    Piscinelace Aly204

    Posted

    We'll, can't say that I read every word from all advisors, but I will share what worked for me when I had 2 frozen shoulders which radiated to  my left leg   I was in misery, started with PT. which was much too aggressive, so stopped.  Saw numerous docs, rheumatologist, primary care,neurologist.  The neurologist was the only one who listened. She advised physical and massage therapy.  She prescribed an antidepressant, neither of which thrilled me But, both of which worked!  It didn't work instantly but in 3 months I was back to normal. Most of the pt and massage by the way was primarily massage.
  • missdiscipline
    missdiscipline Aly204

    Posted

    November 2015

    I've had this frozen shoulder since June. Went to the specialist after tests in Beginning of Sept. and he had me go to 6 weeks of physical therapy 3 days a week. He gave me a cortosone shot before I went and told me "You will need this for what they are going to put you through.

    During that 6 weeks there were many days I wanted to cry too but I kept going and after the 6 weeks I have about 80% movement back however I still have to do these exercises every day or my arm really hurts, yes I still have the frozen shoulder.

    They say it can take 2 months to 2 years even if you do nothing eventually it will go back into place and that the therapy/ exercise just hastens it.

    It's hard to do this every day and yes I still have pain yet I'm going to struggle thru everyday and keep doing it. It's really hard to have this and some days I do cry and yes still if I jerk my arm by accident, wow it hurts.

    Hang in there and fight thru the pain and know there is a light at the end of the tunnel. I feel for anyone who is going thru this.

  • Jay91157
    Jay91157 Aly204

    Posted

    HI Aly204, I have been suffering with  this condition since Oct2013 after a bowling team build exercise. I have had the lot. Arthroscopic, MUA, Steroids and Arthroscopic revision. Pushing the arm through physio is not the way to go. The arm gets irritaed and swells causing more pain. You just need to try and move it, but not push it. If you choose not to go for any surgery you are on a very long road, years, we are talking. I would push for MRI as that will show up a tear in the cuff if you have one and it is big enought to warrant surgery then lady that is the only way that gets sorted. Some people have it and don't know but as you have pain you should feel the arm catching as you raise and lower it arond the 11 o'clock position. Don't say no to every thing just yet as that pain is the most disgusting pain at its worse and the lack of sleep will make you think twice. Cortisone works for some as with all these types of treatment what works for one may not another. Cortisone only works for me for  6- 8 weeks then the pain is back full on.  A nerve block is generally used when you have an MUA but not general use. I have just had my third op and I am beginning to feel I could be on the home straight. Seriously try and get an MRI, push for it as you have the pain not the doctor. Let us know how you go. Best Wishes smile
  • Netmouse
    Netmouse Aly204

    Posted

    Previously had FS after rotator cuff surgery.  Surgeon ordered aggressive PT, said I'd cry but to do it if I wanted to move my arm.  PT pushed arm into the pain in range of motion exercises, as did frequent home exercises.  Result was I felt a bit more movement each time which was a permanent gain.  Tear capsule a bit and my arm could move a bit more.  It took a couple of painful months, but arm was then normal.  At the end PT said how to move arm to do that last range problem, getting arm behind back and up a bit.  I told them I cannot push enough to cause the needed pain, I kept protecting myself, I needed them to push enough.
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