June 25 It’s a gorgeous summer afternoon and the strawberries call. I talk a friend of mine into driving me to the local pick-your-own patch, a spectacular spot with a great view of Mount Kearsarge and Okemo off in the distance. I am feeling pretty good. I am nine days out from a large rotator cuff repair on my dominant arm. I’m in my sling with a bulky bolster and I’m using a hiking stick to walk on even ground. I got off of my pain medications after three days, so my mind is clear. I’m pretty cocky.
We spent a good hour and a half picking strawberries that fine day. I used only my left hand, of course. I consciously worked hard to hold my right shoulder back in a good position, being careful not to move it. We loaded our quarts into the car and headed back home.
That night, my shoulder was very achy and painful. I iced it a lot and still woke up the next morning feeling very sore. I found myself feeling quite scared. What if I screw this up? What if it is doesn’t heal and I can’t get back to doing the things I love to do? I talked myself down eventually and diligently resumed my efforts to rest my shoulder. The pain finally calmed down.
I’m a physical therapist and I know the protocol: six weeks in a sling with a bolster, with no moving that shoulder! After six weeks, it’s a gradual process of starting to reuse the arm, slowly regaining motion and strength. I know this is a process that takes three to six months. I’ve seen it time and time again in my patients. The Boston Shoulder Institute tells me specifically that at four weeks the strength of the repair is just 20 percent. At eight weeks, it’s 40 percent. At 12 weeks, it’s 60 percent. And, sometime between six and eight months, it is finally at 80 percent. Patience is key.
In my head, I know this is about tendon healing. But I am a doer and I am stubbornly independent. Aren’t these good qualities? During those first couple of weeks, I kept testing and pushing. Can I hold the jar while I’m unscrewing the cover? Can I hold vegetables while I cut them with my left hand? Can I figure out a way to water my garden one-handed? It is amazing how it’s possible to overuse a shoulder without actively moving it. Simply writing too much, keeping the shoulder tense or not supporting it enough while I sit can make it cranky. Even if I’m careful to not to use my arm when I’m getting in and out of my sling or getting dressed, I can see clearly now that I’m using it more than I think.
I get that my job now is allowing my shoulder to heal and that rest itself is productive.
So, this process of learning “radical self care” has not been a smooth and easy one! Slowly, I am learning. I’m now at week five and I know that, if I do not do my part, I am wasting the time and effort of all those who are helping me, and will be shortchanging myself in the end. I’m finally practicing what I regularly preach to post-surgical rotator cuff patients—not doing any new activity for more than 20 minutes. That way, I can see how my shoulder tolerates that activity without abusing it in the process. I ask myself more frequently these days, “Is this a helpful choice right now?”
I am not perfect by any means! At five weeks, I continue to redefine what being productive means to me. I continue to deepen my appreciation for what it means to rest, and what self care is really all about. I get that my job now is allowing my shoulder to heal and that rest itself is productive. My new mantra is, “As I relax and am still, I heal.”
I’ll be allowed to start using my shoulder and arm soon enough, and will be starting physical therapy soon. But, for right now, I need to stay where I am. As my surgeon says, “It’s all about biology.” I would add that there’s a fair amount of psychology in it, too. It’s amazing how we keep learning all the time!
~ Julie Dewdney, PT