Elizabeth's Shoulder Updates : May 2013

Thursday, May 2, 2013

Follow-up Appointment

I am two months out of surgery. Yesterday we flew out to Lexington for my follow-up appointment this morning. Though I definitely still have a lot of work I do, I am doing better than they expected! I still have trouble with properly raising my arm above my shoulder, but I knew that, and am just starting to work on it in Physical Therapy. My strength in the muscles attached to my scapula is very good, and impressed Dr. Kibler (my surgeon). He says that this indicates a very good, strong attachment of all my muscles in the area. My AC Joint was also very stable. The challenge now will be learning how to do more with my shoulder, strengthening it, and then building endurance. I got permission to swim now, though not freestyle or back stroke, and in another month I am allowed to canoe, paddleboard, etc. This is very exciting as previously, I was only walking/hiking, which is fun, but it will be nice to be able to mix it up some.

They did say that people tend to get frustrated that they can't do things around month 3 or 4, because of lack of strength/endurance, so I will have to continue to be aware of my situation and know that it will get better as time goes on. In other exciting news, Dr. Kibler and Aaron's (program coordinator) study on scapular muscle detachment was approved for publishing. This is very exciting as their work is now recognized and legitimate to the medical world, helping them and people with these injuries. Overall, it was a very exciting and uplifting appointment.

Description

This blog will be used from now on to update people about my shoulder. It is often difficult to remember to update everyone who would like to know what is happening with my shoulder and honestly, sometimes I just don't feel like doing it. Furthermore, articulating information quickly and smoothly has never really been a strong suit of mine. Thus, giving people the information that they want to know in a way they can understand it is always challenging. Feel free to ask any comprehension questions in the comments of a post.

About My Shoulder

My diagnosis: My diagnosis is scapular dyskinesis caused by a detached scapular muscle, a separated AC joint and possibly a hooked superior medial angle. What this essentially means is that my shoulder blade does not move properly. It often gets "stuck" causing it to stick out from my back (a position that I typically call "out"). Once it is in this position, I cannot get it back to its normal position on its own and need somebody to put it "back in" for me, which is pretty easy as long as you are not too squeamish. To do this, I just need someone (they do not have to be a doctor) to essentially shrug my shoulder (I don't have the ability to do it myself). This is painful, but necessary.

How it happened: When I was eleven, in the fall of 2005, I jumped off a swing and landed on outstretched arms. After this, I began to have shoulder pains. It is believed that this is when my scapular muscle became detached. I initially only had pain in many places on my shoulder and a bit of cracking under my shoulder blade. This proved to make it difficult to diagnose what was wrong with my shoulder. However, by the summer of 2010 it progressed into getting stuck like it does today. I have been attending Boston Children's Hospital since this time. Starting in the fall of 2010, I was able to control my shoulder enough to learn how to fix it myself and do what I wanted. However, at the end of January 2012, I crashed sledding, separating my AC joint (Type II separation). Since then, physical therapy has not been able to get it under control. It was agreed that surgery needed to be done to solve the problem. I had one surgery June 2012 to get a better idea about what was going on inside my shoulder. They could not find anything significant besides some inflammation. They gave me a cortisone shot to reduce inflammation. However, though it reduced the problem for a short period of time, it did not fix the problem, and my shoulder progressed back to its original condition by the end of August. After more testing, it was decided that I may have a hooked superior medial angle. I was then sent to a doctor in Lexington, KY who specializes in scapulothoracic joint issues. It was there where the final diagnosis and surgery was decided on.

Some statistics:

7 years

7 doctors

~6 x-rays

3 MRI's

2 CT Scans

2 EMG's