[Fracture Purgatory #17] The wall of a "slight angle" that should have been a breeze. The 6-day-a-week battle begins. *Includes images of arm movement

33 days since the fracture.

Setting goals

This is my second physical therapy session. The same handsome physical therapist as last time comes to the waiting room to pick me up.
"Sorry to keep you waiting, let's get started again today."
Hmm, he's refreshing. I reply, "Please do," and we head to the bed together.

I took off my brace. Last time I stayed in my jersey, but from this time on, I decided to take off the jersey and receive physical therapy in a T-shirt.
"Starting today, over the next two weeks, the goal is 110 degrees for lifting the arm forward, which we confirmed reached 90 degrees last week."
Hearing that, I immediately replied.
"Flexion, right?"
He looked surprised when he heard that and said, "You know your stuff."

Last week, after my first physical therapy session, I started previewing physical therapy at home, little by little. It's partly because I like gaining new knowledge, but I also thought I should know exactly what kind of procedures are being done to improve my body.
Arm movements all have names depending on the direction of movement. The direction of lifting the arm forward that I answered is called "flexion," and the direction of pulling it backward is called "extension."

"Heh heh heh, I studied up."
I said with a smug look... but that was short-lived, as I would soon learn a harsh reality.

Too high a goal

When I lay on my back on the bed, he grabbed my wrist and started to lift my arm.
However, he stopped when he noticed that my T-shirt had been modified. I explained that since it's hard to put on and take off because my shoulder hurts, I cut it so I could change without moving my shoulder.
"That's amazing. You're the first patient I've met who came up with that idea."
I was complimented. Actually, it wasn't my idea, but my family's, but I'll take the credit.

Pulling myself together, my arm is lifted straight toward the ceiling. Same as last time, this is 90 degrees. My shoulder feels a bit heavy, but it doesn't hurt. The goal is 110 degrees, 20 degrees further in two weeks.
Just 20 degrees, that should be a breeze. He puts in effort to move it further.
"Ah..."

It won't move. As if there were a stopper in my shoulder, my arm didn't budge an inch past straight up.
We looked at each other and laughed. There's nothing else to do but laugh.
"Let's do our best."
Saying that, he brought over a skeletal model hanging on a caster stand from the back.
Seeing that, I thought about telling him the story of how I fell in love at first sight with a fake skeletal model I bought for 30,000 yen at a general store in town when I was a high school student, and brought it home on the train with its hands and feet sticking out of a paper bag that was too small, but I thought it was too early to reveal my middle-school-syndrome, so I stopped (lol).

He explains while rattling the skeletal model.
"I looked at your X-rays, and compared to your normal left shoulder, the head of the bone in your right shoulder is sitting a little high. So I think that's why there's no room when you lift your arm and it gets caught."
The shoulder joint moves like a round ball rolling on a plate. And it's normal for there to always be a gap between them. It seems that in my shoulder, that gap has shifted to one side, which is causing the restriction in movement.

Loosening the surroundings

He continued by teaching me that there is something called the "joint capsule" that wraps around this shoulder. This wraps the shoulder, which performs particularly complex movements in the body, and by secreting a lubricant called "synovial fluid" inside it, it allows it to move smoothly.
And my joint capsule, which I had hardly moved since the surgery, has developed a state of "adhesion," where it sticks together, and "contracture," where it stiffens, which he says is also a cause of restricting my shoulder's movement.

Since we can't move forward without doing something about these adhesions and contractures, we decided to just massage it today. I had been told as homework from last time to massage it with my left hand because it was stiff, so I had been massaging it, avoiding the surgical scar.
But a pro is different.
The moment he flipped up my T-shirt and checked the condition of the scar, he started an intense acupressure massage without caring about the position of the scar at all.
It hurts!!
I didn't say it out loud, but it was incredibly painful. It was a tumultuous massage that made me wonder if the scar would open, or no, if the bone that was starting to knit together would come apart again.

In pain so intense I couldn't even breathe, I finally asked a question.
"Th-that's pretty intense, isn't it?"
When I said that, he replied with a smile.
"The joint capsule is right around the bone, so you can't loosen it with a general superficial massage. Besides, you have a very rare type of fracture, so it's tricky."

The massage I had been doing for the past week was just child's play. Moreover, it seems that my glenoid cavity (the plate part) is not something that breaks easily, and when a load is applied here, the force usually escapes by dislocating, so it doesn't usually result in a fracture. He said this was the first time he had seen a patient with a fracture here.
I have a combination of dislocation and fracture... Somehow, his smile started to look like that of a demon.

The 6-day-a-week battle begins

"You worked hard today, and since it's Thursday, let's let it rest a bit and put our full effort into it starting next week."
I totally agree with that proposal. It's not quite the excruciating pain I felt after the surgery, but my shoulder is throbbing and screaming to the level that I'm breaking out in a cold sweat. I could barely manage to reply, "Yes, let's do that."

Today's hell is over. I was thinking about taking a painkiller when I got home, when he said:
"So, can I go ahead and book you from Monday to Saturday?"
"Eh?"
I raised my voice at the same time he finished speaking.
Monday to Saturday, that's all 6 days except for Sunday when the hospital is closed. But I have to move this completely immobile shoulder another 20 degrees in two weeks. The power word that I have a rare type of fracture also echoes in my brain. I booked the full course for next week, saying, "Please do."

When I got home and flipped up my T-shirt in front of the mirror, the scar was red and looked a bit like a blister.
"Well, of course it would look like that after all that," I thought, as I placed my left-hand fingers avoiding the scar and applied pressure, but I couldn't feel the pressure echoing inside my shoulder like he did.
It wasn't because my grip strength was weak (though it is weak), and since it wasn't just brute force despite the pain, I honestly admired the physical therapist's delicate technique of efficiently delivering force to the inside of my shoulder.

~~ To be continued ~~

I hope that by reading this article, more people will feel inclined to gently offer a helping hand when they see someone struggling with an injury.
And above all, I would be happy if this serves as a reference for those in similar circumstances to mine and helps to alleviate even a little of their anxiety.