How Alex prevented Mariana, from needing shoulder surgery.
How Alex prevented Mariana, from needing shoulder surgery.
In this article, our physiotherapist provides a detailed account of how he treated a 27 year old yoga-lover who came to him with a complex shoulder injury – preventing her from needing invasive shoulder surgery.
The patient is a 27 year old manager at a software company.
She’s very sporty, and has a background as a competitive swimmer. She has a regular swimming and fitness practice, and enjoys wakeboarding.
Her favourite way to move, though, is yoga.
Suffering from anxiety when growing up, the patient discovered that yoga really helped her mental health. It’s become not only an important tool to improve her life, but also a strong interest.
The patient’s shoulder injury was multi-faceted with many issues arising over time.
Initially, the patient suffered from a right shoulder pain which, after an ultrasound scan was diagnosed to be bursitis. After getting her diagnosis and some exercises this improved significantly.
However, a couple of months later, the patient subluxated her left shoulder while sleeping. The patient was really worried because she had been prone to shoulder and elbow dislocation when she was growing up.
So the patient was sent for an MRI scan and a review with a orthopaedic consultant.
The review revealed that she had a SLAP labrum tear in her right shoulder. In light of this, and her history of dislocations and subluxations, the consultant recommended her to have shoulder surgery.
As well as the patient’s shoulder injury being extremely painful, it also significantly reduced her movement, leaving her unable to raise her arm above her shoulder.
As such, it meant that she was unable to do most yoga poses.
Even worse, it meant that her goal of becoming a yogi was uncertain, as the intense yoga teacher training course she’d planned was now off the cards.
Of course, as yoga is a huge part of her life, the patient was absolutely devastated.
In turn, the patient was really torn about whether or not to have the surgery. She didn’t really want surgery, as it would disrupt her life for months. However, she didn’t want to harm her long-term health by and having to give up all the other activities that she loves doing.
After meeting with the consultant, understandably, the patient was upset and unsure of what to do next.
However, after meeting me at Method Physiotherapy to discuss next steps she decided to try an intensive physio programme before committing to surgery.
So with the patient’s diagnosis and goals in mind, I created a custom physio programme designed to reduce her pain and restore the strength and movement in her right shoulder.
Upon testing, the data showed that the patient had lost 20% range of motion, and 15% strength, in her shoulder.
So we aimed to restore her range of motion with a series of exercises that she’d do at home every day.
Once we had restored her range of motion, we started working on improving her strength. We did this with a custom exercise programme developed to specifically strengthen the movements that she was weak in. In in just 6 weeks, we managed to improve her strength by 25%.
Once we’d made these improvements, we slowly reintroduced her yoga practice, leading to more challenging poses as her pain reduced and her strength and movement increased.
As we’re now reaching the end of her physio programme, we’re thrilled to say that the patient has nearly fully recovered and no longer needs surgery.
The patient feels like her shoulder’s back to 90% of where it was before the injury without surgery.
As such, she feels confident in her body again and has returned to her sports, once more swimming and wakeboarding.
Although there’s some movements she’s still hesitant to do whilst wakeboarding (e.g. flips) she feeling very comfortable that she can do everything else.
The patient’s also elated to feel ready do her yoga teacher training in a few weeks time which she thought she was going to have to miss when she was told she needed surgery.
Going forward, the final part of the physio programme is thoroughly monitor that she continues to meet all the baseline criteria to ensure that she’s fit for sport at 100% effort.
To do this, I will do a series of strength and movement tests on her shoulder.
In turn, I will be discussing what the patient can do going forward to maintain the her shoulder strength so minimise the risk of this issue returning in the future.
The patient back doing what she loves, yoga. We’re delighted that the patient has nearly fully recovered and no longer needs surgery.
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Method Physiotherapy · Embody Wellness, 11 St Georges Wharf, Vauxhall, London SW8 2LE · 5 minutes from Vauxhall Station
