SHOULDER STIFFNESS

A neighbor asked if I could do a post on shoulder stiffness, and upon considering it, I figured I may as well discuss stiffness in general…especially the part on how to prevent it!

As Ben Franklin said, “An ounce of prevention is worth a pound of cure.” And I think it goes double for joint stiffness. The good news is that in most cases, it can be easily and predictably prevented.

The most common joints to stiffen as we age, and even more importantly, to cause functional problems, are our shoulders, knees and ankles. Let’s get down to business, starting with shoulders, per my neighbor’s request.

Most shoulders stiffen because of disuse after injury…even the slightest injury. As we age, and don’t really need to use our shoulders in their fullest range, stiffness becomes more prevalent.

Our shoulders are truly amazing. They have the greatest range of motion of all of our joints. With a little help from our torso, we have almost 360 degrees of reach. That enables us to do mundane stuff like reach over and put our seat belts on. Scratch between our shoulder blades. Discipline our kids without having to pull over. And clean our privates, no matter what country we’re visiting! Think about it…long term…that’s probably THE most important thing our shoulder helps us do. But you have to get a stiff shoulder to truly appreciate it.

I injured my shoulder about 20 years ago, and fully recovered with no treatment. I babied it for about 9 months, and it got well. In anticipating the writing of this post, I tested that shoulder range of motion for the first time in 20 years! The right goes all over the place. I can use that right arm and shoulder to reach almost every place in my body, with the exception of a baseball-sized area of the back of my left shoulder. Not so with the left, previously injured shoulder. The area I can’t reach is larger. Where I can lay my right shoulder and arm against my head, without using my neck to get my head to the arm, I lack about an inch of being able to do that with my left arm. There is absolutely no functional problem, unless I have a mosquito bite on the back of my right shoulder. There is absolutely no pain. I simply did not fully rehabilitate it after that injury 20 years ago. Because I didn’t need that range to accomplish anything functional, I just let it go. Well, I’ll never make that mistake again!

From now on, I will check my shoulder range of motion at least every other day. I’ll do the same for all my joints. Just take them through their entire painless range. For my shoulders, I will reach above my head. Across my chest. Reach behind my head, neck, back and butt. If there is a painful restriction, I will approach it gently, never shoving it to the full range. I might gently push it. Warm it up when I take a shower and try again. I won’t do this with any resistance or weight. Just the basic motion of reaching. I’ll compare both sides, keeping in mind that not everyone is born with extremely flexible shoulders, and on the flip side, some people have injured both shoulders.

Like me, many of you will already have some loss. This can be due to:

• normal anatomy and the shape of our bones
• a current or chronic injury
• a current or chronic condition
• arthritis

In my experience, the most common cause of shoulder stiffness is rotator cuff disease (strains, tendonitis, tears, and arthritis due to chronic rotator cuff tears). This is what caused my shoulder pain 20 years ago. It usually occurs in people over 40, and is often not due to injury. Many of us are just susceptible to developing rotator cuff disease. And some of us get injured.

The immediate response after an injury or after the onset of pain is to protect the joint. In a way, stiffness is our body’s natural splint. Picture a caveperson, with no casting materials or braces. Muscle spasm, swelling, immobilization and rest are your body’s natural way of protecting the injured wing. Once the pain diminishes, it’s time to begin moving. And your goal should always be to regain full range of motion. Maybe you can do it yourself. Maybe you need medical supervision and physical therapy. If you don’t make progress with stiffness as soon as healing allows, you might miss the boat, and wake up one morning, realizing that you can no longer reach the top cabinet in your kitchen…or your butt. Then you rearrange your household, and get a Butt Buddy on Amazon.

Sometimes you’ve damaged the limb to the point of no return to normal range, strength, shape or function. So be it. You make modifications and let your doc and PT guide you. Otherwise, your goal is full function and full range of motion, until your doc tells you otherwise. Unfortunately, as we age, our significant others, including some doctors, don’t necessarily have that expectation for us. But I can tell you that at 69, my expectation, right here, right now, is to regain all function and range of motion.

Next time…knees.

As always, consult with your doc if you have questions regarding your own status. My recommendations are based on my experiences, both professional and personal. They are not meant to conflict with the recommendations of your physician.