Archive for April, 2013

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Shoulders

April 1, 2013

A few weeks ago I found myself in real trouble with my shoulders. All of a sudden my arms felt disconnected with serious structural weakness deep in the shoulder joints. When everything you do uses your arms, the legs still being paralysed to some degree, this was potentially a problem! Even by taking it easy and knocking off the hard work, I still often have to move my entire weight around using my arms. I found myself sitting down in the evenings with the top of my arms aching quite uncomfortably, having done very little with my day. My evening therapy routine went out of the window as I was finding it too difficult to work on myself with any degree of comfort.

Something had changed in my body to cause this and so I started to feel for what it was. My back has been growing steadily stronger lately with increasing volume to the top of the back, volume that has been missing for so long, and I realised that there had been a substantial expansion there. This in turn had created a greater anterior – posterior connection through the chest and was having a very positive knock on affect further down the body. My lower body has been improving enormously lately due largely to the work on the neck and back creating a much stronger foundation, but these improvements had taken a sudden leap forward. Having myself been working hard on my hips since Christmas, I no longer felt such an intense need for this input (which was lucky seeing as my arms weren’t up to it) and stability in sitting, with the translation of force through the pelvis and up my spine, was fantastic. The feeling of normality that has been steadily returning to my legs also took another step forward, although it must be understood that they are still a long way from feeling truly normal again.

This still left the question as to why my shoulders were troubling me so much when everything else seemed to be improving so well, but it was the very improvements that were resulting in this new weakness. With the greater anterior – posterior depth and connection to the chest, this had opened up more room for the shoulders giving greater potential for structural improvements there, but this potential is never taken up straight away. The immediate result is the exposure of weakness (in the same way that the opening up of the pelvis exposed the weakness of the hip joints) and this created a lateral disconnection in the shoulder girdle.

It took less than a week for this feeling of disconnection of the arms to transform into a newfound connection. Suddenly the shoulder girdle entered a new level of structural integrity, but more than that, the chest also entered a new phase giving me a sense of uprightness that I don’t remember having, bearing in mind that it is seventeen years since I walked on two feet. However, the discomfort was far from over and nearly a month after this began I am still struggling with my shoulders. The deeper connection established easily once the potential was there, but a long way from being strong at this stage. With only a tentative establishment of deep structural integrity, the superficial levels are still far from being well supported. The intense aching has eased, but then developed into a similar situation to tennis elbow at the outer corner of the shoulders.

The degree to which the entire body is affected by a spinal injury cannot be underestimated. Tetraplegics with an injury high up the spine have obvious loss of muscles in their arms and although paraplegics retain conscious control of the muscles in their arms, the structural depletion in the shoulders, and upper body in general, is extensive. The notion that I must have a strong upper body because I push a wheelchair is ridiculous and yet it is amazing how many people believe this even when you try to explain otherwise. I long ago realised explanations to be fruitless and so tend not to waste my breath. Even doctors cannot see the structural damage to the upper body of paraplegics and believe that paraplegics suffer with shoulder problems in later life only because of, ‘too much use of the arms’!

The shoulders really need working on with some ABR input, but I can’t work on them myself, that would require me to be too much of a contortionist, and with only fifteen hours input a week from my two therapists, I’m loathed to redirect their attention away from the back especially when I can feel that the work at the top of the back really gets to the root of the weakness in the shoulders. The shoulders are settling down slowly, but maybe it’s time I found myself a girlfriend willing to work on me in the evenings.

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