Opinions on my physiotherapy appt. - Astro...or ?

I have been seeing my Physio since end of January. Lyme attacked my nerves on my upper left side - back, shoulder blade, arm, hand, fingers. That was my very first symptom in April, 2013.
One of the results of this was frozen shoulder....
My muscles have atrophied on that side...in particular my rhomboid.
My shoulder blade is stuck - it's pancaked...and not moving properly. The physio has given me exercises...and she also works on the muscles - stretching them, etc.

My arm range of motion is just about 100% now...it took quite awhile...but it's good now.

Today, she said "Let's try something different." She taped the shoulder blade (left) area....so it would move properly...and not stay stuck to the left...and move towards my spine. (not sure if I'm describing it properly)

Next appt. she also wants to try a muscle stimulator on that area...while I do exercises. She said even though I'm doing the exercises, the rhomboid muscle is still not good.

I did explain to her that I don't know how well my nerves are working in that area...but we can try...

So, what do you think? I really like her...and always feel better after I leave. She seems to be very knowledgeable.

New things are good Girlie. Try everything that gets you back to your old self...or your new self.....
Do you try to exercise those parts on your own?
How much can you move your fingers?

The rhomboid is a very difficult to hit muscle generally speaking.....you could try shrugs exercises to loosen it up a bit. Also try to focus on asymmetrical movement of up and down shoulder.....

That is all excellent Girlie. I am a huge believer of the therabands....I have several of different strength. They are exceptionally effective for everyone from rehabbing to pro body building (for warming up) to betweens sets.
I am probably one of the rare coaches/trainers that does not like planking exercises and stretching.

Whatever works for you is what is best. You sound like you did great stride...slowly but steady ...they say wins the race.

I'm having a terrible time with the rhomboid muscles myself lately. I can generally get them to release, but takes me months to do at home, on my own. I've actually gotten a lot of my ideas of what to do from my own time in therapy and from Astroman! Lol!

I wish I knew how she taped your shoulder! I doubt I could do it on my own, but I'm still curious!

If she's been helping you for this long, I would encourage you to continue to follow her lead, until it no longer feels like it's helping. Be open and honest with her at all times.

Personally stretching has ALWAYS CAUSED me an injury of has been the reason for an injury.

As a long time athlete, trainer and track and field coach (based on my experience).....stretching is a very individual thing and should be applied accordingly to each single athlete. Not across the board just because we have heard that is good.

The science behind it......in studies done with athletes, those who DID NOT stretch did not have more injuries than those who did stretch. Interestingly enough, many people who are long time marathon runners do not stretch and are also injury free.
Some people are very tight while others are very flexible. A trainer cannot possibly know at first glance if an individual has muscles that need to be stretched or not if they do not see the person working out and moving about.
That aside ....no muscle should be stretched without warm up. The problem is there is not a set warm up time that applies to everyone. Example it takes me miles and miles to warm up...
When I coached track, specifically sprinters....this is a group who does HIT (high intensity training) who need to be extremely warmed up before training. Unfortunately too many coaches apply one-size fits all formula. Reason why so many young athletes in track have same injury every season.
I would say stretch if you feel you need it....and do so at your own pace and intensity. But if you feel your muscle is good to go, by own means do not stretch as it could cause a major injury and decrease performance. I NEVER....NEVER stretch before lifting. I also never lift in the morning when muscles are much more tight than at night.

I bored you enough......

PS on planking.... it actually stresses the lower back in many people. It does it with me, and I have a strong back. Again I could go on on the biomechanics of planking....but the boredom will continue.....ha ha ha

My shoulder ramblings:

My Physio was not very good, despite high ratings. He was good at viewing digital x-ray imaging of sorts LOL. I gathered/devised my plan info + got help from many "body worker" sources chiros/PT's ect.. Not one of them had a complete plan that worked by themselves, I paid, then learned and devised my own plan, now I'm better.

My past frozen shoulder is about 90% fixed. I started getting aggressive on left shoulder blade / shoulder / upper arm and upper chest about 1.5 years ago. The muscles were stuck, some to bone, some to other muscles, what was left did not fire correctly, and dragged other muscles with it - huge tension. My left blade no longer sticks out when I slide my hands up the backside of my ribs (that is a test). R and L are now even. Think my upper spine is straighter too.

So even though I was super aggressive with harder release tools (lacross ball, thera cane ect), its proven that softer deep massage can benefit anyone needing to heal soft tissue. I would occasionally get upper back massage and take note of the areas that were "ripplely", "ropy" ect.- and roll on them at home (floor on back).. This gets much needed blood, nutrients moving again. I rolled on a golf ball under all of the shoulder rotator tendons several times every day, they were like 2 in long steel cables- this took 8 months to loosen, no cort shots at all. **You first have to fix tendons in order to work out muscles properly**. And this is most PT programs fail, right from the start, as they dont know how to fix tendons with pressure. If they did, well, it takes to long, its a project. I learned how to do this from an Olympian chiropractor who "got it". Lucky me, (ya ho).

**Your physio should have an improvement rating system based on your improvements on some ROM slow stretching floor exercises.**

As tendons get better, muscle rebuilding becomes obviously easier. Again, role on ball (tennis ball for most people) before strength training the area.

Rear delt flys are great and can be done facing down on some bench/ stool with soup cans for starters. Your Physio should know these:

/www.youtube.com/watch?v=DcDOUKzIyiI

Workout the upper back more than the chest. Cable pulling seated rows will also workout the rhomboids - yo can rig this up tying a heavy strechband to a secured poll of some type. Roll a tennis ball along side the upper spine to get this area circulated before working it. Sustained, slow, let sink in..

www.myfit.ca/exercisedatabase/search.asp?muscle=Rhomboids

Lots of you tubes on the upper back muscles.

My opinion on stretching:
1)Some people's body composition is just inherently more limber, not requiring warm up. They are lucky and dont sense the need to do so, since they dont need it.

2)For the rest of the population (myself included): I never though it was a good idea to just "go for it" with out some pre-movement. To me it was like a preliminary check off list of what is moving right and what is not. I start out in the AM as a stiff person, but I'm very limber once I warm up. Was like that as a kid too.

3)For those with knots and past injuries: You CANT completely stretch out muscle with knots in it, you only stretch what is NOT knotted. Knots/adhesions/sticky problem areas are best to start out slowly, or you can speed up the "melt" by manual spot massage, or rolling tools (roller, tennis ball ect). Ignoring these key areas can result in injury. I wish they had these foam muscle rollers years ago, cool early morning event starts would have been much easier on my body then.

So far so good for me, and I was in rough shape. With my improvements, I can roll and self crack my neck now too.

Note: I use several creams to help healing : MSN, Arnica, Asprincream all at once. Blue cold packs at night after "rolling" if needed.

AM

Post Edited (astroman) : 10/8/2016 1:03:12 AM (GMT-6)

After my long winded rambling, I knid of missed your sub topic.

They usually call it Kinesio taping. /kinesiotaping.com/

Its commonly used in sports injuries. I had it done on my foot. Think they supplied me with on off brand to retape daily. It does last through several showers, sticky to wet or dry skin. Its kind of like a soft cast for muscle, holding it where its supposed to be vs where it currently wants to go.

It helps, was not some miracle for me though. Prob helped my foot more when sleeping.

**Tight muscle even with out knots needs to be manually loosened up by the same means I continually mention in this forum.**

Try it laying on the floor on a tennis ball in short spurts to work up to 3-5 minutes if you are unsure you can handle it (if pain present). After about 3-5 minutes (its a long time), you should feel the "melt" start, and you should start to tingle and sink it to the ball. You might have to try this in several areas even 2 cm away makes a difference. Leaning against a wall wont do this, but is still a helpfull massage.

A vertical neck massage (face forward angled chair) helps with this too.

The tendons around the shoulder ball and socket can be felt if they are hard, all 5 or so together are called the rotator cuff. When someones shoulder "clicks" its these that are too tight. Goggle image rotator cuff tendons to see.

"She also works on the muscle under my arm" - yes, it connects to other muscle with fascia to your hip. The fascia is why so many people have complete one sided tightness.

LOL! No worries, Girlie!! You'll know when you hit the right spot I'll bet! Even if you don't have much pain with it, you will feel it being tight, as you will likely feel the pressure seem to increase when you are over the top of the tight muscles.

But this can still help atrophy to some extent. With muscle atrophy there is a lack of circulation from the lack of movments. Foam rolling , tennis balls also increase circulation which is what full muscle contraction does (and what you cant do right now). The "dead" muscle fiber grain is now all messed up in all directions. Rolling it prepares it for stretch which will re-align the muscle fiber grain. Muscle fiber has grain like lumber. Healthy strong muscle has the grain going the same direction, which also self promotes circulation. Its all about naturally regaining circulation. Once that starts, the healing begins.

As far as nerves, the only physical thing you can do are the glides, that you are currently doing. Even though you dont feel pain, you muscles are not healthy, and not right. Muscle has memory and gets "stuck" physically and chemically, it needs to be reminded how it used to be. If you nerves arent activation them, possibly they are "stuck" and forgot how to respond to nerve impulses, working them with above and previously mentioned methods are like training wheels for the real thing.

My left glute was not firing, hamstring did most of the work. My glute had no pain, hammy did, so did SI. I rolled the he// out of the glute till it hurt. Now it contracts. It moves now, but is weak and gets sore. It had no pain before because it was not doing anything, the muscles around it worked overtime. I can feel/ compare glutes firing while walking with hands in back pockets.

The more tools the better. I think your speaking of a "Tens" unit. They stick on and makes muscles minutely jump/ tingle.

Its usually used for spasms, since they have no circulation. In a tight painful, un-circulated spasim it helps pain go away BY creating circulation.

So, yes, physio is trying to get your muscles circulated. And it should do this (well, help) even though you dont have pain. But unless you had it at home, the limited use at Dr office, is, well, limited.

Rolling you can do whenever, the more the better. Do this before the exercises and after.

Our bodies are smart, but like a dead car battery, they need jump starting sometimes.

When you say taping, do you mean Kinesio Taping?

I had these tapes on my back, and it helped. My physio told me that it is ok to wear them 3-4 days. I put them when I know I must sit for a long time or something like that.

My biggest problem is my back. I have other issues as well, but the back are killing me. I have inflammed nerves in spine and the pain is awful. Consequently, I cannot bend over, I cannot take anything more than 500 grams.

Girlie- Ive had nerve pain, but it was from muscle impingement. Then again no one had tight muscles like I did before ABX (like MS at the worst point). My leg felt like there was a hot wire in it from hip to foot for a few years - but only when standing. After a few years it s=changes to left foot cramping, better , but very bothersome. I walked / stood today indoors for a few hours- no foot cramps!

I think it was the piriformis (glute/but/hip muscle near sciatic nerve).

My hand nerves felt "electrified", shock like. The glides help that, my my usual tight muscle work. Then after ABX, it went away almost for good. I can write much better now, early AM can still be a struggle though.

Interesting topic as i wonder if atrophy is càused from nerve impingment also ...or is tit the bugs or both as i know the bugs have messed my c5 shouldet area also the left and if forward it goes numb..i listed a lot of nerve building stuff on bfs threaď ...keep us posted on the physio...for a while there the more i used the more i lose ..scary stuff as i was healthy active last year ...Creek trail did recommend way more abx and an also carnatine amino acid