Substitute Clubbell Swipe for Shoulder ROM Flexion exercise?

[PaoloValladolid]

Current condition:

I am recovering from a left shoulder injury. My orthopedic doctor initially feared it was a torn labrum, but X-ray and MRI film showed otherwise. While nothing has been shown to be torn, there is pain around the front of my shoulder where it meets the biceps when I straigthen and raise my arm to the front and to the side. The doctor prescribed an anti-inflammatory drug and rehab with a physical therapist.

The prescribed drill:

One of the exercises in my rehab routine is a ROM flexion drill with a broom handle. In this drill, I grasp the handle with both palms facing up and both arms straight and use my right arm to raise my left arm towards the front until it is pointing straight up, then hold for 5 seconds. This works fine going up, but going down I have trouble relaxing my left arm sufficiently so that the pain doesn't kick in as I let it go back down.

The substitute drill:

The clubbell swipe seems to work the shoulder in the same ROM. I can do these completely pain-free.

Question: Am I on the right track in substituting the CB swipe for the original ROM drill?

[bob_stra]

Seems to me that the broom handle exercise is a very specific type of AAROM, with the other arm acting as a restriction on what you do. There must be some purpose for this.

Talk to your PT. Swipes do not replicate the broom handle action - they actually allow you to 'cheat' on it by activating other articulations. Ergo, less pain for you in target tissue. This can be a good thing, or a bad thing, depending on what the program is designed to do.

Ask your PT for approval to substitute.

[PaoloValladolid]

The PTs at the place I go to for my PT sessions, including the one mainly in charge of my rehab, all voted down my clubbell swinging idea. They don't want me lifting more than the 2-2.5 lb weights I use in my rehab routine.

I was shown the prone-position variation of this up-down flexion ROM exercise. This one is easier to do pain-free.

Thanks Bob for weighing in...

[Jarlo Ilano]

Paolo,

Allow your P.T. to guide your program for an appropriate amount of time. An amount that you both agree on. During this timeframe, follow their advice. If at the end of the agreed upon time you are not happy with your results, then let the therapist know. And of course, if you have any questions regarding your care, tell your therapist. Communication is key.

This is both fair to yourself and to the therapist.

Good luck to you.

[PaoloValladolid]

Thanks, Jarlo.

My orthopedic doctor prescribed 4 weeks of PT. I just started my 3rd week. He actually thought any lifting I could do without pain would be fine.

However, I have in fact been mostly faithful to the PTs' prescribed rehab program. The one session in which I did the clubbell swipes was my only deviation from the program. A few days ago, they increased the number of reps/set for the strengthening exercises.

[PaoloValladolid]

Update:

I forgot to mention my orthopedic doctor's prescription for PT told the PTs that he thought my injury was shoulder inpingement, though I like I said he suspects one of my biceps tendons.

Early last week, I "graduated" from the red Therabands to the green ones. My PT then had me try wall pushups, which I can do pain-free if I pay close attention to technique (keeping the neck and spine in line with one another, letting the load go into my lats and upper back instead of the shoulders). If my technique is off enough, I feel pain in the injured shoulder.

Today, the PT had me try a new band movement, for the left arm of course, in which I start with the left arm extended down towards my feet, with the hand making a fist with the thumb pointing to my left. I then raise my arm to my left side while keeping it straight and leading with the thumb so that the thumb should eventually point up. My pain-free ROM was limited in this exercise - I could not get my arm to 45 degrees.

Also today, the PT had me to 2 sets of 10 biceps curls with an 8lb dumbell. This is the first time he let me lift anything more than 2 lbs in our sessions. I asked him if I could use my EZ curl bar at home, which is 15lbs unloaded. He said I can go ahead and try it at home. If 2x10 is too easy, I'll try 4 sets of 5 instead, but with possible weight increases from set to set .

Feedback is welcome.

[PaoloValladolid]

I think the PT found an important clue about my shoulder condition. Raising my left arm straight to the left with the thumb pointing up is a problem for me. She tried electrically stimulating certain muscles in the shoulder area to assist, but my ROM only improved very slightly.