Shoulder to the Wheel

By late March, I was really starting to feel good about how easy walking was starting to feel again. I was going all over the city for shopping, social gatherings, workouts, and dining out. Not only was I no longer afraid of falling, I no longer was coming home exhausted, either. I was well on my way to being done with using a cane by the end of the year. I would still be doing a lot of leg exercises for the rest of my life, but hitting that milestone would allow me to relax some.

Now I needed to focus even more on my shoulder. Although I had regained a significant amount of mobility in the joint, and the independent living staff were stretching it every morning, there was still a great deal of pain when it was stretched too far. I wondered how much of a barrier this might be to regaining even more use of the shoulder. From early experience I knew that exercise would be the best way to alleviate the pain. The irritability was from lack of use, so passive movement could only help so much. But which exercises to do?

When I was an inpatient, the therapists had used an e-stim hand bike to get the joint moving. But in the gym, I was on my own when it came to finding ways to target the muscle group. The point on my body that seemed to be the source of most of the lingering pain was the top of my left deltoid. While I regularly engaged in exercises like pulldowns and lat rows to stretch out my arm and shoulder, these were also more passive movements. I don’t wish to downplay how much they helped with the problem. But these exercises were designed for the back. I needed something that would build shoulder muscle.

I had recently begun performing shoulder presses on a Smith machine. This exercise involved grasping a bar behind my head and lifting as high as I could. I was barely able to raise the bar above my head. My shoulder and arm were so tight that they just wouldn’t allow me to fully extend on my left side. Nonetheless, whatever amount of movement I could force was important for my shoulder. In fact, if I just sat there with the bar laid across my back, it would help with the constriction in my shoulder and wrist. So just pausing in starting position for a few minutes between sets became part of my routine.

I was still on a quest to find an exercise that would strengthen my shoulder. Then it occurred to me that the best movement at this point of my recovery would be some form of shoulder raises. In the past, I had worked out in clubs that had machines that could isolate the muscle group. This seemed ideal, given the limited mobility in my left arm. Since I didn’t know of any such machines at either of my current gyms, I would have to accomplish this with dumbbells.

The next time I went to the gym, I went through my normal gauntlet of upper body exercises. When it came time for shoulder raises, I selected a pair of 5-lb dumbbells. Starting with them atop my thighs, I brought them up and to my side, mimicking flapping wings. I couldn’t bring my left elbow to my ears. My left wrist drooped; I couldn’t even maintain a tight grip. Somehow I willed myself through fifteen reps. I wanted to try using more weights during my next two sets, but I knew that I shouldn’t risk form or safety. Doing moderate exercise had been what had gotten my body to this point over the last few years. Regaining use in my elbow should be no different.

With all of the time I was putting in at the gym, my body was recovering its ability to do many of its daily tasks so quickly that it was hard to keep track. There had been many things that I either couldn’t perform after the stroke or had to find new ways of doing. For instance, before the stroke, like most people, I had been used to taking a shower every morning. After I lost such significant use of the left side of my body, this became a drawn-out and tiresome task

I would lay out my socks, underwear, and pants on the bed. Then I would strip down and hobble to the tub. Next I would maneuver myself onto a shower bench or stand upright in a shower. When I was standing, it was because I was in a shower that couldn’t accommodate a bench. When I was using one that couldn’t, I would lean against the wall, making sure that I didn’t move so much that I would lose balance and fall. During these showers, I felt so restricted that I never did enough to fully get clean. But standing was so exhausting that I would finish the shower feeling drained. I would drag myself back to the bedroom and take thirty minutes to dress.

I had a little relief when I used the shower bench. Sitting didn’t take as much energy, nor did it require much effort to balance. So I was able to wash myself until I felt thoroughly clean. These showers felt wonderful. But I was usually living in a house or a facility with other people, so I had to wait until there was someone to help me cover up and to walk alongside me. So even though I had a shower chair, I would only shower about two times a week.

After I moved into my own apartment, not only could I keep my shower bench in place permanently, I no longer had privacy concerns either. The shower was designed for wheelchair access, so there was no need to sit down on the bench and swing my legs over the wall of a tub. I could simply walk in and out. At first I only felt like showering every other day. But as time wore on and I built more leg strength at the gym, I began standing for longer intervals. Then, sometime in March, I realized that I was showering every day. There was no fanfare or eureka moment. I just noticed that I was using my last dry towel every week on laundry day.

One day I was getting dressed after a shower. When it came time to put on my shirt, I wondered whether I should try putting it on over my head first. When I had been inpatient in 2015, I had been unable to move my left arm at all. As consequence, I wasn’t able to put on a shirt the normal way. Instead of putting my head through first, then sticking my arms through the sleeves, my occupational therapist taught me to put my left arm through the sleeve first, then the right arm, then I could pull the shirt over my head. It would often take me several tries to get the shirt all the way up my left shoulder, and it usually took me about ten minutes to get the shirt all the way over my head.

Now, with the additional stretching my shoulder was getting every morning and the fact that I had been using my left arm to lift weights, something told me that I just might have the mobility to get the shirt on the way I used to. So I pulled it over my head. Then I rotated it around my neck until I could see the writing on it. Now I found the left sleeve, and punched my left fit upward till it was through. The right arm went through without any effort. Just like that, I was able to start putting my shirt on like I always had. Now I have options.

I was no regularly taking Mary outside three or four times per day. Picking up after her had been an easy job when I could scoop up the surrounding snow with her droppings. But now that the snow was melting, it was becoming more difficult to get everything in one scoop. Sometimes I would have to drag the bag over the spot, and some would fall out of the bag as I tried to get more from off the ground. I could squat as long as it took me to complete this task, but it was annoying.

It occurred to me that I could just use disposable gloves. That way, I could just handle the feces quickly without getting any on me. But I couldn’t put on regular gloves. I could use my right hand to pull a glove over my left hand initially, but I couldn’t move my fingers enough to get them into the finger holes of the glove. I could move the fingers of my right hand easily, but my left hand lacked the dexterity to pull the glove over my right hand. I felt like plastic gloves, which would be far less rigid, were completely out of the question.

Then one day I decided to just try putting a plastic glove on my right hand. I loosely held it with my left hand, then pushed my right hand halfway down inside it. Then I wiggled my fingers by feel into the finger holes. Only the two smallest fingers didn’t find their finger holes. So I pulled the fingers of the glove as best I could with my left thumb and forefinger and forced my fingers along the back of a chair to get them in farther. This still was not enough, so I used my teeth to try to pull the glove all the way down over my palm. It got most of the way down before my teeth sank through.

This was the method I used over the next few days. I learned to bite the glove a little more gently to guide it over more of my hand without tearing it. I succeeded in not ripping it after a few tries, but I never got it all the way over my hand. This really didn’t matter because the glove covered the part that might come into contact with dog poo, so at least picking up after Mary would be simple.

I was now doing so many regular exercises that it was becoming easy to neglect some body parts in a given week. One of the things I had to remind myself to work on was my hip flexors, the muscles that I would need to strengthen if I wanted to step up higher. Neither of my gyms had machines dedicated to this body part, and I didn’t have exercises that the staff could help me with. So I was on my own to find a way to work this muscle group.

Then I remembered what they taught me in physical therapy. I could lie on a raised surface and lift my leg toward the ceiling, a simple exercise that just needed to be done on a consistent basis. To avoid neglecting this step, I added it to my morning routine as the item scheduled just after my morning shower. I also added it in any time I was idly doing something like sitting on the couch, petting Mary before leaving for the gym.

Although I had initially been discouraged at how little I could lift my leg, my strength developed quickly. In two weeks, stepping up with my left leg no longer needed a lot of planning. When I got to low curbs or steps, I now stepped up with my left foot with my right foot firmly planted. This felt like a safer option, so I was happy to have it at my disposal.

The treadmill was a different beast. It sat higher up and required me to step higher. It took me another week of intense leg raises, but I mastered it next. I barely got my foot over it at first. But I didn’t let the difficulty keep me from boarding it that morning and every day since. It has simply become one more routine exercise on the road to getting stronger.

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