MS complicates everything, even recovering from shoulder surgery

Physical therapy can be a bit of trial and error with multiple sclerosis

Benjamin Hofmeister avatar

by Benjamin Hofmeister |

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I had surgery on my right shoulder last month. I didn’t write about it at the time because compared with a shoulder replacement, the quick arthroscopic clean-out procedure wasn’t a big deal.

The orthopedic surgeon removed some loose material from the joint area and cleaned it up without having to cut or repair anything. My arm was immobilized for about 24 hours, after which I was told I could do anything tolerable.

Unfortunately, my physical therapists received the same instructions, and their estimate of what I could stand was a little different from mine. I can tolerate quite a bit, but on one or two occasions, they might’ve made my eyes sweat a little.

Seriously, though, the therapy has been wonderful. While my shoulder was initially sore from the surgery, I’m no longer in pain from the loose material getting caught in the joint space. Any pain I have now is from stretching and moving a shoulder that’s had only minimal usage for a few years. I shouldn’t have put this off so long, but in my defense, I didn’t anticipate some of the consequences of having multiple sclerosis (MS).

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Working around MS

The initial damage to my shoulders happened years before my MS diagnosis. I knew for a while that eventually, I might have to do something about it. The mobility issues caused by MS started in my legs, though, so I focused on fixing and protecting my knees and ankles first while ignoring my upper limbs. As my mobility worsened, however, I found myself relying on my arms more and more, which aggravated the old injuries. Ignoring them was no longer possible.

MS symptoms definitely made shoulder surgery more complicated, and I’m fortunate that mine was only a minimally invasive procedure. I was worried about needing a lengthy rehabilitation process and having one of my primary means of locomotion out of commission for months. I still have plenty of rehab to do, and while it’s much better than it could’ve been, MS complicates that, too.

It’s hard to set rehabilitation goals when you have multiple sclerosis. The main obstacle my physical therapists and I face is learning to distinguish between what’s been caused by injury and what’s due to disuse from MS. That means we don’t know what’s possible, so setting realistic goals is difficult.

Another challenge is getting motivated. No matter what I do, my arm will still be impaired because of MS. I don’t have any lofty expectations about what function I’ll regain, but I’d really like to. This disease feels like an extra weight that counters the idea that anything’s possible.

Fortunately, my lack of motivation is usually temporary. My shoulder doesn’t hurt as it did before the surgery, and eliminating that pain is a victory for me. Any improvements in strength or range of motion, no matter how small, are bonuses. I don’t know what my goals should be at this point, but I do know that I’ll be more comfortable while trying to achieve them.

As luck would have it, I’m heading to rehab today. I hope no one’s using those 2-pound weights, because I’m trying to get buff.


Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to multiple sclerosis.

Comments

Lorna Humphreys avatar

Lorna Humphreys

That is a very timely blog for me as I can identify with what you wrote. I recently had a fall, fractured the top of my femur and was given half a hip replacement. It is so hard trying to work out what is post operative recovery and what is my MS (secondary progressive). I guess I just have to be patient and see how things progress.

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Benjamin Hofmeister avatar

Benjamin Hofmeister

Good luck on your recovery Lorna!

I wasn't blessed with the virtue of patience. When I say don't over do it, it's because I've heard those exact words from my physical therapists.

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Jan Greenberg avatar

Jan Greenberg

My PT has me using a 2 lb ball to
lift, stretch and punch forward.
I use my walker’s seat as a side table and store the ball under the seat.

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Benjamin Hofmeister avatar

Benjamin Hofmeister

I've thought of borrowing one of my kid's soccer balls for just that!

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Stephanie Billings avatar

Stephanie Billings

Ben, I too had my right shoulder repaired after I was diagnosed, mine was a torn labrum and rotator cuff. My rehab took 8 months instead of 6 and due to the MS affecting my right side, the shoulder is always inflamed and swollen. Unfortunately, for me during Covid, I wasn’t receiving my DMT, not my choice , the doctors office was closed, so I progressed some. Just enough to have more issues with my gait, and the inflammation of my right side. Sorry for the trouble you have with your shoulder now, but I can relate. This disease really does suck.

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Benjamin Hofmeister avatar

Benjamin Hofmeister

You had the surgery that I was afraid I'd have to have. I was terrified of a long recovery and was so lucky that mine was a quick clean out. One of the five particles the doctor took out was just over half an inch (1.8 cm) long. I won't miss my pearls at all. I hope your recovery goes well.

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Nancy Anne Starks avatar

Nancy Anne Starks

I currently am recovering from surgery that removed my entire female reproductive system due to having symptoms that were not normal. At the time of this post, I had it a little over six weeks ago and although the initial healing period has gone well, I wonder if my MS will complicate matters in returning to full recovery. They say that complete recovery will not occur until three months from the date of surgery. I am anxious to get back to my workouts to keep me moving despite my MS.

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Benjamin Hofmeister avatar

Benjamin Hofmeister

Wow Nancy! Just wow! I think we're slower to fully recover because we started at a deficit, no matter how severe our MS is. Don’t over do it We're going to heal just fine.

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Jacklynn Baker avatar

Jacklynn Baker

I’m with you. I also was diagnosed with PPMS in 2014. Had to get a left total hip replacement last December. Since I am a Physical Therapist, I did my own rehabilitation. It was rough since my MS affects my right side (leg worse than arm). I didn’t have a good leg to stand on. 🤬

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Benjamin Hofmeister avatar

Benjamin Hofmeister

You're a physical terrori....I mean therapist? Don't over do it. You're probably going to be harder on yourself than you would be on anyone else.

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Angela Stogner avatar

Angela Stogner

Your article is timely as usual. With my surgeon’s okay in a couple of weeks, I will begin physical therapy after complex hip surgery. After surgery I’ve not been able to bear weight on my operated leg and have been using a wheelchair or hopping with a walker for the last 3 months. I’ve been concerned about recovering muscle strength and aerobic capacity but even more so about regaining the MS-affected balance I had before surgery.. Your experience gives me hope that I may recover well.

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Benjamin Hofmeister avatar

Benjamin Hofmeister

Hi Angela! We will recover, but it takes us longer it seems. Rehab helps a ton as long as they understand where we're starting from because of MS.

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Karen Strube avatar

Karen Strube

Keep up the good work and stay positive. I am 1 month out of total knee replacement surgery, until I saw my neurologist last week I had put MS out of my mind during this recovery. I was frustrated with my rehab until she explained the impact MS has on surgery. I am kinder to myself now and am celebrating every achievement. My knee will get there it just takes time.

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Benjamin Hofmeister avatar

Benjamin Hofmeister

Thanks Karen! Ten years with this disease and sometimes it still feels like I barely know anything.

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