Stroke Survival ~ Subluxation

The topic today for the Tattler is subluxation. For me it was my shoulder and still is. I had a minor problem with this immediately after my stroke where my right shoulder which was paralyzed dipped below the unaffected side.

My arm weighs roughly seven pounds of dead weight. It threw my balance off when trying to walk. It also was pulling my shoulder out of the joint. The quick fix was a sling to hold the arm close to the body and take some of weight of the arm off the shoulder while standing. It helped on both counts. My balance was better and my shoulder was not bearing the full weight of the arm.

There are two schools of thought regarding sling use- use it and don't use it. I can see the reasons behind both of them. If a sling is used all of time it prevents the brain from relearning the proper alignment and posturing. It also limits or delays the recovery of use of that joint through range of motion. My point is it works well when limited in use for post stroke.

Now for part two of the story. Some of you may remember the hard fall I took right after I returned home. The one where I tore my AC joint tendon that took months to heal on its own because surgery wasn't an option.

This is another way to get shoulder subluxation. I had a definite dip and forward rotation of my shoulder because of it. I was put in a sling for pain control and to limit the motion of the shoulder. I was supposed to wear it constantly, but I didn't. I had regained full use of the shoulder by staying out of the sling as much as possible and moving the shoulder after my stroke, so I didn't want to lose that motion by making the arm inactive.

Not entirely smart on my part, but that was my reasoning. Yes, there was pain. Nine or ten out ten on the pain scale, but the old adage of 'use it or lose it' kept ringing in my ears. I didn't remove the sling until I was ready to work the arm and shoulder, and then it went right back into the sling. And yes, I did tell my orthopedist that I was doing it. His response was, "Don't go overboard. It's injured."

I'll admit it was rough going for months. It took three shots of steroids, extra PT, seven months, and a whole lot of pain pills to get through it, but I did it. Now with added PT on the shoulder and ten months later, it's almost back to where it was. The only thing holding me back is the spasticity in the upper arm from regaining 100% again. But that's another issue.

I'm on the fence on whether the best option is to sling or not sling a shoulder subluxation. I see the benefits and detriments having lived both. I guess it's ultimately up to you and your doctor on what the best course of action is. I'm just hard headed by nature and I'll kick a sleeping dog in the hinny. Sometimes it works, and sometimes I get bit.

Be proactive in your care. Research alternatives and be vocal about it or as best as you can be. Ask questions. Think about what is best for you and your goals. What works for me may not be the best option for you. Just as there are varying degrees and types of strokes, there are various tools that help us recover uniquely to the best of our abilities.

Nothing is impossible with determination.