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Shoulder Surgery: Prevention and Recovery tactics for wheelchair athletes

Sep 29, 2016 10:05:58 AM / by Işıl Tanyeri

If you are an active wheelchair user, you are probably aware of the risks of getting a shoulder injury and potentially a surgery. It is almost more common to have a shoulder surgery among athletes than not these days. Even pushing your chair on a regular day to get around puts pressure on your shoulders. If you add vigorous exercise where you try to push harder and faster, it adds a significant density on shoulders. You need to take good care of your shoulders and have a balanced work out method, in which you work not only your big muscles in your shoulder gridle, but also the smaller ones.

DK.jpgDave Kiley, photographed in his last NWBA Championship season in Louisville, KY

We reached out to Dave Kiley, the 11-time Paralympic athlete and 9-gold medalist, who told us everything we need to know about care, prevention, surgery and the recovery period for a shoulder surgery, by drawing many examples from his most recent one:

  • Do preventative exercises to strengthen your shoulder muscles: Back up in your wheelchair and do light weights (2-3 lbs). As chair users, we push forward all the time and the big muscles of the shoulder get bigger, while the small muscles of the shoulder tend to get ignored and soon become out of balance. A common results can be dislocation or tears. I am the first one I know to tear all three mentioned at one time.
  • Set aside a good amount of preparation time leading up to the surgery: I did everything to prevent getting injured on my shoulders. All it took was a fishing tournament and an air born bass boat with a death grip on the wheel for me to tear my shoulder apart. Rotator Cuff, Labrum, and Bicep Tendon all in an instant destroyed. 

Image Source: Hospital for Special Surgery-www.hss.edu

 It’s a big surgery and you need to not only be mentally prepared for it, but also physically and practically. For DK it took nearly a month to get everything scheduled and insurance aligned. "Surgeons are used to doing this deal and sending the walking patient home the same day. Well, in my case and others in a wheelchair it is much more complicated. We arranged it so I would stay in acute care for 3 to 4 days, so I would qualify for care in a nursing home rehab type place with my Medicare Insurance.”

  • Staying Positive post-surgery: Shoulder surgeries are big operations and the ramifications may last for a long time. Trying to stay strong and positive is crucial to your healing process. Do not try to think about the amount of time it will take to recover as it could get frustrating. “After the surgery, I would still hear a little voice that said, ‘You are DK’ Have no fear!’ Most of the times in my life, I feel like King Kong!! But, not this time. Being told that at 6 months I would be 75% and a year to 100% was daunting. The length of time to get back to ‘normal’ and to work my butt off to get out of the assisted care facility I found myself in was very frustrating” Dave Kiley shared.

    dk_corner-_shoulder_surgery.jpg                                                                                                 Dave Kiley photographed soon after his surgery 

  • Adjusting to a new life style post-surgery and relearning daily skills: What is potentially more difficult in some cases is adapting to a different lifestyle in which you have to be less independent and more patient with yourself and with others. Dave Kiley was discharged to a nursing home, which he found far more challenging to adapt to than he had imagined. “Those initial days were really tough from a pain stand point, but as far as challenge goes, little did I know how tough being in a nursing home would be. I knew it had to be done because even the simplest transfer was no longer possible until I healed. I had to learn how to do my activities of daily living again” he shares.

Dave Kiley continues: “On my first night of moving from acute care and the posh care of the staff to a nursing home with horrible smells, sounds, and food and staff that were over worked and came to your call when they could. I had so much fear. I felt like a teenager in terms of age in this place. I met my roommate and at the Ritz or acute care hospital I had a private room! That first night he had the heater going full blast and then he had a bowel blow up in the middle of the night, OMG!!! I covered my head and wanted to cry. I could not run and hide from this, I was stuck. I prayed for strength. It’s hard to do anything with one arm but being in a wheelchair is no joke. I pulled and pushed one handed through the halls of the center as the old folks watched and cheered me on.”

  • Keep trying to do things on your own and never give up: We all eventually get accustomed to the new lifestyle, whether we like it or not.  You have to continue to work hard to do things on your own and be independent: “In a couple days I forced myself to dress myself one armed. Not an easy deal putting on shoes and socks with one hand. I was willing to do anything I could to shorten my stay” said DK.
  • Surround yourself with a good support system: Let your loved ones care for you and support you during this time. Their positive energy and love will give you tremendous strength. DK thanks his wife and the hospital staff for taking care of him.My wife visited me every day and brought me food as I would not eat much at all from the hospital menu. Sandy got me through a lot in the joint lol. She helped the staff while also learning techniques for my discharge to home. I longed for home but also wondered how it would go with one arm and lower leg paralysis. The therapy staff was awesome in teaching me and making me aware of what equipment might help my situation in home. I had an awesome home health therapist from Bayada come to my house and do strengthening exercises and range of motion stretching, three times a week and this really helped me progress. Sonia, the ‘lil general’ was key with keeping me real and improving” DK said.

  • Find the right equipment that makes it easier for you: After surgery, you are going back to learning a lot of basics, which might remind you of the earlier years of your SCI. “Using a sliding board and being safer I needed a landing pad to get where I needed to be?? I became a ninja with the sliding board I had to have always have laser focus on technique. One wrong move and I would need to have it done all over again and that was not going to happen! So each and every transfer I was fearful of a fall or mishap that would cause it to be redone. Never let it happen though.”

    dk_corner-_shoulder_surgery-commode.jpgLike the need for one of these. Using a sliding board and being safer I needed a landing pad to get where I needed to be?? Dude this was so needed and foreign to all I had been previously.

    dk_corner-shoulder_surgery2.jpg                                                                                      Strap hung from the ceiling can help you sit up and reposition yourself

“I also had a strap hung from my ceiling over my bed to assist me to come to sit and reposition myself, installed by my favorite handy man, Dwight. It really helped.”

Sonia my therapist came up with this beach ball exercise with thera-band attached to my arm where I had to bounce ball over my head up against the wall. I thought at first it was silly but was crazy hard. Shout out to you Sonia and Bayada! 

  • Accept that it will take time but don’t forget to recognize the progress you have made: About four months after his surgery, DK saw the improvement he had made. He started working out at his local YMCA soon after he got home, working his right side on the arm bike or ergometer with one arm.

Lessons Learned from Having a Shoulder Surgery 

Be Grateful for the Progress you are making, even it is tiny steps 
"When people would give me a ride and only if they had a car or a van I could get in to. I have amazing friends that got me out of the house which really helped even if it was just once a day. Not driving is really hard thing to not do for 3 months. I have been driving my wife’s Honda Crosstour for last three weeks and I thought my F150 was only a few weeks away until I went and saw my doctor for my 3 month appointment and he dropped the bomb and told me he did not want me pulling myself up into my truck for another three months.  I was not happy but accept that for at least 2 months I can handle lol. I will not let my shoulder get reinjured from rushing it. I was given the clearance to fish !! I got on my boat yesterday and by days end was a 67 degree day on Lake Norman with my fishing buddy, Rich, who helped me get on board. It felt great to drive the boat and navigate it from the front seat with my remote control Minn Kota trolling motor. Wind in my face as we traveled the lake in search of some bass which were elusive all afternoon. 

dk_corner-_boat.jpgDK back on his boat in the lake 

 I am so grateful to be on this side of recovery. I can push myself and drive a car and put my chair in it. I am working out with both arms and feel half way ‘normal’. I have taken back all equipment and my old faithful sliding board and donated itto the nursing home where I got really good care. I feel fortunate that I can see the light on the other side and feel my strength and healing is about 40%.

I want to thank Rick Slaughter, Brad and Wendy Parks and Candace Cable for their invaluable coaching of my fear leading up to and into recovery. To Kim, LJ’s mom for being my YMCA taxi using her son’s van with a lift. My wife gets the biggest thank you for the support she has always given me. Thanks Sandy!

Accept the circumstances and Be Patient 

I have learned for the first time I can not out work this situation. My normal routine is to throw a ton of work at a setback or injury like this but in this case I have to be patient and accept being impatient as I wait to be at full strength. 

Take Extra Good Care of Your Shoulders and Do Not Get Reinjured 

If you learn anything from this blog it’s to take care of your shoulders because this surgery does not play. It is a challenge beyond my wildest imagination.

Do you have tips and tactics to recover from a shoulder surgery or how to prevent it? We'd love to hear from you! 

Are you dreaming of becoming a Paralympic Athlete someday? 
Download free guide to learn the basics from the legendary paralympic athlete, Dave Kiley. 

Topics: adaptive sports, shoulder injury, shoulder surgery recovery

Işıl Tanyeri

Written by Işıl Tanyeri

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