SHOULDER TREATMENT SPECIALTY
One of my many shoulder patients suggested that I put some special information on the website about shoulders. When she “found” me, she had given up on ever having a pain-free functional shoulder ever again after seeking doctor’s advice and previous therapies. She was so thrilled with her progress and success, that she most wants others not to give up hope and to keep searching for the right therapist who can really make a difference.
I love working with shoulders and probably have treated more of them than any other diagnosis in the past 10 years. Most did not have surgery, some even with complete “rotator cuff tears”. Two with complete tears regained full motion and strength and were able to resume all the activities they wanted to do and hadn’t been able to, including chopping wood, diving, swimming, and professional orchestral cello playing – without pain. They amazed the orthopedic surgeons that they had consulted with.
Below are some of my patients' stories:
My Shoulder Story
A Tale of Loss and Restoration
The accident occurred while I was at the sink preparing Easter dinner in 2009. When I started to walk to one side, I caught my foot on something, which caused me to stumble and begin to fall. Instinctively I reached out to catch myself with my right hand and jammed it against the counter with the full force of my body behind it. Ouch! Suddenly there was great pain in my upper arm, and when I stood up and tried to move it, I found that I could not do so!
Problems with this shoulder were not new, and perhaps my shoulder was already vulnerable to receiving a new injury. I'd been dealing with a strained bicep muscle that had become inflamed when I had carried something too heavy several months earlier. I had had some standard physical therapy for it, but the therapist had given me just some textbook exercises in a disinterested way, and it had not helped.
This time my injury was more painful and debilitating. It required making many adjustments in my life because I could now not move my right arm. And it required me to give up playing my beloved cello, because I could not move the bow back and forth with my right arm.
I clearly needed a physical therapist that was better than the one I had had, whose treatment had not helped. Fortunately someone had given me the name of Bonnie Masi, a physical therapist with a specialty in shoulder problems. Bonnie could see me right away, thankfully, and I began a healing journey with her that was to engage my life for nearly a year.
I felt improvement after just one session. Bonnie not only knew what was especially helpful for shoulder problems, but also she excelled in adapting her physical therapy and other healing methods to each individual's particular needs, customizing her treatment to each situation, rather than offering a standardized set of exercises and treatments, as my first physical therapist had done.
Over the weeks I started to improve noticeably, through a combination of the treatments she gave me at her office and the exercises she taught me to perform at home. I could use my arm more and more, my range of motion and my strength were increasing, and my discomfort was decreasing. However, while everything else was improving nicely, I still could not do the motion of the cello bow (moving my arm right and left in front of me) without extreme pain.
And not being able to play the cello had become a painful loss for me. I had been a very active musician with my cello, playing in the orchestra and other ensembles nearly every day. The adjustments in everyday living that my injured arm required because of its pain and immobility were challenging enough. But the loss from having to suspend all my musical activities with my cello was particularly sad and emotionally painful, especially since there was no guarantee that I would ever play the cello again.
By September 2009 it was time to get an MRI to learn what was going on with the two muscles that were not making any progress. The MRI revealed that indeed two muscles had torn off my rotator cuff, the very two muscles that I needed to move the cello bow.
I was referred to a surgeon to discuss a repair through surgery. He told me that the two muscles that had torn off from my rotator cuff were old and atrophied, so it would be impossible to re-attach them to the rotator cuff in order to make a repair. He pointed out that my other arm muscles had improved greatly and were working quite functionally, so I would be fine as long as I did not try to play the cello. He concluded by predicting that I would never play the cello again and suggesting I take up a different activity.
It was quite a blow to hear that a repair could not be done and that I would never play the cello again. I went for a second opinion. The second surgeon I consulted told me the same thing. The muscle was too old, atrophied, and withdrawn in order to make a repair. He, too, had the opinion that I would never be able to play the cello again and suggested I take up singing instead. He did suggest that I consult with a third surgeon, a shoulder specialist who had just moved to Seattle, who might have some suggestions.
The third surgeon shoulder specialist agreed that my torn muscle was too damaged and atrophied to repair by surgery. The only thing he could do, he stated, would be to replace my whole shoulder when the arthritis I was bound to develop became bad enough. But, unlike the other two surgeons, he did encourage me to work toward playing the cello again. He encouraged me to continue exercising my arm and to play the cello every day for a few minutes, working to increase the amount of time over the weeks. As he put it, 'You've damaged two of the muscles in your shoulder, but there are eleven others. Get them to work!'
This encouragement resonated strongly with Bonnie's faith that muscles could be restored through exercise. Surgery was not going to be an option, and the answer was going to have to be exercise and other alternative means. So I redoubled my efforts to continue with the physical therapy and arm exercises at home. And I began to try playing my cello for just a few minutes each day
Also, I decided to add some energy work to my healing program. I took some treatments with a practitioner who offered Reiki, a form of 'hands-on' energy healing. The increased flow of energy into my body helped to enhance the work of the physical therapy and exercise.
Progress on the cello was slow, but little by little I began to see signs of improvement. Over the next few months my ability to move the bow slowly increased. I could play the cello for longer periods of time, first five minutes, then ten, etc. Finally, it was a day of celebration when I could play it for a half hour at a time. At this point I returned to the orchestra, where I continued to build my strength by playing for half hour periods with rests in between. This was in March 2010, nearly a year after the accident that caused the injury.
During the months since then, my arm strength and ability to play the cello have increased steadily each month. By now I am practically back to normal again! I can play steadily during all my rehearsals and performances and just need tiny breaks to rest my arm once in a while. I am jubilant that I am back in the world of playing cello once again!
So this is my story, and I'm happy to share it. It demonstrates the power of the body to heal through methods that do not involve surgery, the power of exercise and energy work to help build muscle that compensates for a full rotator cuff tear, the power of the mind to hold to the goal of healing and restoration of function (in my case playing the cello again) despite the pessimism of individuals in the medical profession. And it demonstrates the effectiveness of a very special physical therapist, whose faith, wisdom, skill, and encouragement inspired the success of this journey!
With much gratitude,
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I found Bonnie while recovering from Shoulder Surgery in October 2010. According to my surgeon I had an 80% tear in my supra spinalis, with accompanying inflammation of the bursa in my shoulder. In real life what that translated to was over a year of not being able to sleep at night, because the pain was intense and woke me often, limited ability to participate in sports of any kind, particularly swimming, which has been an important part of my life, and the inability to engage with my children in just basic fun that required the use of my right arm. I gradually used my painful arm less and less to avoid the pain.
There was no "injury" that I can recall, it just became gradually more and more painful, so out of desperation, after chiropractors, physical therapists, massage, x-rays, MRIs, etc., I agreed to have it surgically repaired.
The rest of the story is retrospective, as now that I am finally beginning to see that I will be ok eventually; I question whether surgery was truly necessary. What I have learned was that it wasn't necessarily the tear that was the problem, but more, my year of guarding it, which in fact rendered my arm nearly useless. Not only was my arm nearly useless it was also excruciatingly painful. Because I have no tolerance to traditional pain medications, relief was nearly impossible, especially after the surgery.
Happily I found Bonnie, who got me onto a road away from Ibuprofen every 4 hours, and who believed steadfastly that I could experience full recovery. She believed this, mind you, not me. After 5 months of seeing Bonnie I have nearly 100% of my range of motion back and a firm belief that I am going to recover fully. This has not been an easy road, but I have followed her instructions and pushed through a lot of pain and self-doubt.
Without Bonnie's unequivocal confidence and knowledge of what my body needed and was capable of, I fear I would have abandoned my recovery long ago. Bonnie's level of awareness of the body mechanics around my injury was unequaled in all of the western medicine avenues I had turned to for relief, before finding her.
I am ever so grateful, every time I wake up in the morning and realize I slept through the night without waking up to pain, every time I hug my children with both arms.
Thank You Bonnie, SINCERELY!!
42 years old, mother of three, teacher parenting coach, swimmer.
"I was still suffering from a previous shoulder injury for almost two years when I finally came to Bonnie Masi for help. I couldn't figure out why I was continually re-injuring the shoulder after months of rest and recuperation. Not only did Bonnie help heal my shoulder, but identified that my poor posture was a main factor contributing to the continuing injury. Bonnie gave me an invaluable 'shove' towards better posture while she worked effectively with healing massage and ultrasound. During the sessions, Bonnie also provided self-massage tips and 'trigger points' to release tension that was contributing to my frequent headaches. Bonnie also coordinated her treatment with that of my chiropractor to speed the healing process. After only a few months of treatment I am free of pain, and armed with exercises to strengthen my shoulder and correct my posture further. I can't thank Bonnie enough!" - Mike Pollack