Stroke Survivor Blog

About three weeks after Steve’s stroke, he started experiencing much pain in his left shoulder. This was caused by it becoming dislocated, a condition also known as shoulder subluxation.

The shoulder joint is like a ball and socket held together by cartilage, muscles and tendons. Subluxation often occurs in the affected side of stroke survivors, because the weight of their limp (flaccid) arm pulls the shoulder out of joint. When the shoulder muscles can’t hold it in place, then the tendons stretch causing further dislocation.

Steve’s left arm weighs about 25 pounds, and all of that dangling weight is pulling the shoulder out of joint. When he stands from a sitting or lying position, his arm falls down resulting in more pain and more separation. What he needs is some type of sling to prevent that from happening, but not all slings are created equal.

His physical therapist found one designed by two therapists who work with a lot of stroke survivors. This sling is designed to reduce the subluxation by pushing the shoulder up into the socket, and thereby reducing pain and further shoulder separation. It will help while the arm is flaccid. Eventually the sling can be eliminated if the muscles are strengthened through therapy, and the tendons tighten up drawing the arm back into the shoulder socket.

Steve has one-sided weakness (hemiparesis) and although he can’t move his arm right now, he has sensation and tingling in it. So with repeated therapeutic exercises his arm can learn to respond, which would reduce the shoulder subluxation. Even passive exercise will help. By that I mean that someone moves his arm for him, and he tries to make those movements. Through repetition the brain can create new cells and pathways to trigger those muscles to move on their own.

That’s why consistent exercise is so important even if it’s years after a stroke. It takes many repetitions for the brain to “remember” how to do something. We all want that one big thing to happen, but with stroke recovery progress comes in small increments leading up to that big thing. It takes patience and perseverance.

The most important thing to remember is this:  Don’t give up no matter how many people tell you that you’ve reached your limit, or that you’ve plateaued. Many so-called professionals (therapists, doctors, etc.) say that after two years no more measurable progress can be made. That used to be what the medical society believed and taught. But now new evidence proves otherwise. If you have a will and desire to get better, and you are diligent to follow through with the exercises, you can continually improve many years after a stroke.