Community Member SpotLight: Rotator Cuff Injury Solutions

Real quick, before we dive into this episode, I have a little sleep secret I want to tell you about. Look, sleep is crucial for your fitness, but it's crucial for just plain old everyday life and function. And I find I sleep great unless I have a migraine. And I've had more than my fair share since perimenopause all the way through postmenopause. My secret weapon was Blue Sky CBD sleep gels. Each gel contains 25mg of CBD and 25mg CBN for deep restorative sleep. Something about it helps to reduce inflammation, which I believe for me was key in helping me get to sleep. But the biggest thing is so many of the over-the-counter solutions, whether for sleep or migraines, can ruin gut health, and liver health. Neither one of those did I want to be problematic for me. So this option is recommended by healthcare providers worldwide and backed by thousands of happy customers, many of whom come from our Flipping 50 community. There is zero THC, so it's non-habit-forming. It's made by a trusted family-owned company that we all can feel good about. Third-party tested for purity and potency. And if you're interested, you too can try a sample for just $6. But even better, you can get 30% off forever with discount code FLIPPING50. That's FLIPPING50. Just go to flipping50.com/blueskycbd. We'll put that link in the show notes and you'll find it everywhere on Flipping 50 at My Favorites. What are you waiting for? Good night. My guest today is one of our community members. Sue is here, and I'm just gonna use her first name. And I asked— every once in a while someone comes up with a comment not really telling their story and certainly not being boastful in our community, but I identify that as something that I feel you you, listener, would identify with, that more women really need to hear. And I think from Sue's standpoint, this is, this is not that we've told other people's weight loss stories. This is not that, but this is about rotator cuff injuries. And so if you've got a knee thing, an ankle thing, a hip thing, or you too have a shoulder thing, I think what you'll get here is a little hope for what happened. How did you respond and react? What did you fear? Because I think for many of us, we fear this is it and it's downhill from here on out. So we'll talk a little bit about how she sustained her injury, what she did, what were her symptoms, what she's doing to recover, how she's doing now, and talk a little bit about the timeline. Because inevitably this may happen, not necessarily a shoulder rotator cuff, but it's always my pleasure to highlight us a member. So if you, by the way, are in one of our programs or you are one of our VIP Flipping 50 members, we love to hear from you and we love to tell your story. So we're going to dive into this episode, but first, I'm Debra Atkinson. You're listening to Flipping 50, where I address your top struggles and concerns and I share what to eat, how move and how to change your mindset so that you can have the energy and vitality that you want, need, and deserve in this second and better half. And in this episode, you're going to learn exactly how to get started even with an injury. Sue, thank you so much for being here. And first of all, I should— didn't tell you this in the green room, but everybody knows that I'm a sucker for an accent. So you had me at hello. Thanks again for being here.

Oh, thank you. Oh gee, my accent is very, very much mixed up these days. I'm originally from the north of England, but have spent the last 40 years in Australia. And my accent from where I originally hailed from had to change so I could be understood.

Interesting. But now it's lovely. It's just very lovely. I absolutely am loving it. So just to give everyone a background of really why you're here and the basis for our discussion. So Sue came up with a question in our members area, and I invited her to come on so that we could actually talk about it and unpack it, because the answers that I could provide her were limited when it's just back, you know, to one person. It's not actually a volleying conversation. So number one, I wanted to be more helpful than I felt I could. So hopefully that will be the outcome of this. And, um, I also think that every listener out there potentially gets into this situation. We all have an injury here or there, and I think that's just a fact of life that doesn't necessarily have anything to do with whether you're exercising or not exercising. In either way, we can find we get ourselves into trouble from overuse that we unintentionally might be doing or simply a fluke movement with a body that is no longer 6 months old and, you know, flexible as we thought we once were. So Sue, tell us a little bit about where this all started and, you know, what the concern is or was depending on status right now.

Right. Well, I was recovering from COVID and I hadn't exercised for just under 4 weeks and really felt quite weak. And I'd picked up a couple of weights and thought, no, no, need to lighten the load. And so I did that. I did take note of that and went through a workout. And then the next day I was thinking, no, I'm— it wasn't that I had done too much in the workout, but I was aware that I wasn't as strong as I had been. So anyway, it was a day or two later and I went to take my top off the way that ladies do, crossing your arms in front of you to lift it up, and I couldn't do it. And the pain in my left shoulder was instant. And I found that I had to totally, very, very carefully remove my clothing and I thought, no, sounds like I've done something. Quick trip to the docs. So I went to see the doctor who gave me a referral, and so I saw this specialist who did some dry needling, and then I was sent for an ultrasound. It was a usual thing that you're sort of immediately then bouncing between trying to establish exactly what it was and what you've done and also being told nothing until you know. So I have torn two tendons in the rotator cuff. And what was interesting was that they said that they were quite old injuries. So I was surprised because they asked me if I'd been in a car accident, had I had a really bad fall, and of course I hadn't. I had no memory of any of these things. Really, really was quite surprised that they could be so old, but it was only now that I knew about them. But I think that what had also happened had been that I had been helping a girlfriend with doing some painting, and when they did an ultrasound, they found that there was bursitis there too. So I had a steroid injection to help reduce the inflammation. And I'm still on this no exercise at all. I've had dry needling done and I go back next week again to see this osteopath guy that I've been to see about all of this. And I'm hoping then that he might be able to give me a little bit more advice about exactly what I can and can't do I did try discussing it with him, but again, it was just no, rest. So yeah, there we are. It was the supraspinatus and the subscapularis that I've got the tears in, and there is still quite some difficulty in moving my arm across the front of my body and a little bit of crackling. Okay, yeah, so there we are.

Yeah, that is helpful. However, that— so for all listeners, the rotator cuff is a family of 4, and so supraspinatus and subscapularis, that tells us a little something about the movements that number 1 probably cause pain, but also number 2 is what can we do to strengthen it. And again Typically you've got to get past the, the point of, you know, tearing and inflammation, because then what, what healing can happen can occur. And while there's lots of inflammation there, that's probably why they really wanted you to rest it, to not continue to cause inflammation or to slow down the movement of that inflammation out and the calming down. So that they can get a better idea of now what's your range of motion, where's your strength and weakness within that muscle, so they can give a better potentially a prognosis. My guess is when you were in the first time, did they do any movement screen? Have you move your arm this way or that way or attempt to or push?

Yes, he tried to get me to, um, to push against his arm and there was virtually no movement at all. He said, "Yeah, you've got no strength there." And I was really surprised because I've always considered that I am very strong. And so that was quite confronting actually. It made me feel like the little old lady that I look like.

If he were to ask you to do that same test again this week or next, which I suppose he will, Do you think you're doing better?

No, I must be honest, I don't. I still feel that— I guess because all I have had done is the dry needling and the taking the inflammatories and resting it, I still feel difficulty crossing my arms in front of my body and that that does concern me.

So, okay, okay.

Yeah, yeah. I think too, because normally I would be doing yoga, I would be doing swimming. It's that right time of year here. And, you know, the only way really that I can get in the pool is if I use a kickboard, which is fine, but I just wanted to get in and do some, some proper swimming. But, you know, I've been told no. Really, no, arms above head, no.

Yeah, and would that include holding on to that kickboard?

I guess not. If I've got it sort of just held across my front, I would imagine that that would be okay. It's just me wanting to do things that I've been told not to do.

Well, and yet I think that would be really good if you did, if you can get in and you have no pain whatsoever doing that, holding on to the board, that would be a really good thing for you because you're going to involve your core, you're going to work on that lower body strength.

Yeah.

And if you have the choice and you have access to a pool, given now that I know you have a pool you can get to for swimming if you wanted to, access to a pool where you could get in depth from nipple to navel.

Yep.

And do water walking.

Yep.

Yeah, that would also be good for you. Yeah, so walking forward, walking backward, sidestepping back and forth, you know, and then just mixing that up. So rather than just going for a walk outside, doing that in the water— water has a property that allows 12 times the resistance of any movement that you do in the air. So even the just walking back and forth is not really a just walking, it's, it's great resistance activity. And of course we're not talking strength training, I, I realize, but, um, would be very helpful for getting you back into it so that we could do a little bit more soon, hopefully.

Excellent. Oh, that's great.

And then hopefully your first step after seeing your orthopedic expert will be some kind of physical therapy. Yes, that there will be a referral. That would be my hope for you. So yes, yes, generally, yeah, I shall ask external rotation. Yeah, internal rotation. Um, generally they're going to give you, based on those two muscles specifically, they're going to give you some actions to be doing and probably continue to suggest very often with anyone who's had a rotator cuff issue, you know, it— they'll, they'll be saying no overhead lifting, but swimming may be different, right? Because of the— what you're doing is pulling things down to your body. It's not that you're pushing a weight away from your body, right? So it may take some time because there is so much shoulder movement there. But you ideally will be able to come back to it, given especially for you if it's a skill that you have and enjoy.

Yeah, thank you. Yeah, it certainly is. That's, uh, it's a good place to be, the water, isn't it?

Yeah, yeah.

Now I have a, I have a question too for you that, um, when I had reached out to the group and had said about my injury, and you had done a quick little list of suggested things to follow, and you had mentioned blood pressure constriction cuffs.

Yes.

Something I am not at all familiar with, and I was waiting to speak to you today before going out and buying some because I thought, well, I'll find out from you exactly what the benefits are and how I should be using them, please.

Yes, and there is more. So we'll link to in the show notes to some of the prior podcasts that I've done. There is a, a company called Kaatsu, K-A-A-T-S-U. They make actually one that is electronic, and there are others on the market, various places where they're not electronic. It's simply more like a 2.5 or 3 inch. And as a smaller woman, a smaller female, you want a 2.5 inch if you're putting it on your arm, otherwise it's taking up too much space, right? Um, that are just like a Velcro belt essentially. So you're just putting it around you and then tightening it up so that you can keep it as snug as possible. But you can either— they are used either at the upper arm, kind of right in the bicep and the, the appendage where your arm meets your, your torso.

Yes.

And then at the lower body on your thighs, very similarly, it's like just below, you know, where your leg meets your hip or your torso. So you're putting these on and you're tightening them up to a barely bearable— I mean, it's very tight. You want to know This is restricting.

Yes.

Okay, hence the name. Yeah. And what we're doing, the physiology behind it, is we're actually restricting blood flow back to the heart. And the cause of that, or the result of that, is we're tricking the body into believing that it's exercising, because this is essentially what happens when we do anaerobic work when we're, you know, doing strength training. And, and you— they can— these can also be worn when you're walking. Um, a lot less comfortable to do that than, um, you know, walk without it for sure. But it— if you are limited in the amount of time that you can spend, maybe because of energy or just simply because of being busy, people are thinking, well, I might wear it because of that, or for the extremely aged, you know, who are very, you know, inactive and somewhat unstable. But there is— I think we can all picture, you know, someone who's more frail and really legitimately has lost, you know, a significant amount of muscle. You know, we want to do every possible thing and make every activity count as much as possible without creating any injurious situation. Like heavy loading would. So what we're doing is tricking the body into thinking it's either lifting heavier than it is. If we're able to lift with more than say body weight, it might still be a very lightweight. And if you are starting, say lifting with bands or tubing, you know, or very, very light 1 or 2-pound weights, which you certainly might in the situation that you're in, once you're ready, you could potentially wear blood flow restriction bands while you're doing that to not stress anymore. So you're not actually stressing the tissues, the damaged tissue, anymore because there's no extra load on it. It's just your cardiovascular system is getting the message that you're lifting more than you are. So the response is really in the cardiovascular system. It's not in— but that as a result has a result on the muscle. All right, so it's been proven to help preserve muscle loss for those who are immobile. So in terms of— I'm talking exercise right now, but you could also use it periodically if you are someone who is at bed rest. For instance, you know, had you had these in your closet and, and while you were ill with COVID or you were up, say someone with a knee replacement or bunion surgery where you're not going to be weight training and weight-bearing on that leg for quite some time, but you might wear for a period of the day the blood flow restriction bands. And you do have a— wear them for 20 minutes and then you want to loosen them and let the blood flow freely flow. And you can do that periodically throughout the day, but you don't put them on and leave them on and forget it. We do at some point want on blood flow.

Yes, like see how long you can hold your breath, right?

Right. So yes, but there is scientific literature to show that this has been proven for people in bed rest or who are immobile for one reason or another, that it can help preserve muscle losses that otherwise would happen. Now, it might be that it simply reduces the muscle loss you have from activity, but as long as it does that significantly, that too is worthwhile, you know, or it might prevent, you know, um, any loss from happening. Or if you are able to do isometric exercise, which is another option, so not necessarily doing anything with that arm but maybe tensing, you know, squeezing from your, you know, palm to your shoulder, and, and consciously focus is— can be a part of recruiting muscle fibers to create some tension. So that's been shown to be one of the greatest values for it. But there are also athletes that will use them. You know, we need to cycle through periods of time when we are healthy and we're lifting, periods where we're, we're having a recovery week and we're lifting lightly. And there are people who really struggle with those recovery weeks mentally because they're used to driving harder and thinking it should be hard. And This is one way to kind of get over that, still have the benefit of less damage to joints and ligaments, giving them the recovery that they need, but yet still signaling the muscle that we are lifting hard. And so progress can still be made. Not that, um, anybody should negate recovery and think you are, you are still making progress. You're making long-term progress possible and injury risk go down when you're recovering. So my conversations were both with the, the owner and kind of the product developer from Katsu, but also I spoke earlier, and this was probably back in 2019, it might have been, with Dr. Joe Mercola, who at least in the States is somewhat infamous for being kind of a, a leader in the health field and disruptor and maybe a a health journalist, if you will, physician. And he is himself probably, uh, somewhere at 60s, maybe late 60s. And he said, I really think this is going to be, you know, a, a huge part of solution for supporting people with frailty, sarcopenia, significant muscle losses, and/or beginning to prevent them, because we're seeing people be able to wear them and not move, wear them, maybe do isometric exercises, or wear them and do lighter exercises than we may otherwise want or wish that they could and still make progress.

Okay, and presumably using the bands as well would be something with this too, wouldn't it? You're saying about the isometric exercises, of course, yes.

Yes, and you're so—

sorry, I'm just thinking aloud.

Yeah, no, and by the band you mean like the bands or tubing? Yes, is that what you're— yes, yes, yes, yep, you could use it with that. Yep. And so if you're given some exercises from physical therapy to begin doing with those, you know, I, I would suggest try them without first, as you probably will. You'll go through it with the physical therapist and here's how that feels without You know, and when you do get them, the biggest challenge for any female listener is most likely finding a set that is built for women. So the width for our arms, certainly, and if you are a more petite woman, you actually want narrow ones for your legs as well. So you might want to buy two pair of arms, you know, and yeah, and so that they're 2.5 inches or 2 if you can find them. I've not been able to find any, but you certainly do You don't want 3-inch wide because that's just taking up too much surface area for a smaller body.

Right. Okay. Thank you. That definitely answers that one.

You are welcome. And the other thing, Sue, and to anybody who's got an injury and you're feeling very limited, I will say that I empathize, first of all, because I want to say this out loud. And that is that it takes a lot of energy if you're dealing with an injury. And yet you do want to like mentally go over a physical scan of your body and see if there any place I'm holding tension here because I am compensating, I am favoring that side, and I may be overcompensating with another side. And be aware of that because I think that can be as more injurious as you're recovering than can the injury itself. Sometimes an injury can end up being a strength because we do the recovery and the physical therapy so well that you're actually strengthening it to the point where you're very careful, your form is really excellent. But what we've missed is we carry a load more on one side for such a long time that the hips or the lower back are out of alignment. So while you can not do a lot, continuing to move by the walking outdoors, the water walking, or focusing still on doing core work, you know, even if that is more isometric in nature, smaller movements in nature, trying to keep ahead of the core and keep yourself in alignment there so that when you are ready to start, you're, you're already in good alignment left to right up your kinetic chain.

And of course, you talking about that does bring me to something that surprised me, which was he massaged my back last time that I was there, and he week, he did comment on how much tension I was carrying across both shoulders. And not something that I'm normally aware of. I thought he was going to have to peel me off the ceiling by the time he'd finished. It was so painful.

Oh my goodness.

And he did make sure to tell me he hadn't actually gone full bore. And I don't believe him. But it was— It was extremely uncomfortable and that did make me think about what I'm doing there to compensate for this tightness because I've obviously let it transfer somewhere else. And of course, under normal circumstances, I would be doing yoga and he said, "Don't you go doing those downward dog thingies that you yoga people do." So, okay, you're not a yoga fan, but I suppose I can do the stretching, can't I? And just make sure that I limit the upper part of the body.

Yeah, and you will— just for anyone, so during the pandemic, we did a lot of free yoga and made it available to the public because, well, to start, I didn't know it was going to last 3 years. So I know I was doing yoga every day, what I was getting myself in for. So after a few months, I got a little wiser about, I, you know, I can't quite do this every day. But at Flipping 50, Flipping 50 TV, that's our Facebook page. If you go into media into the videos. We did a lot of yoga, and some of them we would have requests from people who could not bear weight on their shoulders. They were having shoulder issues or elbow or wrist issues. So we do have some in there, and you may have to find them and maybe mark them somehow in your computer so you can get back to them. But there are some like non-upper weight bearing where we're just standing and going into transitions, stepping back and into it, as opposed to coming through up and downward facing dog. And, and I'm sure you can, you can do a search on YouTube and find a number of those as well. So that, that will help in helping you keep your mobility. And, and I would also say some optimism. Right? So an injury can do a number on you, especially if part of your identity is being a very active person. And, and I think for many of us it is. But that can help you get a piece of it back and help you think, you know, I'm building up my strength and keeping my mobility so that I, when I get that yes, you know, I am ready to go back into more.

I think that you actually nailed that that when you said about the optimism because I think as you get older and you have an injury and when you're already struggling with the changes that are occurring in your body as you get older anyway and you are aware that you are not as strong as say a decade earlier, to then be confronted with hearing words like arthritis and you know sort of limiting And also the fact that they will say, well, as you get older, this. And I just hate the way that sentences are preempted with that. As you get older, this. And so optimism, you are so right, because I did come out of the surgery after being told, well, you know, you've got arthritis there, and you feel like throwing your hands up in the air, except of course I can only throw one of them up, and then say, "Well, you know, what do I do? Do you keep on trying?" Which of course I know that we need to, and you've made me feel so much better about that, so thank you for that. Get back to being optimistic.

You are welcome, and thank you for bringing that in. And you know, I hadn't thought about that, but that is so true. There's another phrase— we could probably stay here all day doing this— that quite often a woman will get complimented and, and someone will have found out how old she is, what her age is, and say, you look so great for your age. It's just like, you could have stopped a little sooner. Just didn't need that second part.

Oh, absolutely.

I have a friend who has 3 kids. She used to hear about that? You, you look so great for having 3 kids. And she's like, you know, somehow it lost its muster.

Oh, I feel her pain. I really do, because it is— it's just not right, is it?

Right.

Nobody says that to my husband. You look great for 3 kids.

Oh, that's exactly right. Oh, so good. This has been such a pleasure. Thank you for coming on and just allowing us to unpack this. And, you know, no secret, I, I want to be totally transparent to anybody listening who might be thinking, but you didn't give her any conclusive answers. Sometimes when you have an injury, there can't be— there isn't an absolute do this do that. I think you're on the right track. I think you do wait this one week out, don't test anything, because this might be the mover of the needle that helps reduce the inflammation so that they, they have a better prognosis when you get there. So I wouldn't want to mess with that. Even as a medical exercise specialist and strength and conditioning coach, we defer, you know, to the medical health allied people and we can suggest questions. But sometimes, and Sue, I'll let you be the judge of this, sometimes talking through it, am I on the right track, what other ideas are there so that I've got a bag of tricks when I am ready to start, even just talking through it is helpful.

And I've got to go along with you with that. I wanted to take issue about the fact that you said you didn't think that you'd done that much. The short area there where we did about the swimming with your suggestions for that is just gold. And then of course unpacking about the constriction cuffs because that was something that I don't really know very much about and can already see the value in getting some and using them going forward for even when when this has recovered. So, you know, that— and that's great. That's, that's what I needed to hear.

Fantastic. It's been an absolute pleasure to have you here. Thank you again for coming on and sharing kind of where you are, what you're going through. And of course, we're gonna look for, you know, in 6 months, I want to know that you're swimming laps and thinking about some huge goal.

Oh yeah, absolutely. For my age.

Oh my gosh, she did it, she did it.

Oh, thank you so much, Debra. It was a pleasure to talk to you. I really do appreciate all your work within the, um, the forum, and, uh, I, I just love how you are as approachable one-on-one as, as you seem to be in all of your videos. I just love listening and watching to you, so thank you.

You are so welcome. Okay, listeners, so if there was something you wish I would have asked, I think we kind of unpacked it all here. But if there is another, another injury or another scenario, it is really probably due time that we start including some of the obstacles, not just some of the things that occur to women in midlife. But some of these kinds of real-life obstacles that we come up against that are outside of motivation and discipline. It's actually when you want to but can't. What can you do if you've got, got a problem yourself or you know somebody who does, or there's something you'd like to hear? When you see this posted on Facebook or Instagram, just message us. I read every one of those. You can find the show notes for today at flipping50.com/rotatorcuffinjury. And what are you waiting for? Let's start flipping 50 today.