My daughter has also had shoulder issues. Her stent is high at the C-1 vertebral.
Within a few days of surgery, the shoulder became weak and she was unable to lift her arm above her head. Her shoulder was also drooping - probably 1-2 inches. She started therapy with my LMT/PT within two weeks of the surgery. Also, used muscle relaxors to help ease the spasming.
My daughter's physical condition prior to surgery was good - she exercised on a daily basis and was in a formal body pump class. Strength in her shoulders and arms was good. Dake told her to continue with her exercise program, but to modify. The weight bar was not to be on her shoulders.
She is now 3-1/2 out from surgery. The shoulder pain has decreased significantly and the shoulder droop has also decreased to some extent. The evenings are the worst. Her shoulder curves in to the front which is caused by the pectoral muscles being stronger than the romboids.
Daily activities tend to use the pectoral muscles more. Anyone who sits at a computer for a length of time is going to suffer the negative effects of continual engaged pectorals. People tend to get shorter muscles from working keyboards - this in turn means a tighter chest and weak back muscles. This then becomes a postural problem - the rounding of the shoulders. This can lead to a decreased range of motion in the shoulders.
Think of working the muscles in pairs - equal amounts of exercise with the opposing muscle groups. Be conscious of pulling your shoulder blades back and together - visualize trying to hold a pencil between the blades. You need to keep the abdominals engaged in order to support the back. Another suggestion is to place a lightweight bar or stick on your shoulders. Hands are gripping bar in alignment with the shoulder cap - fingers are facing forward. This forces the shoulder blades to go back which in turn is stretching and lengthening the pectoral muscles.
Marie has posted about the spinal accessory nerve SAN and its relationship to the weakening of the shoulder muscles, mainly the trapezius. It is sort of like a game of dominoes - the damaged SAN weakens the trapezius. There are three muscles groups that have to cooperate for the shoulder to be healthy - the romboids, the serratus anterior and the trapezius (upper fibers). If any one of the three muscles is too strong, too weak, too loose or too tight, you are going to have shoulder problems. These three muscles have to all cooperate in order for the shoulder to be healthy. If you’re a deskjockey, chances are your rhomboids, lower trapezius, and serratus anterior are weak and your upper trapezius is strong.
From
http://www.floota.com/RhomboidStretch.html
Here is a concise summary about the SAN.
Quote:
Accessory nerve
From Wikipedia, the free encyclopedia
Nerve: Accessory nerve
Plan of upper portions of glossopharyngeal, vagus, and accessory nerves.
In anatomy, the accessory nerve is a nerve that controls specific muscles of the neck. As a part of it was formerly believed to originate in the brain, it is considered a cranial nerve. Based on its location relative to other such nerves, it is designated the eleventh of twelve cranial nerves, and is thus abbreviated CN XI. Although anatomists typically refer to the accessory nerve in singular, there are in reality two accessory nerves, one on each side of the body.
Traditional descriptions of the accessory nerve divide it into two parts: a spinal part and a cranial part.[1] But because the cranial component rapidly joins the vagus nerve and serves the same function as other vagal nerve fibers, modern descriptions often consider the cranial component part of the vagus nerve and not part of the accessory nerve proper.[2] Thus in contemporary discussions of the accessory nerve, the common practice is to dismiss the cranial part altogether, referring to the accessory nerve specifically as the spinal accessory nerve.
The spinal accessory nerve provides motor innervation from the central nervous system to two muscles of the neck: the sternocleidomastoid muscle and the trapezius muscle. The sternocleidomastoid muscle tilts and rotates the head, while the trapezius muscle has several actions on the scapula, including shoulder elevation and adduction of the scapula.
Range of motion and strength testing of the neck and shoulders can be measured during a neurological examination to assess function of the spinal accessory nerve. Limited range of motion or poor muscle strength are suggestive of damage to the spinal accessory nerve, which can result from a variety of causes. Injury to the spinal accessory nerve is most commonly caused by medical procedures that involve the head and neck
In summary, I think the CCSVI post-op recovery plan needs to include information about PT for the shoulder issues. I know that Dake will write a script for PT if you cannot get it from another doctor. AND, we are our own worse enemy -- we get home and immediately get on our computers and start updating our stories on TIMS. I know that Dake has warned people about spending too much computer time because members have reported this on their posts. The recovery takes time -- Permanent damage to the SAN is most noted when there has been a dissection of the neck. Hopefully, since our procedures were not an invasive surgery of the neck, time will heal.
Sharon
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