The Pesky Rotator Cuff Joint (బంతి గిన్నె కీలు)

 The Pesky Rotator Cuff Joint

(బంతి గిన్నె కీలు)

Symptoms

నిజముగా ఆరోగ్యము మహా భాగ్యము! There were many objective symptoms. It was painful to wear/remove a jacket, long sleeve shirt, or T-shirt quickly. Putting a towel on a line to dry was difficult. Even just pushing a light lunch box on the (car) rear seat would trigger a sharp pain through the shoulder. Driving long distance with the affected hand on steering wheel used to produce prolonged pain for hours. Shifting sides, turning the head on pillow, quickly getting up with the injured hand as a vertical prop (support) – they all became proscribed activities for a long time. The funny thing, yes, it is hilarious now that the problem has been resolved, is still the hand performed most of the movements even in this chronic injured state. Though grudgingly. Luckily, on most painful days fomentation with a wet towel (just one minute microwave heating is enough) and rubbing topical cream kept the problem in check. Only in extreme pain, ibuprofen was used, that too in a very moderate dose (just 300 mg once or twice a day). Would a prolonged intake of higher dose (600 mg of ibuprofen) have cured?

Recovery

In the beginning, physical therapy (PT) was prescribed. Though the subject went through all the drills of daily exercise, hot packs, etc., it did not help. To prevent further deterioration of the joint, PT was withdrawn. At that point, the only medicines used were: over the counter ibuprofen and a prescribed topical cream (sort of muscle relaxant). Daily application of Maha-Narayana Tailam (Dabur, Baidyanath) followed by gentle fomentation was used with external massaging. It helped, but the effect lasted only ten, twelve hours.

The big breakthrough came from the traditional Yoga. Thousand salutations and prostrations to the great Patanjali, a multifaceted rishi whom I consider as my own great grandfather. The Sanskrit saying goes thus: “Faith yields fruitful results”. So, with total faith in our traditional yoga, with no outside help (or teacher), the subject did yoga¹ exercises (Surya-nakaskaram) twice a day. At first, these were the gentle stretching poses, facing the East. No force was used. You lift the arm only as high as it allows. Everyone wants rapid progress, but the body has its own natural pace of things. It all depends on many factors – severity of the injury, general state of health, even the mental equilibrium, etc.  Slow recovery teaches us a sense of humility, perseverance, and a great respect for the physical body. We value a joint, a gland, or even skin only when it malfunctions. Till then, we take everything for granted, not only that we even venture to abuse it. 

            Thus, in this case, the subject used either singly or in combination the following treatment techniques: During daily walking, placing hands on the back (for example, look at old classic photos of Nehru walking on the lawn). Try forming the following postures with hands clasped behind: shape of X, 4, or U. When possible give the afflicted shoulder, mild exercises of Surya-nakaskaram twice a day. At least once a day is needed for any noticeable improvement.

            This is the third or fourth time Yoga came to the rescue. Earlier, the gentle yoga (particularly the Sarvanga-asana) helped bringing back the normal functioning of a gland. Much of the present day hype and attention of yoga is unfortunately catered to rich clientele. But the original yoga proponents were more interested in preserving body and mental health through a properly controlled stretching and breathing exercises. Instead of (mechanical) springs and weights, yoga uses the body’s own physiology to correct the injury. It is much more gentle than many physical therapy exercises. There is no need for expensive yoga paraphernalia like special mat, sack, big books with colorful photos etc. Nor is there any need for expensive teachers (coaches, gurus) with exorbitant club fees; in the age-old Indian tradition, there was never any compulsory fee. Neither for learning music, dance, or yoga; nor has any Ayurvedic (or herbal) practitioner demanded up front payment for medicines. Erudite teachers rarely asked money from indigent students – whether it is for Ayurveda, music, yoga, or scriptures. The modern world has totally degraded this once glorious tradition, a veritable treasure of holistic healing knowledge. How far things have deteriorated in the name of commerce and global reach!

            When performing the whole body toning Sarvanga-asana was difficult, so the subject opted for other asanas (ex: Dhanura-asana, Bhujanga-asana, Hala-asana). But upon recovering fully (or about 90%), the subject resumed the Sarvanga-asana in total earnest. Of course after full recovery the subject was able to do even pull-ups on the horizontal bar.

            This write-up is no substitute for medical advice. Often in the real world, many patients cannot access expensive treatments, surgeries, or costly specialists. Valuable lives are wasted due to a frozen shoulder or a locked knee. Money alone cannot produce good outcomes. Even with very minimal expense, one can get back a working shoulder. Patience, daily regular topical massaging, and gentle yoga exercises will yield remarkable progress. And such a progress is certainly more durable in the longer time frame. It must also be remembered by all that health is a complex issue; it has a strong psychosomatic component. But what matters finally is happiness and a living that is free of pain.

Finally, each patient has to explore all possible avenues and costs for a cure. For those who have the patience to heal themselves, this information will help; it may present a ray of hope. I thank my high school drill (PT instructor) master (Mr. Raju) for teaching yoga-asanas to our class at a very tender age. I have also benefited from a Telugu yoga book – a slim volume with all the asanas in black and white photographs. I cannot recall its author or title now, but I must express my gratitude to my cousin(s) for the invaluable book. That was decades before I came across the English yoga books by Sri. B.K.S. Iyengar and Swami Vishnudevananda. 

Copyright 2015 by the author

1. Plates 1, 2, 3, 12, 24 in “Light on Yoga” by B. K. S. Iyengar, Schocken, 1994

2. Surya-namaskarams are found in “The Completed Illustrated Book of Yoga” by Swami Vishnudevananda, Pocket Books, New York 1972