Hire Movers! Be Kind to Your Back (and Shoulders)

Moving is always a very busy and stressful time. Even when you have a healthy team of movers on hand, you still have to sort and prepare often a lifetime of belongings yourself. This stress and extra strenuous activity puts you in a risky position to sustain an injury.

 

Since I was a kid, I often heard the advice of my parents and other adults to “bend your knees, lift with your knees, Don't bend over, Don't use your back”. Despite this proper advice, I did manage to hurt my back badly 30 years ago while working as a route salesman for Coca-Cola handling and delivering products. After my injury, I never went back on the truck again, and I took a less lucrative job as an advanced salesman at Coca-Cola that did not require the physicality of my former job. Since the injury, I was extra careful about how I treated my back, but after about 20 years, I finally wound up having a very successful back operation.

 

 

Conversely another part of the body I never really worried about, nor had I been coached to pay attention to, was my shoulders. You don't have to be an athlete to experience shoulder pain. Second to back pain, shoulder pain is the most common musculoskeletal problem seen by healthcare professionals in this country. More than 6 million people seek medical care for shoulder pains in the US each year, and more than 30% of these are related to the Rotator cuff, with approximately one in seven of these eventually requiring surgery. The high prevalence of shoulder pain and particularly rotator cuff disease lies in the unique anatomy of your shoulder joints as being the most mobile joint in our body. This mobility gives us the ability to place our hands, virtually anywhere in space, such as reaching for that grocery bag in the backseat of a car or screwing in that high ceiling light bulb. In exchange for this increased mobility comes with its inherent instability. 100% of shoulder stability relies on the rotator cuff muscles. There is no bony socket for structural support as in the hip joint. The four rotator cuff muscles emanate from the shoulder blade and extend out toward the top of the arm bone like a group of outcropping legs of an octopus. These are the four rotator cuff tendons. These tendons are supple to allow directional changes when they move, however, must simultaneously stiffen up to keep the shoulder joint centered and aligned during our motion and prevent dislocation. It is this delicate balance between flexibility and rigidity that is so taxing on the rotator cuff. The three most common complaints by patients who have rotator cuff tears are pain at night and inability to sleep on the affected side, history of recurrent episodes of shoulder tendinitis, or bursitis, which may be minimized by the use of rest and anti-inflammatory medications, and reproducible pain and weakness, with arm elevations overhead, or against resistance. Treatments for a torn rotator cuff are varied, not everyone necessarily requires surgery. Many factors weigh into the decision making process, mainly how much does the shoulder bother you? How frequent, severe, and under what circumstances are you willing to live with the symptoms, and how much are you willing to change your activity in exchange for less symptoms? In spite of many technological advances the vast majority of all rotator cuff repairs fail to heal properly after surgery. Broken bones reliably heal because it is bone to bone healing. Torn muscles heal because it is muscle to muscle healing sewn together. In the case of rotator cuff tendon, where the tendon is detached from the bone, when repaired together, it is relying on tendon to bone healing and tendon to bone healing is not very reliable because tendons and bones are dissimilar substances. As we age the integrity of our tendons, particularly in our shoulders deteriorate in part due to age alone, but also wear and tear from repetitive motions.

 

There are activities that should be avoided to help prevent shoulder injuries, and there are also stretches and exercises that can help strengthen your shoulder. To help avoid injuries proper lifting techniques should be employed such as Carrying items centered and close to your body, stepping on a stool to reach something high, and positioning your body squarely in relation to an item you need to pick up. Get out of your car and open the back door to gather items in the back seat. If you are a dog Walker, you should consider a leash with built in shock absorption in the event your well behaved dog decides to thrust towards its nemesis. If a certain activity hurts when it didn’t in the past, don't just tough it out, seek medical care as toughing it out may be worse for it.

 

 

 As far as strengthening and stretching, there are many exercises available, and can be easily found on the Internet or through a personal trainer. They typically do not include heavy weights, but actually light weights doing specific exercises to strengthen some of the 17 small muscles that help the shoulder move in so many ways. An ounce of prevention is worth a pound of cure, particularly with shoulders.

 

As I stated at the beginning, I was always aware of back concerns, but foolishly somewhat oblivious to shoulder concerns. I learned the hard way.  Six months ago I was dragging a mattress upright, with my left arm extended up above it. As I dragged it I suddenly heard and felt a pop. I knew instantly I had done something terribly bad. Turns out that pop was indeed the result of my rotator cuff tearing, as well as my bicep tendon detaching. I had extremely successful surgery without nearly the pain I had been warned about, particularly the pain that would be associated with therapy. 14 weeks post surgery I was receiving therapy 2 to 3 times a week and progressing famously until at a Christmas party in early December I snapped it again while opening a bottle of champagne. Although I was trying to just use my hand strength to open it thinking I could accomplish this without any threat to my shoulder, I was wrong. My options now are to continue therapy and try to get as much as I can out my shoulder without any further surgical intervention and in a sense just put up with my now dramatically limited strength, range of motion, and increased pain, or a number of far more invasive surgeries without any guarantee of a positive outcome such as a full or reverse shoulder replacement. The chances of a positive outcome from a knee or hip replacement are far greater than that of a shoulder replacement due to the complex anatomy of your shoulder. For the foreseeable future I will just continue with therapy and hope to realize incremental improvements over time.

 

 

Another thought to consider is your state of mind while moving or performing any strenuous activities. A friend of mine asked me if I was angry while I was moving the mattress. I was sorta perplexed by his question, thought for a second, and said yes I was a little angry as I was in a hurry to move it in a time frame not chosen by, and inconvenient for me, to accommodate someone else's schedule. Being hurried and a little angry likely contributed to my not thinking through what a vulnerable position I was putting my body and shoulder in. Take a breath, think about what you are moving and how you are doing it. Don’t get mad at IT, and kick it! So as stated in the title, hire movers, and be kind to your back AND shoulders!