A Shoulder to cry on/about

"Physiotherapy across Southern Europe - a comparative study"!

.. and if all goes to plan - Goa too!

Almost seven months sine the fall, and just over six since the operation to fit Ruth's prosthetic shoulder joint the bulletin is mixed! No pain whatsoever, but not enough flexibility to - say - fasten and unfasten a bra! (Not a luxury item as readers will know if they are in her circle!) So Greyrocks is still paying for -  and planning round - sessions with the local professionals! Practices vary thus:

France A where the person is a kinésithérapeute - said "kee-nay"

Not elegant - but it worked!

Had Ruth been a French national there would have been a programme of daily "rehabilitation" after the operation, but she was just told to find someone in town and get on with it!  The receptionist at the Dax accommodation made a recommendation and we went at least three times a week to see Frederique for half an hour. At first all the work was on the shoulder as the leg was in plaster, but this all had to be done without standing so was limited. After the plaster was removed the concentration was on the leg and ankle, and included use of a pneumatic boot thing on the leg, and the "ventouse" on points in the shoulder, as described previously. By the time we left France Ruth was walking from car to treatment with just one crutch.

Crete

"Get your calf and ankle into this!"

Enter Maria in the Church-owned centre in Paleochora! We recognised each other from 2015 when she worked on the wrist, but was then off on maternity leave. The centre is lavishly equipped, and includes facilities for hydrotherapy - not on the menu in France! We developed a set of activities to work mostly on the leg - with dunking in the agitated water, very effective massage and some active exercises. Sessions would often exceed the hour, with meeting other patients who also know us, and were "cheap as chips"! At some point there was the opportunity to have a short consultation with the visiting orthopaedic surgeon, and he said the leg was fine and to get on with the shoulder. By this stage Ruth was walking almost normally anyway- but nervously! So sessions continued with massage - sometimes electrically assisted and a series of exercises, With time Ruth got better at raising the arm from the shoulder, but was evidently "compensating" by lowering the other! After twenty or so sessions in all it was time to leave and in due course move on to the next

France B

In the unfortunately named Rue Ang Sang Si Chi!

In advance Greyrocks had selected a clinic very close to the Montpellier apartment. It was very modern -as one would expect in Port Marianne, and Ruth's kiné was Sarah. She is young, sports-mad and fluent in English! Almost all the interaction took place in an open communal spice with other sock-wearing kinés and punters  doing their thing. Sessions of half an hour - at French price - had some strong massage and passive movement, but a lot of active exercises - to continue at home - in both seated and standing position. A real focus was stopping the "compensation" that had crept in over the summer! All "hands-on" here!

Fuerteventura

Once returned home it was a swift visit to the sports clinic ten minutes walk away and used for various problems over the years by both of us! We settled on a package of fifteen sessions of an hour across the month of November, and the physio would be - usually - another Sara. We would start with at least five minutes seated and using the double pulley, then move into a cubicle here the rest of the session would be with R lying down! We would communicate in slow simple Spanish and she explained the reasoning behind the position as gravity-related There was the same sequence each time of independent work with weights and resistant bands,  some tough passive rotation and sometimes TENS or the arm version of pneumatic pressure kit! By the end there was a definite improvement in the rotation and strength, but still not enough for some dressing and lifting tasks. So we moved over to gym membership entitling Ruth to visit at liberty and use the pulleys, weights etc unsupervised.  That worked for the first week, but then "other forces" = see next post - intervened and it fizzled out close to departure day. By that time depression had also set in following a scheduled return visit to the traumatologist at the private clinic, where the knees had been done! With the brilliant surgeon who did them gone we had seen another in November, and this was a third, who looked at the x-rays and expressed surprise at what had been done in the operation, His opinion was that with the damage done to some tendons a different sort of prosthesis should have been fitted. Asked about the prognosis he was vague!

Ruth continues to do some exercises - especially now in the warm Arabian Sea - and has a lead for a therapist here who might help. Watch this space!!