Lindsey Ebbs Podiatry - Insights

How 'muscle memory' helped my recovery from shoulder surgery

Is 'muscle memory' a thing?

Here are two explanations for this phenomenon

Firstly, that the muscle itself remembers.

Not that we have mini brains in our muscles as the brain is definitely located in the head! But there is no doubt that our muscles remember movement, otherwise we would struggle on a daily basis to walk, run and perform our jobs.

How does that actually work, well there has been studies suggesting that each muscle cell has a nuclei present inside them, these nuclei may now be thought to hold the `memory` of how that muscle works.

In real terms, if a person has been strength training for long periods of time, especially in adolescence (when the body is growing) to a competitive standard in any sport, then that muscle has been stressed enough to recruit extra muscle fibres to achieve that gain in muscle size and strength.

So, consequently an increase in muscle fibres mean an increase in nuclei, it was once thought this was a reversable model and the nuclei would be lost once a muscle was no longer stressed but now there is growing evidence that the nuclei remain present in the muscle, even after training has stopped and the muscle has reduced in size. Therefore, nuclei seem to hold the key to muscle memory? if retraining commences the extra nuclei are already present to start synthesising new protein which is necessary to build muscle mass and strength.

Secondly, that muscle memory is also achieved by neurons that are transmitted to and from the brain to the muscles.

This creates muscle memory by the repetition of movement, something we have been doing throughout our lives. For example; riding a bike takes time and patience to learn but once that skill has been learnt then the body knows how to ride a bike forever. The brain and the neural system remember how that works due to the continuous repetition of that movement.

That neural repetition works for so many movements on a daily basis that we just take it for granted, it just when you actually think about it – it’s amazing!

So, the reality of muscle memory is the combination of both the muscle nuclei and established neural pathways.

How does this concept of 'muscle memory' apply to me?

I am a Podiatrist of 31 years and had shoulder surgery 6 1/2 years ago, which I have struggled to recover from. Given my occupation, it would be fair to conclude that is my job that might have caused the problem with my shoulder but actually that was not the case!

11 years ago, I moved house 3 times in 10 months, not something i would ever recommend!

The constant packing, cleaning and carrying took its toll and the final `icing on the cake` scenario for the demise of my shoulder was when I took a saw to the garden for days, whilst clearing the garden.

The shoulder joint started to be painful after that, something the doctor and physio said would eventually go away, a couple of steroid injections later, physiotherapy and pain killers, there wasn’t any improvement. I was totally incapacitated with pain, stiffness and a lack of movement. Getting dressed was such a challenge as was simply washing my hair!

I knew there was something wrong with my shoulder and after 2 ½ years of being passed around, I was so desperate I paid for a specialist consultation and an MRI. The diagnostics showed up a tear in one of the tendons and a bursitis that was so irreversibly large it was stopping the joint from moving at all. Two problems in one joint, how unlucky was i?

Surgery was the only solution to this problem, which I had 8 weeks later.

My recovery turned out not to be that simple either, I went back to work 3 weeks later – which was incredibly hard but is one of the downfalls of being self-employed!

Physiotherapy was initiated six weeks after surgery and it was almost impossible to do, the pain was just as bad as before the surgery- I just couldn’t do anything for the physio, very much a low point for me.

After 6 weeks of little improvement -a frozen shoulder was diagnosed, I knew this was a risk factor prior to having the surgery but hoped it wouldn’t be a reality. A steroid injection under guidance (Imaging) was recommended, which I gladly agreed to, sadly I slipped through the NHS net yet again and I finally got my injection 6 months after the surgery.

The relief was instant, I could move my shoulder for the first time in 3 years, it was truly was amazing.

Then life got in the way, my mum proceeded to deteriorate with rapid dementia and needed a lot decision making and care quickly. I relocated my clinic at the same time and as my shoulder was giving me zero pain, shoulder rehabilitation was low on the list of things to sort out at the time.

My recovery had been stalled again as although my pain had gone, there was no strength in my shoulder at all.

Four years came and went with various life distractions and dramas along the way and time for looking after me was almost impossible to achieve. The final straw came about whilst I was on holiday, I attempted to water-ski and failed as my shoulder was too weak to be able to pull me out of the water.

Water-skiing is something I have always enjoyed doing, not particularly well but an achievement non the less.

I decided there and then that this denial of rehabilitation had to stop and I needed to dedicate the time that was required to retrieve the strength and movement in my shoulder and to be able to water-ski if I choose to do it.

The decision had been made now and the reality had to follow!

Swimming is the one sport I could do well; I was a competitive swimmer in my childhood and well into my late teens but twenty-one hours of weekly training takes up a lot of time and at eighteen other seemingly important things, took priority (like going out with friends, drinking and clubbing!)

I continued into my late thirties having not seen a pool unless on holiday and I never went in it but my children were showing signs of inheriting the `fish genes` and had already started swimming at the local swimming club, consequently I was spending more time at the pool again.

Oh, that smell of chlorine is something a swimmer never forgets!

Before I knew it, I was teaching at the club and swimming as a master with the older swimmers and I was starting to gain my strength back and managing to keep up with the club swimmers.

I carried on swimming with the masters until my shoulder presented as a problem and then it was not possible to swim at all, I was totally incapacitated.

A total time lapse of 7 years had passed since I had last trained in the pool. But I knew it was my only hope of re-habilitating the shoulder as the gym doesn’t do much for me really!

So, I purchased a couple of cossies, hat and googles, I knew this was the easy bit!

I checked with the local leisure centre and booked in on the `lane swimming ` sessions that suited around work.

After dropping into the water in the `slow lane` so I could just get the measure of how I was doing? the answer to that was `not well` at all! My joints clunked and grinded, cramp was a regular companion. I was nearly in tears that night, it was worse than I could have imagined. I persevered hoping that I would get better?

Determined to regain the strength I needed I upped my visits to the pool to twice a week and the same outcome was for all those sessions. My surgery affected arm was painful with every stroke and I just felt I was dragging myself through the water.

My brain didn’t seem to know where my left arm was, especially when it disappeared out of sight, something I wasn’t prepared for?

After some thought, I realised my brain had forgotten its communication with the affected arm, after all I had barely used it for 7 years and I certainly had protected it, consciously and sub consciously.

So here I am, 10 weeks later after dipping my proverbial toe in the water, still swimming twice a week in all three strokes except butterfly, (that is definitely another day’s challenge!) I have progressed into the fast lane and am holding my own……just! I am gaining in strength and a little speed and my pain is decreasing.

My goal now is to be able to swim as naturally as I used to, without discomfort and to be a little faster

I can see from the video that there is a difference between my arms in stroke and entry into the water and I know what to work on now and improve with lots of swimming drills! it is really picky at this point to most folk but once you have coached swimming you know what to look for and improve on.

Basically `you have to swim slow to swim fast` meaning by retraining the brain in a new skill (swim drills) and alongside repetition of movement is a successful path to creating new muscle memories.

I am so pleased that I persevered and I am on the way to getting back what I had and am now very grateful that I did the 21 hours a week of swimming training for all those years , to establish those muscle memories as without it, my recovery wouldn’t have been as successful as it is.

I am an example of how muscle memory can help your recovery from injuries and surgery and I hope it helps those of you that may still be struggling with your recovery... you will get there!

Sources:


About the author

Lindsey Ebbs

Bsc, Pod, Med, MChs MCPod

Lindsey qualified in 1988 from Durham School of Podiatry as a State Registered Chiropodist. Lindsey then returned to Durham in 1993 and qualified with a BSc in Podiatric Medicine.

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After working in a private practice in Guisborough and briefly for the NHS, Lindsey set her own practice up in 1989 at Mulgrave place, Whitby. Two years later Lindsey moved to Hunter Street and developed the Hunter Street Podiatry practice for 23 years before moving to the Green Lane Centre in 2013.

When fundholding for GP practices was introduced in 1991 Lindsey was asked to set up a six month pilot Podiatry scheme for Egton Medical Practice to see if it could be rolled out nationally. It was so successful Lindsey stayed for Eight years! These clinics are now present in most GP practices all over the country.

Lindsey specialises in Biomechanics (Musculo- Skeletal Care) with Prescription Orthotics, helping patients with painful joints/muscles and sports people to achieve their full potential of movement.


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