Case Study: How Alex prevented yoga enthusiast, Mariana, from needing shoulder surgery

“Alex’s approach is holistic and revolved around my very own goals, which made a huge difference. He checked-in regularly on how I was feeling physically and mentally about my injury and adapted my rehab programme to match my progress and objectives. His advice was essential to my recovery, and I’m so glad the hard work paid off so I’m pain-free and I could avoid surgery.”
Mariana, 27 year old software project manager and yoga-lover
In this article, Alex, one of our physiotherapists, provides a detailed account of how he treated, Mariana, a 27 year old yoga-lover who came to him with a complex shoulder injury – preventing her from needing invasive shoulder surgery.
BELOW: Mariana back doing what she loves, yoga. We’re delighted that Mariana has nearly fully recovered and no longer needs surgery (28 August 2021).

The client: a yoga-loving 27 year old professional

Mariana is a 27 year old manager at a software company.

She’s very sporty, and has a background as a competitive swimmer. She has a regular swimming and fitness practice, and enjoys wakeboarding.

Her favourite way to move, though, is yoga.

Suffering from anxiety when growing up, Mariana discovered that yoga really helped her mental health. It’s become not only an important tool to improve her life, but also a strong interest.

The problem: bursitis, a SLAP labrum tear and shoulder subluxation

Mariana’s shoulder injury was multi-faceted with many issues arising over time.

Initially, Mariana suffered from a right shoulder pain which, after an ultrasound scan was diagnosed to be bursitis. After getting her diagnosis and some exercises this improved significantly.

However, a couple of months later, Mariana subluxated her left shoulder while sleeping. Mariana was really worried because she had been prone to shoulder and elbow dislocation when she was growing up.

So Mariana was sent for an MRI scan and a review with a orthopaedic consultant.

The review revealed that she had a SLAP labrum tear in her right shoulder. In light of this, and her history of dislocations and subluxations, the consultant recommended her to have shoulder surgery.

The impact: no yoga

As well as Mariana’s shoulder injury being extremely painful, it also significantly reduced her movement, leaving her unable to raise her arm above her shoulder.

As such, it meant that she was unable to do most yoga poses.

Even worse, it meant that her goal of becoming a yogi was uncertain, as the intense yoga teacher training course she’d planned was now off the cards.

Of course, as yoga is a huge part of her life, Mariana was absolutely devastated.

In turn, Mariana was really torn about whether or not to have the surgery. She didn’t really want surgery, as it would disrupt her life for months. However, she didn’t want to harm her long-term health by and having to give up all the other activities that she loves doing.

The solution: a custom shoulder physio programme

After meeting with the consultant, understandably, Mariana was upset and unsure of what to do next.

However, after meeting me at Technique to discuss next steps she decided to try an intensive physio programme before committing to surgery.

So with Mariana’s diagnosis and goals in mind, I created a custom physio programme designed to reduce her pain and restore the strength and movement in her right shoulder.

Upon testing, the data showed that Mariana had lost 20% range of motion, and 15% strength, in her shoulder.

So we aimed to restore her range of motion with a series of exercises that she’d do at home every day.

Once we had restored her range of motion, we started working on improving her strength. We did this with a custom exercise programme developed to specifically strengthen the movements that she was weak in. In in just 6 weeks, we managed to improve her strength by 25%.

Once we’d made these improvements, we slowly reintroduced her yoga practice, leading to more challenging poses as her pain reduced and her strength and movement increased.

The results: shoulder surgery not needed

As we’re now reaching the end of her physio programme, we’re thrilled to say that Mariana has nearly fully recovered and no longer needs surgery.

Mariana feels like her shoulder’s back to 90% of where it was before the injury without surgery.

As such, she feels confident in her body again and has returned to her sports, once more swimming and wakeboarding.

Although there’s some movements she’s still hesitant to do whilst wakeboarding (e.g. flips) she feeling very comfortable that she can do everything else.

Mariana’s also elated to feel ready do her yoga teacher training in a few weeks time which she thought she was going to have to miss when she was told she needed surgery.

The future: maintaining shoulder strength

Going forward, the final part of the physio programme is thoroughly monitor that she continues to meet all the baseline criteria to ensure that she’s fit for sport at 100% effort.

To do this, I will do a series of strength and movement tests on her shoulder.

In turn, I will be discussing what Mariana can do going forward to maintain the her shoulder strength so minimise the risk of this issue returning in the future.