NHS Physio - 1/3 of the way through

I started with the NHS physio last week for my left shoulder (private physio is on hold until that's completed). As far as I know, the NHS only offer a course of 6 sessions(!).

This morning was my 2nd appt. Still no ultrasound, manipulation or massage. Just a series of test/assessment exercises and recommendations for new physio exercises to strengthen the lower trapezius muscles to stabilise the scapular. I came home and iced my shoulder.

Discovered this morning that my intercostal muscles through my rib cage are stiff/strained. And, judging by how they feel since the physio appointment, I know the cause, lol. The trouble with engaging/strengthening new muscles, is that these inevitably pull on shortened (and invariably) weakened opposing muscles which are then pulled taut and risk strain and continued stiffness. I think this is the problem with the structures around my shoulder. By continually retracting and stabilising the scapular, I've introduced a level of tension through the opposing muscles/tendons/nerves and they are struggling to accommodate and adapt to this. I suspect that the whole of the front of my shoulders and chest will take a long time to stretch out, adapt and become elastic at the longer lengths. In the meantime, I just have to put up with the pain and be careful not to induce injury.

Feeling kinda despondent. It's the complete lack of muscle which is depressing really and knowing that rebuilding the back muscles is going to take years, with all the associated pain etc. I've probably written this a million times already, but the major obstacle with severe deconditioning is this critical lack of muscle to begin with. It's so much easier to build muscles once you have the capacity to move the joints in a stable, controlled, pain-free way. If you don't have the strength and joint stability to even lift your arm above your head you've got a heck of a lot of ground work to do before even thinking about 'bigger muscles'!

Ah well....what's a few more years of rehab in the grand scheme of things....!