 Aloha, and welcome back to Movement Matters on Think Tech Hawaii. I'm Christine Linders, your host and physical therapy orthopedic clinical specialist. Today, we're kicking off Shoulder Injury Prevention and Treatment Month by talking about shoulder surgery and how you can live the life you love and keep those shoulders healthy and pain-free from future injury as you go about your life. Personally, I've had five shoulder surgeries, four between the ages of 19 and 20 and a fifth a year and a half ago. Since then, I've completed three Iron Man triathlons, many three-mile swims, and I'm still playing and competing a little bit in beach volleyball, as well as working as a manual physical therapist and enjoying my active life thanks to the surgeon who put my shoulders back together again, Dr. Kevin Shea. We are speaking today with Megan Kumo, who is playing basketball for the University of Connecticut when we met in the training room. She was a big role model of mine in choosing the surgeon I did, and she had just undergone surgery herself and I was about to. Megan and I will be talking today about how we've managed to keep our shoulders healthy and the bumps along the way in order to enjoy our shoulders during the activities that we love, and you'll learn more about the anatomy of the shoulder complex, the unconscious movements during your day that are making your shoulder vulnerable to injury, and the simple ways you can correct them. Let me welcome Megan Kumo, color analyst for the Yukon Women's Basketball Team and fellow former collegiate athlete. Aloha, Megan, and thank you for joining me on Movement Matters. Can I say Aloha, if I don't live in Hawaii? I wish I did though, it's cold here in Connecticut. You could say Aloha anywhere, it means love, we're extending love to you. So Megan and I both had shoulder surgery. We had suffered some subluxations and dislocations, she white playing basketball and myself all playing volleyball. So Megan, how many years ago, we don't have to tell me that because I don't want to tell you that, but what happened to you? Was it dislocations? How did you hurt your shoulder? So the first one was my right shoulder, my freshman year, and we were at Boston College and I kind of slid down and I went to block the ball out of a girl's hand. And when I did that, my shoulder just popped out and I fell to the ground and I went back in. So I'm like, oh, okay, that kind of hurt and it was a close game. I remember going out of the game and then I looked at Gino and I'm like, I'm okay, I can go back in. And then I went back in and they were pressing us and I remember I got the ball and I went like this to throw it and I'm like, oh no, this wasn't a good decision. That was the first injury. And then I just rehabbed it then and then the next year we were at St. John's and I was rebounding the ball with my left hand and this girl from St. John's had her hands on it and was pulling the ball and I was pulling it and my shoulder just popped out. And then the trainer had to put it back in right there on the floor. So but then my right shoulder had sublexed many times my junior year and then the spring of my junior year I had surgery from our boy Kevin Shea. Our boy Kevin Shea, I know I need to get him on the show. So it's funny that it's not funny, but it's funny that you mentioned the trainer put it back in that just bought a memory back of my first shoulder dislocation. I was probably not supposed to be doing it, but it was my freshman year in college and I was playing in some, I don't know, all star tryout thing that they have you do. I can't even remember where it was over the summer. And I went for a big swing on a set that I had to reach a little bit too much for. And out it came and it was kind of a little off and I had seen, I don't recommend this by the way, but I had seen lethal weapon. So I went back. I was afraid you were going to say that I was 17 years old, I mean 18 maybe. Maybe this is before college. I went in the bathroom and I just took my arm and I put it up against I was trying to like move it around and I couldn't, so I put it up against the wall and did this. And I, and I put it back in and I, I went through the tryout. I don't know how, but it wasn't until the next year in, in college, you know, playing, I was playing middle front, but she also ran me middle back because I was a floor rat. I was just scrappy. I would touch everything. So diving baseline like this all the time, it just stayed out. And so when Kevin met me and went in for the scope, he said there was a one inch tear in the, in the labor room and so they took it out. And I, I remember why, because I did that. I took it right off. Oh my gosh. That's crazy. So, so when you had surgery then so that you could use your arms overhead without subluxing and dislocating while you grab balls from these girls and you'd be aggressive with rebounding and block shots and all that. What, what kind of surgery do you remember what you had done? I know for both of us, it was a while ago. Well, I, here's what I do remember and he, I've seen Kevin over the years and he always laughed because I had local anesthesia. I talked through the entire operation and, you know, I was a little loopy and I, I started calling him Bob Vila at one point because I heard like a drill or something and I thought it was a sugar tack, but I think it's called sure tack. Yeah, yeah, you're right. That's the only reason I remember that because I was like calling it the wrong thing, but I think he just tightened it up. I have two, you know, you probably can't even see like the little scope marks, you know, you just have a little hole. Yeah, they're just right up here. I honestly got, you probably can't even see him. It's been, it was 1991. Probably 92. It was 91. Was it? Because I had mine right after her, yeah. Oh, okay, funny. So yeah, so it was a long time ago and the rehab, it was hard. My senior year, I just wasn't the same player because if you think about it, like with basketball, like so much of your arms are out at this, like you're posting up, you know, you want the ball or you're boxing out like this, your shoulders grow up in this motion and it's just impossible because if they would get hit all the time and, you know, I did tons of rehab. I mean, we were both in the training room so much. Those elastic bands, how many of those things did we do? Yeah, thousands for sure. So I mean, I was never quite the same, but you know what, he did a great job. And, you know, I'm really lucky that my shoulders are pretty good today. I'm pretty active. Like, you know, I like to play golf. I like to work out and because I like to eat. I know. Well, we have a lot. I like to eat and drink and I got to, yeah, I got to work out. So your your shore tack or sugar tack, it's funny. I think I called it a sugar tack back in the day. I had what they called a anterior capsular shift. So if we go to image number one, this is from the ONS MD. And that just shows the lower part where it says capsule. Mine was stretched two times the length of a normal joint capsule. So Dr. Shea went in and cut that off and then tightened it up and shortened it up. So they might have called it a shore tack. I might have had a slightly different procedure, but for the same thing, that subluxation dislocation. And so if we go to the second shot of the shoulder anatomy, you can see it's pretty complex. There's a lot of tendons going in there. There's a clavicle. There's a shoulder blade. There's rotator cuffs. There's biceps and there's labrum. And the labrum is the cartilage structure that holds the ball in the socket while all the other muscles control the ball on the socket. That bicep tendon, that little skinny tendon that you see going up in the front, that helps hold the ball in the socket as a muscle tending complex, whereas the labrum and the capsule help hold it on the socket. But you and I both dislocated. So we had stretched out our capsule and or tore our labrum. So just as far as shoulder anatomy, when we were strengthening, we were strengthening our rotator cuff muscles, but also image number three, the scapular muscles are so important over on the right, your rhomboids, your serratus, your lats, your trapezius, your posterior deltoid, all those muscles in the levator scapula. They control the position of the scapula and it's kind of like a coordinated dance, like one of the hardest dances that you could possibly do might be, I'm not sure I'm not I'm not that kind of a dancer, but maybe flamenco or there's these dances that are so incredibly hard. The shoulder blade muscles have to coordinate the shoulder blade so perfectly so that your rotator cuff can just stabilize that ball on the socket while you block shots and grapple with balls on the ground and box out and keep people at arm's length so you can get your position down below. And it's fascinating that we can have a capsule shift and rehab and maybe not get back to that level because of the time and the way the brain works with, hey, wait, that was injured. I got to protect myself. I'm not sure I'm as strong as before. So it's fascinating. So like you golf and you've had some kids and holding your babies, your shoulders have been good over the years. What kind of problems have you had, any? I mean, I honest to God with my shoulders, obviously holding my kids, you know, they were, my son, well now in 14, 13 and 11. So when they were babies, I mean, I had like kids all over me all the time. But I did have some trouble back then with my shoulders, but I have been really lucky that I really haven't had much shoulder pain. Now the rest of my body is a little bit of a different story. And I don't know if there's any sort of related situation with my elbows and stuff, but it's just weird. Like, and then my, I had the late torn labrum in my right hip. So I don't know if, so I, and I have arthritis in my knees. So I can't really run. So I, you know, I also abuse my body for a long time playing sports. So, you know, some of it's just natural wear and tear. You know, some of it is, I always say with the, you know, when you have elbow and hand issues that is not arthritis driven per se because of genetics or like beating them up. And it's too much joint wear and tear over the years, which I don't know that I don't know that you would get the elbow thing in basketball. You could like in volleyball, you can, but your posture is so important to the performance of your shoulder, elbow and hand. Because when our posture is forward at all, like without being perfect, I know I was sitting up straight or two, the muscles of your shoulder don't hold it in the perfect spot. And then your elbow, which is a joint further away and your hand become vulnerable. A lot of people working on computers can get tennis elbow or golfers elbow, just because they're forward. And so where their shoulder complex and their shoulder blade muscles should be stabilizing that shoulder joint, it's not. And so your elbow muscles have to do more of the work. Or if your elbow is not supported on a surface, but it's swinging high, those muscles have to do more to control the joint. And that can affect your elbow and your hand. It's one of the things I like to talk about with computer workers is, Hey, like my patients too, you've got to support your elbow. You have to find a way to support your elbow because if it's swinging free, people get neck pain, people get rotator cuff injuries. And they also get tennis elbow because you're not supporting the limb. And we're doing it for, I mean, you could be hovering your hand over the mouse like this with the muscles on for 15 minutes on a call, listening to someone before you go to look something up. It could happen. Oh, you're on a phone call and you're not resting your hand. You have to let it rest and over time. And as we age, it becomes problematic. And so I know we were going to do a phone call yesterday where I was going to show you these stretches for your hand. Is that something that you're doing for your elbow? Yeah, I'm trying to. I've got to do that. Yeah, for sure. You're on board. But yesterday, you had a great reason for us not getting together, which we will, because you were watching. Tell me. Yeah, the Yukon women. Yeah, the Yukon women were winning a championship yesterday. That's right. That's a great championship. Go help you. So, I mean, sometimes you got to take one for the team. You got to take one for the team. But we're going to meet up, you know, we could do it tomorrow. So I can show you, I wanted to show you more stretches when you were talking about your elbows and your hands because the thing I like to convey to people like those little stretches here to make sure you have the normal range of motion. We could jump ahead to the peck stretch for your posture, which is image number eight, where you're standing in a doorway with your hands on the doorway. I like to put one foot in front of the other always so you're not hanging on your shoulders. But you just bend the front leg a little bit just to stretch out your chest. That helps to open up your posture so that you can do strengthening exercise. And another way if that one's uncomfortable is image number. The next image, which is the T stretch, I call it, because they look like letters of the alphabet, where you put one leg in front of the other again, and you gently lunge forward so your weight's on the front leg so the weight is not on your shoulders. And that helps to open up your chest, especially if you've been child rearing, nursing a baby, working on your taxes, picking up groceries, doing laundry, like doing your work. Like when you're doing your lower analyst and you're sitting at a desk and you've got to talk to people and you're maybe using your hands or writing things down, you need to undo that sport. I say that all the time, undo that position so that over time in five years, you're not more hunched. I'll show you those, but for everybody. I'm psyched, yeah. You're psyched. So we're going to go to a break briefly. My name is Christine Linders. I'm the host of Movement Matters. We are talking with Megan Kumo about shoulder surgery and how to keep your shoulders healthy afterward so you can enjoy your life. We'll be right back. Aloha. I'm Kili Ikeena, the host of Hawaii Together on the ThinkTech Hawaii Broadcast Network. Hawaii Together deals with the problems we face in Paradise and looks for solutions, whether it's with the economy, the government, or society. We're streamed live on ThinkTech bi-weekly at 2 p.m. on Mondays. I want to thank you so much for watching. We look forward to seeing you. Again, I'm Kili Ikeena. Aloha. We're back. We're live. I'm Christine Linders, ThinkTech host of Movement Matters. I'm speaking today with Megan Kumo about shoulder surgeries and how we keep our shoulders healthy to enjoy the life we love. Welcome back. So, Meg, before the break, we were talking a little bit about posture and how it could affect your elbows and hands. And one of the things I wanted to show for you and everybody about posture is that when we are slightly even hunched forward and we go to reach our arm, you can't reach as high as normal. So if we go to the video, you'll see a picture of this person slouching and raising their arms and they can only get so high and then sitting up straight and then raising them overhead. So for anybody watching it, try it. Hunch forward and raise your arms up forward as high as you can and then sit up straight and see if you can go higher. Why this is a problem? Because we need to reach overhead. We need to reach into a cabinet, which I show a little picture of reaching into a cabinet with your posture erect and then the second picture, reaching into a cabinet when you haven't had good posture. And so that can pinch the shoulder and that can impinge on the rotator cuff and cause a rotator cuff tear, which I have another image of. You'll see that over time, as you reach and reach and reach that top little red muscle, the supraspinatus can get pinched up underneath the clavicle and the scapula where they intersect there and you start getting fraying. There's many ways to get a rotator cuff tear but when it comes to posture, it's usually reaching when you've been slouching, reaching in the backseat of the car on a slouched posture, reaching and lifting something heavy like a heavy briefcase out here and over time that's an internal tear that you can get and then all of a sudden you're going to grab something and you're like, oh, what happened? I don't know what happened and you have a rotator cuff tear or if you go to spike a volleyball like I do or you go to block a shot in image number seven and you've had a slouch posture, that arm has to be really high so you're not just spiking a volleyball once or blocking a shot once or grabbing a rebound once, you're doing it over and over and over again and that's when your rotator cuff becomes vulnerable even though you don't even know it. So posture is something that I used to hate to talk about but I talk about it all the time now because it's the one thing that we can control and call our awareness to to feel better, look better, have our shoulders and our back be better, our neck be better. So yeah, it's so true. You know, Christine, and I told you long before you asked me to do this show with you I saw one of your videos. Could you have posted it on maybe some sort of social media? I don't know. I did, I posted it on Facebook, yeah. Okay, so that was where I saw it and it was fascinating and it talked about a lot of these things like our everyday kind of patterned behaviors that we do and how without knowing they can lead to different, whether it's a rotator cuff or whatever, all these different injuries and it was fascinating. And so the funny thing is you didn't even prompt me, I just watched it one day and I'm like, it's so true and there is, yeah, it was great. And it is stuff, like the posture thing, as much as you may not want to talk about it, like, you know, we're at the ages now where, gosh, it's more important than ever to sit up straight, pull in your core, and I find, I'm sitting probably a little bit straighter today than I normally do because I know you're here, but it's a really good lesson and I feel better. Like a lot of times, because I do sit at the computer a lot and some days when I'm lazy or tired, I'll be satching and then I'm like, and then it kind of bothers my back or me to my low back and I'll try to sit up straighter and do what I got to do, but I definitely consciously try to do it, but I feel better when I sit with better posture and sitting more erect. I just feel better physically. It's just, I mean, so I try to do it and obviously there are days that I fail, but I try to do it. I think that's great and there was a show that I did about mindset and in getting to the next level and what you want to achieve and I talked also, no, it was a different show. It was posture and the 10 ways that posture can improve your life and we were talking about how, you know, I went to this Tony Robbins thing it was the best year yet in San Diego and he was like the final speaker. They all spoke for like 20 minutes and he had us all get up. He asked all slouch and frown and he asked us how we fell and then he's like, sit up straight, stand up straight, jump around and how did you feel? And I was trying to tell people that sitting up straight not only is good for your body which is something that I am a big promoter of because of biomechanics and the way your neck sits over your shoulder blades and your shoulder blades sit on your ribcage and your humerus sits in the socket and your low back also gets affected as you mentioned but also when you sit up straight you immediately feel more confident, happier, you look better because you look prouder and if you are depressed or you're bummed out about something sitting up straight can be that one avenue that improves your mood enough to get you out of what you're in and moving forward with your life because we're all struggling with different things at one point or another or all the time, you know? And yeah, I agree with that. Posture is a great thing and I've, you know, I never like to nag people in posture when I was a new PT because we were always nagged as kids to sit up straight but I started nagging people when I realized that I was doing everything I needed to do as a physical therapist and they were doing their homework but the one thing they weren't doing was sitting up straight more. They were sitting slouched more and I used to tell people, hey, listen, you don't have to be perfect but if you are sitting up straight 51% of the day and slouching 49% of the day then the strain is less and you progress from there. Be proud of yourself. 50, 51% you're up. 49% you're down. Now the pain can start going down because the strain is starting to go down and then you achieve 75 to 80% and then you relax. It's okay to relax. Sure. Now, did you get positive feedback from those folks? I did. I did because I think there's always ways for me to try to have, to help my people, my patients, my friends, my family have an epiphany where they're like, oh, I get it and I think people get the oh, I can't sit up straight all day long but you know what? I can do it more than half my day. Right. And it's not as overwhelming when you, when you, it was so smart of you to pitch it like that. Just pitch it in a way that, listen, just try a little bit. A little bit at a time is far less cumbersome to people. Right? Well, and by the way, when you talked about nagging, I have to tell you this, when I was in like middle school, I must have been in like middle school. My mother always used to tell me to stand up straight, but she always told me to suck in my belly. I love it. Like just always kind of, and I got to tell you, it bugged the crap out of me many times, back in the day. But I am so thankful because the, you know, that was less of a problem area for me most of my life because my core was always pretty strong because I was always sucking it in. It was crazy, but it's something that I've always done. So I can't believe you just said that, and I don't know if anybody can see this, but I wear these wristbands and I make them for my patients that they suck it in. No way. And it also says on the back, end low back pain. So I wrote a book. I wrote a book in 2014, and I titled it Suck it In because I believe in engaging the transverse abdominus. It's been a little bit delayed. It should come out in the next month, but I have been telling people, yes, to suck it in because not only do you suck it in and improve your posture, but it also gives you that flatter stomach that you were just talking about because it holds, it runs this way. It holds your organs in. It holds everything in and it's also the deep core that works with your pelvic floor, your diaphragm to keep that trunk, that torso stable so that your arms and your legs would be stable. It's so, so important. I love it. And then when I was doing a video. What do you tell you? I tell you, as I'm approaching 50, this core is getting a little softer. You've had three kids. You've had three kids. You just need to retrain it. You need to remodel it. And you know, when you're, when you're doing your orange theory, because I know you're doing orange theory and you love it. Love it. Do you still suck it in? I do. I try. Okay. I like today, today with the 10 minute row, I was joking with the lady next to me that my fat rolls were prohibiting me from leaning forward at times. And I was struggling to breathe at times, but I managed to get through it. I think it's great. So were you squeezing your shoulder blades back too, as you wrote? At minute eight probably, in nine and 10 probably not, but I usually try to. Okay. And actually, I had went and seen this hand specialist recently. His wife was on the row or next to me. And she told me who she was and we started giggling. So, you know, we try to have fun. It's weird, just a couple of minutes left, but you had mentioned yesterday, and I wanted to touch on this for everyone too, that you really need to stretch more. You feel like you don't stretch enough, but you should do this yoga tape, but it takes so long. And as we get older, we're less motivated to do a long tape, right? And so 100% like I, and I love how I feel after I stretch, but I don't know what my problem is in motivating myself. Like I have this tape that I do. And of course that's how old I am. I'm saying tape, right? Like we, you and I talked about this. So now it's like a link or whatever. But it's like 40 minutes. And it seems like a day. How am I going to do 40 minutes worth? But I feel so good when I'm done, but getting through it is difficult for me. So one of the things that we were going to go over to when we met earlier, it's yesterday, but you were watching the game, which I would have been if I wasn't preparing for this, right? So go Yukon again. Is there's just a few exercises that we all need that we should do every day, a couple stretches, a couple strengthening exercises that can get you what you need to do. So at least you're doing that. And then when you have the time, you can do the video. So I showed a couple of those stretches today, the T stretch and the W stretch. I was making sure I didn't knock anything over. And next time we're going to show some more. So we're going to wrap it up right now. Megan, thank you so much for coming on. This was awesome, Christine. Thank you so much. You are the best. This was great. So for those of you watching, we're going to wrap up today. Thank you so much, Megan Kumo, for coming on the show to talk to us today. And we learned a couple stretches today, the T stretch and the W stretch. But stay tuned next week if we can. And we're going to be learning specific exercises from athletes of Hawaii and myself who have been surfing and body surfing for decades that are going to teach us how to keep our shoulders healthy so that we can do our sport for the rest of our lives. Thank you so much to Think Tech Hawaii, our sponsors and our donors, and Megan Kumo for coming today. Aloha, everyone. We'll see you in two weeks. And remember, life is better when you listen to your physical therapist.