Tuesday, November 25, 2008

The Shoulder

Most people that know me are aware that for the past year I have been dealing with a shoulder injury. But even then I do not talk about it in depth to most people. So here it is, finally all laid out in writing. The truth, the frustration, the worry and the decision, good and bad.

I will start by saying that this is the first time that I have had to modify my exercise to accommodate an injury for any length of time. Last year I over trained and messed up my calves but within a few week the Physical Therapist had me back to normal. Now I have been dealing with this shoulder for a year now and it is getting really tiring having to manage around the pain.

The Problem:
I have a constant annoying discomfort in my right shoulder. there is some popping and cracking that goes on when I move it. The pain gets even worse after I swim or lift weights, it will stick around for a few days and then become that annoying discomfort again. Doctor says that it is Acromicavicular Arthrosis, or arthritis of the AC Joint, coupled with 2 labrel tears that have developed cysts. The tears are probably due to a dislocated shoulder that I had about 15 years ago and the arthritis is due to overuse (years of swimming and canoe racing).

The History:
I have never had much of a problem with my shoulder. It never effected my swimming or my weight lifting until this past year. I increased my activity in both those areas about 2 years ago and may have gotten overzealous. So all of the sudden I started getting a constant pain and one day I am doing push ups in the gym and my shoulder gives out. From that day I have been unable to fully do push ups. So I saw the doctor and he gave my the diagnosis I mentioned above. He pushed for surgery but I was not convinced because I was perfectly fine the year before how could arthritis just show up with a vengeance? Shouldn't it be a degenerative problem that develops with old age? Apparently not, says the research I have done. I scheduled the surgery anyway but was going to wait until after my season ended in October. It was set, October 5 was the Longhorn 70.3 and October 15 was the surgery. Then I ran into a Physical Therapy (PT) friend of my brothers and he convincingly talked me out of surgery for the time being and told me to see a PT. This is exactly what I did. The doctor was not convinced it would work and even seemed mad at me for not believing him. It's my body right? I can try if I want to.

The Decision:
It is now the end of November and I am done with my 30+ days with the PT. Did it help? Yes and No.

Because of the weakness in the shoulder my muscles were reacting in weird ways which was causing more pain than necessary. The PT fixed this with massage and Advanced Release Technique (miracle technique, it is what got my back on the road when I had calve problems). This put all the muscles back into alignment and worked out any scar tissue. There was immediate improvement in range of motion and strength but the pain was still there, although it was now localized over the AC Joint. You can here the doctor laughing right now!!

After a few sessions, I started on a regimen that included multi planner shoulder exercises, and techniques that were to realign the shoulder. I was even doing some of this at home!

Did I make the right decision? Yes and No. Results are still out.

The Future:
The short of it is that I am mildly disappointed in the results of physical therapy. I was hoping it would be the miracle cure. I say mild disappointment because I did learn a lot about the injury and became very self aware of what causes or does not cause pain. This lets me manage my workouts better and allows me to be in control. The injury is such a fickle thing. I took two weeks off from swimming and only did light weights during that time and still felt some discomfort then over the weekend I was putting together some bar stools and the act of screwing the legs together aggravated my shoulder to the point where I had to ice it. On Monday I was in the pool again (after two weeks off) and everything felt fine. I was able to swim a mile without any aggravation.

After all this I think that I am still leaning towards surgery but now the recovery time would take me into the Tri season (this aggravates me the most). So my plan is to deal with the injury the best I can through the season and probably get a Cortisone shot to hold me over until after the Longhorn 70.3 in 2009 then straight to surgery. Unless something great happens between now and then.

Dealing with injury is hard on any athlete, the first thing that always pops into my head is, how much time and conditioning will I lose? We work so hard to get to the physical condition were in and to give that up means slower times in the next race. There is also the physics law stating that objects in motion tend to stay in motion. Meaning that if I sit and rest for a week or more I may not be able to get myself off the couch.

Good decisions or Bad? That will have to be answered later. We'll see where it takes me over the next year.