Saturday, April 2, 2011

Shoulder Update

On Thursday, my wife and I took my daughter to see the podiatrist. She's been having some ankle issues for more than a year, and a hard kick to her ankle in soccer season last fall made things worse. She made it through basketball and skiing, but her ankle just hasn't been getting any better and lacrosse will have her in cleats in the next week or so.

We went through the results of an MRI and the podiatrist didn't think it's a big deal. She has a bone bruise that is healing slowly, and some other structural issues that can be helped by inserts. So, we were pretty optimistic about her prognosis.

The podiatrist is the dad of one of my daughter's best friends, and he and I know each other pretty well from our time in the gym. He is a real stud powerlifter, and I mentioned my shoulder issues as we were leaving. We talked about it, and he told me about a rotator cuff injury he'd had that took 8 months to heal, and he couldn't bench press the entire time. The doc I was seeing on Friday wanted him to get a cortisone shot for some continued inflammation, but he's held out so far. I asked the podiatrist if he'd be in the office on Friday, because I told him I suspected I would be getting a cortisone injection in my shoulder and they might need help holding me down.

The last two times the orthopedist has gotten close to me with a needle was for a Synvisc injection in my knee (very uncomfortable) and a PRP injection at the top of my hamstring (seriously painful). So, I expected no less for my Friday appointment.

The fact that this is the third injury I've seen the orthopedist for in 2 years should probably worry me about how old and fragile I'm becoming. But, I still like to play hard and he's keeping me out there.

When I first got there yesterday, before I'd even seen the doc, his assistant was worried about a fracture high in the humerus. So, I got some x-rays, but they showed no breaks. Next, I got to talk to the doc.

It didn't take long to confirm that the injury was in the rotator cuff, in the Supraspinatus muscle. He did some strength tests and I had a hard time pushing in certain directions without a lot of pain. So, he used an ultrasound machine to look at the muscle in more detail. He found one problem area right away, and his first suspicion was a partially torn tendon (I started thinking about another PRP injection immediately - costly and painful). But, as he looked at it more and re-considered how I'd hurt myself - a hard hit to the shoulder rather than something that stretched me beyond normal range of motion - he started to suspect that he was seeing a hematoma and inflammation.

He said there was a quick way to tell the difference and that was an injection of lidocaine. If after the injection of the painkiller, my strength was equal between the two arms, he could assume that there wasn't a tendon tear, and then he'd want to do a cortisone injection to help with the inflammation.

If my strength was not good, he said he'd still likely suggest cortisone and then possibly an MRI.

Since cortisone was likely in either case, he suggested a single injection of cortisone and lidocaine. I agreed to that. He used the ultrasound to guide the needle right to the trouble area. It seemed like the needle was in there for quite a while, but it didn't hurt too much. As soon as the injection was done, I could push against resistance in just about every direction without pain. So, my strength was good and he thinks the cortisone should have me back to normal in a few days. He told me no lifting until Monday and sent me on my way.

It's been less than 24 hours since the injection and my shoulder feels noticeably better already. I was able to put my arm in a jacket sleeve without pain this morning for the first time in a month. I'm working right now, but plan to get out for a run a little bit later this afternoon.

Hopefully, I'll be doing pain free push-ups in a few days.

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