Friday, February 1, 2013

Shoulder update

Not long after I posted last week that I was going to stick with just the chiropractor for my left shoulder problem, I changed my mind.  We have a very good non-surgical sports med doc in my region, and he has helped me with a variety of injuries over the past few years.

I explained to the nurse when I called that I hadn't had a decent night of sleep in weeks.  Normally, it can take 4-6 weeks to get an appointment with this doctor, but after I brought up the lack of sleep, they got me an appointment within a week and I saw him yesterday.

Things went very much as I expected.  X-rays first, even though I was fairly sure they would show nothing..

Then, a physical exam that pushed both arms through a range of motions and strength tests.  My strength and mobility were fine, but I did have pain on some of the movements.  The tell-tale sign was my complete failure of something called the Hawkins Test (also called the Hawkins-Kennedy test).  This indicates an impingement in the shoulder, particularly the AC joint, where my pain has been centered.  I also passed a test that is used to detect arthritic degradation in the joint, which was reassuring.

Next, the doc looked at both shoulders using an ultrasound machine.  The bursa on the injured shoulder was clearly inflamed.

He guessed that I'd done something very minor to the shoulder - something that I don't even remember.  That minor tweak essentially led to some inflammation, and after that, everything I was doing, even if it was pain free, was continuing to irritate the bursa.  When the bursa swells, there isn't enough room for the tendons to move freely, creating the impingement syndrome.  He described it as a classic case and said that cortisone is the best option.  I'm not crazy about cortisone, but it is a very powerful localized anti-inflammatory.  He injected the cortisone with some lidocaine.  He wanted to be sure that the first shot removed all the pain.  If I still had pain after the first shot, he would do a second at a slightly different location.

But, the first shot took care of the pain immediately.  As the lidocaine wore off, I felt a little soreness, but nothing bad.  Cortisone typically takes about 36 hours to do its job.  However, I slept pain-free last night for the first time in six or so weeks.  It feels like a miracle.

I had to promise no workouts at all yesterday and today.  I'm allowed to ski this weekend and I can return to lifting on Monday.

I will continue to work with the chiropractor and do a lot of foam rolling and mobility work.  I think that this will reduce the risk of injury in the future, especially when doing Olympic lifting.

Because I felt better today, I (perhaps foolishly) signed up for the CrossFit games this year.  It only costs $20 to enter.  For five consecutive weeks, you do a workout in your own gym, and record the results at the main CF web site.  For younger athletes who qualify, the next step is a regional competition in Boston before the finals in California.

For an old athlete like me, the five workouts are the qualifiers to go to CA.  Now, there is no way I will be one of those athletes going to CA.  Perhaps if they'd had  an "old, fat, beat-up ex-ultra-marathon runner category, I'd be able to qualify, but I wouldn't bet even on that.

Oh yeah, I've completely given up wheat so far this year.  As usual, I'm eating very little sugar and fruit.  I am having some white rice and potatoes for carbs after CF workouts, but not a lot of them.  Since the first of the year, I've lost about ten pounds.  I'm almost back to weight I was at when I started using testosterone, but my body composition is much improved.  I still have some body fat to lose,  but I'm hopeful that I'll get down to 90kg in time for a power lifting meet later this year.  Ultimately, I'd like to get back to about 190 pounds.  I spent most of my running career in the 168-180 pound range, but I've got more muscle mass these days, so 190 pounds should have me fairly lean, if I can get there.

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