Friday, March 1, 2013

Three CrossFit Workouts and a Shoulder Update

CrossFit this week has been kind of funny.  On Monday, our strength work was heavy squats.  After skiing all weekend, and skiing pretty hard, I had low expectations.  And then, I had a really good workout, and I hit 315# for my back squat in my fifth working set.

Last fall, I did 365#, but I haven't squatted over 300# since then, so the ease with which the 315 moved was surprising.  I followed that up with a good metabolic workout.

Tuesday night, I started out OK.  Instead of squat snatches, I opted for power cleans to take it easy on my shoulder.  Those were done at a light weight with no problems at all.  After that, though, during our metabolic work, which involved 4x10 reps of 245# deadlifts, I was beat and disappointed.

Great workout on Monday after skiing hard all weekend.  Poor workout on Tuesday after a great workout on Monday.  And then Wednesday, I was really happy with my workout - a ladder of power cleans and pull-ups 1 power clean, 3 pull-ups, 2 and 6, 3 and 9, 4 and 12, 5 and 15 plus one more power clean in my 8 minutes.

I'd preceded that workout with 6x8 dumbbell bench presses at a moderate weight.

I saw the sports orthopedist for my wonky shoulder again yesterday.  One of the first things we looked at was an older x-ray that showed the acromion bone in the shoulder.  This bone can take on a variety of shapes from flat (known as type 1, to curved (type 2) to hooked (type 3).  Of people who end up having rotator cuff surgery at all, only about 5% have a type 1 acromion.   And over half of those who have surgery have a type 3.  Essentially, a type 3 acromion means you should either have it fixed by surgery where the bone is filed down, or you should never lift overhead.  Mine is between type 1 and type 2, so I should expect to be able to lift overhead.

Next, the doc performed some functional tests.  He did find one direction in which my left shoulder was not as strong as the right.  This led to some further tests and finally the ultrasound machine.  He was very happy to see that the bursa that had received the cortisone injection a month ago was no longer swollen and seemed happy.  He said that explained why my shoulder pain has been different that what it was before.  He also said it was probably due to the fact that I've stopped doing overhead lifts in the past few weeks.

But, he then needed to find out what was really going on, if the bursa was fine.  He looked first at the supraspinatus and it looked solid.  But, the infraspinatus tendon didn't look as good.  So, he now suspects that I somehow partially tore or frayed that tendon, and that tendon in turn inflamed the bursa.  He said he also saw minor arthritic changes in two joints, including the AC joint, but he does not believe those are related to my current issues.

The doctor indicated that the infraspinatus is a good candidate for a Platelet Rich Plasma (POR) treatment, but it's something to consider down the road.

So, here is his plan for me:

Stop all overhead lifts for a while, although pull-ups are OK - just no pressing.  Do lots of DB bench presses and push-ups in various formats.  Continue the rest of what I do to stay in shape.  Add some specific rehab exercises for the next 6 weeks.  Continue to work with the chiropractor on Active Release and Graston techniques to work on overall back and shoulder health.  This includes lots of foam rolling, stretching, and weekly treatments by the chiro.  Return to the doc is six weeks for a check-up.  If things are much better, continue on my own.  If not, continue and come back in six more weeks.  At that point, we would consider a PRP treatment for the shoulder.

Hopefully, within less than 12 weeks, I will have my shoulder back to nearly 100%, and we won't even be considering the expensive PRP treatment.  But, it worked well for a torn hamstring tendon for me, so it remains an option.

Oh yeah, I had to take a rest day yesterday and today.  I did sleep much better last night, although the shoulder is a bit sore from the injection today.

No comments: