Sunday, 29 December 2013

Lets begin .. History

Never an 'athlete' but someone who likes to work out for fun, fitness, stress relief and aesthetics.

Circa 2008 I started to get shoulder problems, left and right, both having impingement issues. Not really traceable to any trauma, possible fall on left, but both gradually built up to the point I started to see a physiotherapist.

Pain reduced with normal shoulder movement exercises, scapular control etc but not 100% and eventually led to me seeing an Orthopedic surgeon (OS). MRI showed a genetically hooked acromion, which is never going to be fixed with conservative methods, and so to the operating table.

April 2009 - Left shoulder arthroscopy, buroscapy, labral resection, slap repair & subacromial decompression.

Findings : Superolateral labral tearing of the labral lesion, healthy articular surfaces.  Partial top surface tearing of the cuff with kiss lesion present and scuffing under surface of the anterior half of the acromion and CA ligament. Healthy AC joint.

May 2009 - Right shoulder arthroscopy, buroscapy, subacromial decompression & ACJ arthroplasty.

Findings : Minor labral tearing o/wise health and minor labral fraying o/wise healthy glenohumeral joint. Anterolateral subacromial impingement syndrome, a degenerate and unstable ACJ with impingement from that as well as the acromion.

Some post surgery physio and taking things easy and eventually everything is great. Shoulders are fine, back in the gym. Still conscious of posture, rotator cuff, push v pull ratio etc. The only thing I never went back to was dips.

I was, I thought, paranoid about shoulder problems and so did everything to keep them healthy. Well maybe not enough, or maybe I just have shit shoulders.

September 2013. Start to get some niggly left shoulder pain. Nothing that I can put my finger on but doesn't feel right.

Started to back off the workouts, working the shoulder with a lacrosse ball to see if its just tightness, testing my ROM, ice packs, anti-inflammatory & rest. Prodding an poking I find that I get a sharp pain at the end range with abduction, just as your arms are about to touch your ears. Also with a normal arm across the body back of the shoulder stretch, same pain. Also getting some 'clunking' in certain movements.

I go to see the same OS who operated in '09.
  • Positive O’Briens test
  • MRI : SLAP lesion plus a posterosuperior labral tear with a para labral cysts in position and some older changes to the cuff.

Again as '09, no one incident seems to have caused this. I do OHP, have done for ever. I added barbell press and played with some muscle ups in recent months. But neither ever caused problems so the thought is this is just wear and tear as there was early evidence in '09.

We discussed surgery and rehabilitation, both discounted surgery due to lack of pain and impending vacation.

One thing I didn't get great confidence from was when I asked the question. 'Well what can I continue to do?'

Answer was don't do heavy weights, don't stress the bicep. All a bit vague for my OCD desire for details.

So I immediately hit the internet and got thoroughly freaked. The surgery is pretty simple but the rehanb is a good 12 months! I start a sports massage class in the new year so the timing of this couldn't be worse.

I read a ton of stuff, from OS who don't recommend fixing it, people over the age of 40 (me!) should not have repairs but relocate the bicep tendon, to everyone has SLAP tears get on with it. The internet is great, but also a nightmare for too much information.

But the more I read the more I realise that in SLAP tear circles I'm a 1 on a 1-10 scale of how badly this injury impacts people. Other than training its not inconveniencing me in any way so I figured I'd go away and deal with this in the NY.  

Two week holiday in the sun.  High arc pain has mostly gone. O’Briens test pain very slight. Tip of shoulder soreness gone. OK, so maybe this isn't so bad.

Back to work, and winter in London and shoulder has started to feel ‘stiff’ again and some knots/trigger points returning.  It would seem environmental factors are impacting shoulder/s, weather, job (desk/sitting) etc

So here I am back wondering what to do. Rest is obviously important and I still have good ROM and no issues with strength or sleeping. I continue to stretch, some basic band work, posture, lacrosse ball and foam roller are my new friends but I'd like to get somewhat back to working out, knowing what I can and can't do and get a good shoulder strength and mobility program in place.

Decided my next step is to contact some physiotherapists and see what PT can bring to this. Maybe the more I can do going into surgery the better the recovery, or maybe I can put this thing off for good. But I think I'm going to better 'management' advice from someone with these skills rather than a surgeon.

The plan is to use this blog to record progress, thoughts, panic moments & anything else shoulder related that crops up.

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