Ben Ashworth

Hooked up with Ben Ashworth today, the poor guy I'd been stalking on twitter.

He'd agreed to take a look at my shoulders all in the name of science, as long as I was happy for anything found to be used for teaching purposes.  Which of course anyone in their right mind would agree to faced with a CV like Ben's.

Started with some history and some ROM, strength & mobility assessments. Which good for me, not so much for Ben, are all within acceptable range.

We ran through some upper body exercises I could start to integrate back into my program, things to watch for and modify to keep the shoulder in a happy place.  Eg watch the elbow travel for push/pull, don't let them pass the body in either direction.  Worked on how to find a neutral shoulder position and a brutal lat stretch.

Came away with the thought that yeah I have a shoulder problem but its manageable, I'm not a pro sportsman and its probably a bit late for me to become one, so start to ease back into a general program and be mindful of what I'm doing and importantly how I'm doing it.

Ben's approach was simple & pragmatic, don't over think things, take care of the basics.  The guy rightly has a rep to be proud of and I wouldn't hesitate to recommend him, and or seek him out again.

So a big thank you to Ben, and sorry there wasn't a great deal for you to find.

Onwards and up, no, not up, onwards and neutral!

No real change ..

Arm abduction seems better at the very top, certainly less painful than it was but arm flexion is painful in the same area. Deep ache has not returned.

Pushing the legs in the gym in an effort to get some ski fitness in them and just starting to add some shoulder exercises back in.  Very light, very few reps, just to see if there's any reaction.

Still scheduled to see the shoulder guy at the end of the month.  And interestingly I got chatting to a girl in the gym who I'd heard had shoulder surgery before Christmas.  Turns out it was in the summer and her shoulder was a wreck.  Full SLAP, rotator cuff damage etc.  Final tear happened whilst pushing the flat bar bell bench, of course it was.  The should be renamed flat barbell destroyer of shoulders.  They should be removed from all gyms unless supervised!

She's making good progress with range but poor strength.  Turns out she also visited the same shoulder guy via a family connection & spoke very highly of him.  We also swapped surgeons, my list is growing.

10 Days ...

With no ache pain.  And in the other movements the pain is really low, unless theres a set back I'd estimate 1-2 weeks and potentially pain free!

Had some stunning news today as well.  I've been stalking physio's on twitter and one recently sent a shoulder tweet out.  This resulted in conversation between us and him recommending someone for me to talk to in London.

Google was not very helpful but I contacted him anyway.  The result being he's currently working at a major sports club and has offered to see me for a session sometime in the next month or so.

And the best part, other than him being one of the foremost shoulder experts in the country, is its free, nada, zero! .. As long as I'm happy being a case study if theres anything worthy in my injuries and/or rehab.  Damn right I'm happy.

I have high hopes for this and for the first time in a long time I'm in a relatively good place.

Returned to the gym this week abut only working on fitness and lower body, good ski prep for later in the Spring and keeps my stress levels down.

Two days 'ache' free

And anyone with shoulder problems knows that deep dark ache that I mean.

Not sure if its anything I am doing. I'm wearing an Under Armour cold gear compression top to sleep in & the lacrosse ball work has released the tender points at what I think is the infraspinatus and teres minor insertion point.  Other than that its just stretching & using a heat bag a few times a day.

All other movements have the same symptoms ..

Shoulder is aching today

Was fine yesterday, felt stiff when I woke this morning.  I remember at one point waking up and I was sleeping on my left side, maybe I aggravated it o/night.  I'm pretty much trained not to now but still lapse.

Found some muscle soreness in the back of the shoulder, working it with a lacrosse ball to see if that clears it up.  The ache comes and goes in waves.

Back in the office and its cold, could be a variable.

UPDATE : Wrapped up super warm @ home and continued w/ lacrosse ball.  No pain in the evening.

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.

AWESOME !

What is a SLAP Lesion?

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.