Tuesday, September 2, 2014

Burdens to (My) Shoulder

In early July, I left a karate class with a slightly sore shoulder. I had been something of a crash test dummy that day in the demonstration of a certain technique (knife defense number 5, to be precise). Said technique involved my right forearm being somewhat immobilized as I fell backwards around to the right with my shoulder acting as something of a pivot point. That's a lousy description, I know, so let's just say that my right shoulder got more of a workout than it usually does. The next day was push-up day at SEAL Team Physical Training, meaning we did 200 push-ups in the course of an hour workout. Everything felt fine during the workout, but my right shoulder remained a bit sore after, a bit more sore than it had been before the workout. The day after that, I again did the full workout including push-ups. Again, everything felt fine as I was doing the exercises, but the shoulder soreness after had increased noticeably.

After workout the next day, I asked a retired orthopedist for a parking lot consult on my shoulder soreness. He had me press against his hands in various directions and had me move it in various directions to the point of pain. He said it seemed like something called impingement. He didn't think it was a rotator cuff problem given the strength I showed pressing against his hands. He said to rest it and if it wasn't better in a week or two, to have it checked further.

As it turned out, I was seeing my own doctor the following week for the old annual physical. By then, my right shoulder was sore all the time with random stabs of sharp pain as something "popped" or seemed to move inside it. My doctor did pretty much the same things the other doctor had done and said I should get an appointment in the sports medicine clinic. She also said it didn't seem to be a rotator cuff issue given my strength. Have you guessed where this is heading yet?

I was lucky enough to get an appointment in sports medicine two days later, at which I saw a physician's assistant and had x-rays done. Nothing looked amiss on those. After pretty much the same exam I'd had twice already, the PA said she didn't think it was a rotator cuff issue but the bursa or a tendon might be inflamed. She gave me a cortisone shot into the bursa and told me that if things didn't feel better in several days to check back about having a cortisone injection done into the joint itself, using imaging to ensure the cortisone went into the proper place.

The first cortisone injection had no effect, and neither did the second one. Several days of doing a series of physical-therapy-like exercises actually made the shoulder feel worse. The next step was an MRI, the results of which showed--you guessed it--that my right rotator cuff is torn. Well, two of the four tendons that make up the rotator cuff are torn about 80 percent through in a tear that is almost an inch long. My labrum is also torn, but I have no idea what the labrum does. What I do know is that it aches more every day and the popping-stabby thing is happening a bit more often. There's a bit of soreness in the shoulder even when it is totally at rest.

So, I'm seeing an orthopedic surgeon this week with the very real possibility that sometime after that I'll be having shoulder surgery that will limit just what I can do for a while. I know three martial arts instructors who have had this surgery, two of them in the past year. I'm probably looking at four to six weeks in a sling with limited movement. Getting back to what passes for normal may take six months. I must not skimp on the physical therapy or take on new things too quickly. As inconvenient as that sounds, I just want to get rid of the pain. It is surprising what movements of one's body are reflected in the shoulders. I can't reach up--or down--without pain.

I obviously have no idea whether the surgeon will suggest fixing it right away or later down the road. Personally, I'd like to start on the fixing and recovery process as soon as possible. Pain is quite tiring. The husband was planning to go to a meeting in Philadelphia next week, meaning there is no way I could have surgery that soon. Instead, I'm going with him so that we get some "couple" time before anything happens.

In the meantime, I think sticking with walking or stationary cycling is the limit. I made it through about 15 minutes of this morning's workout before I stopped and just walked for the rest of the hour. Every little thing was making the ache worse. Walking, I was almost able to keep the shoulder from moving at all, which kept the pain down to a reasonable level.

Stay tuned for details, though if I forget to post an update before any surgery, well, it will be a short update, typed with the fingers on my left hand. Expect typos.