Yes, I'm still here ... just been particularly slack over the last few weeks in blogging.
April 2006
I've decided to record a history of the problems I'm having with my right shoulder. Not that it's going to make for gripping reading, but I'm used to writing down these sorts of things for my own future reference.
It all started (as far as I was aware) in April 2006 when I was doing some dumbbell inclined presses at Jenkins gym. As I lowered the weights at one point my right shoulder made it known in no uncertain terms that it was not happy with the action. There was a sharp pain although I didn't hear or feel anything suggestive of a major tear in a tendon or muscle.
The pain continued for a couple of weeks in spite of laying off any presses, so I decided to have it checked out with a physiotherapist. The pain was mainly on the outer side of the upper arm but the physio quickly isolated the problem to the supraspinatus. Pain from shoulder injuries is often referred anywhere from the upper arm down to the lower forearm. He gave me some rehab exercises to do ... you know the thing ... internal, external rotations using a pretty coloured Thera-Band tied to the door knob. (A green one to add to my collection of red and purple ones.)
Two or three weeks of "rehab" didn't make things any better, in fact even using fewer than the suggested reps with quite small resistances the pain increased. We agreed there was no point in continuing with the exercises and that there was probably something more than a strain to be dealt with - possible tear and inflammation of the subacromial bursa - which cusions the supraspinatus tendon so it can slide easily over the bone.
I got referred to a sports doctor - who turned out to be an ex-pupil of mine from my earlier days of teaching Physics!
January - March 2007
Shoulder Problems
John
X-Rays and Ultrasound Scans
With the suggestion of a hydrocortisone injection into the joint to reduce the inflammation I guess the doctor might have seen this as an opportunity to get her own back on that teacher who inflicted all those horrible physics assignments on her some 20 years earlier. I had X-rays and ultrasound scans done and she gave me the injection and, to my surprise, I honestly never felt it go in!
The scans were interpreted as a tear of the suprapinatus - at least partial, but a full tear not being ruled out.
As I guess was to be expected, the injection gave some temporary relief but I still found pressing even the lightest of weights (e.g. 3kg dumbbells) were hurting on lowering the weights - and I sensed the hurt was a 'bad' rather than a 'good' hurt.
I didn't do any presses or exercises involving elbows overhead for several weeks - except for pullups, which didn't cause me any problem.
I wasn't satisfied things were improving and wanted to find out with more certainty the extent of the tear which, by my logic, needed to be established in order to determine the best option for the future; in other words - whether or not to press for surgical repair rather than nursing it in the hope a partial tear might repair itself to some extent. So, I was referred to an orthopaedic surgeon.
At the initial meeting with the surgeon he pretty much told me that an MRI scan probably wouldn't yield much more information. He advised me I could carry on with gym workouts but just being careful to avoid movements and angles that I knew would be painful.
In the last couple of weeks leading up to this time I had found that light-weight flat bench presses (40-60kg) were not causing any pain, although shoulder presses were a different matter. So, having got the 'nod' from the surgeon about continuing with exercises that caused no problem, I went back to the gym a couple of nights later and decided to have a go at some heavier flat barbell presses ... with a spotter.
Not too long ago I had no problem with sets right up to a few reps at 100kg. I did a couple of reps at 110kg without spotter help and put on another 5kg to try for 115kg - which as pretty near my limit prior to first injuring the shoulder. Just as I had fully lowered the weight a pain shot into my shoulder accompanied by a tearing sensation. I had to get John to lift the bar off by himself as I was in no state to push anything! Went straight home and iced the shoulder. I had well and truly learnt a lession. Given the relative ease of doing the 110kg presses I believe a slightly different angle of the upper arm with the heavier weight caused the injury rather than the extra 5kg.
The scans were interpreted as a tear of the suprapinatus - at least partial, but a full tear not being ruled out.
As I guess was to be expected, the injection gave some temporary relief but I still found pressing even the lightest of weights (e.g. 3kg dumbbells) were hurting on lowering the weights - and I sensed the hurt was a 'bad' rather than a 'good' hurt.
I didn't do any presses or exercises involving elbows overhead for several weeks - except for pullups, which didn't cause me any problem.
I wasn't satisfied things were improving and wanted to find out with more certainty the extent of the tear which, by my logic, needed to be established in order to determine the best option for the future; in other words - whether or not to press for surgical repair rather than nursing it in the hope a partial tear might repair itself to some extent. So, I was referred to an orthopaedic surgeon.
At the initial meeting with the surgeon he pretty much told me that an MRI scan probably wouldn't yield much more information. He advised me I could carry on with gym workouts but just being careful to avoid movements and angles that I knew would be painful.
In the last couple of weeks leading up to this time I had found that light-weight flat bench presses (40-60kg) were not causing any pain, although shoulder presses were a different matter. So, having got the 'nod' from the surgeon about continuing with exercises that caused no problem, I went back to the gym a couple of nights later and decided to have a go at some heavier flat barbell presses ... with a spotter.
Not too long ago I had no problem with sets right up to a few reps at 100kg. I did a couple of reps at 110kg without spotter help and put on another 5kg to try for 115kg - which as pretty near my limit prior to first injuring the shoulder. Just as I had fully lowered the weight a pain shot into my shoulder accompanied by a tearing sensation. I had to get John to lift the bar off by himself as I was in no state to push anything! Went straight home and iced the shoulder. I had well and truly learnt a lession. Given the relative ease of doing the 110kg presses I believe a slightly different angle of the upper arm with the heavier weight caused the injury rather than the extra 5kg.
John
Workout
Been seven days since my shoulder op.
- Treadmill: 5kph, 0%-15% incline, 20min - only 3min on 15%
- Linear Hack press: 2x12x80kg
- Seated leg press: to 12x200kg
- Horizontal calf machine: to 10x190kg
- Leg extensions: to 12x82kg
- One-armed DB power snatch: 5x26kg
John
MRI
I went back to the orthopaedic surgeon and told him what had happened and he decided to get an MRI scan and see what that would show. I had the scan on 20 September. Here's a pretty picture from the coronal section sequence:
Coronal shot of R shoulder showing worn supraspinatus:
Report indicated a complex tear of the anterior supraspinatus 15mm AP and 17mm longitudinally, having "a full thickness component".
The surgeon told me that it was something that he could fix if I chose to have it repaired. Given the limitation on overhead activity I decided to have the repair surgery, but not until after the indoor rowing events at the NZ Masters Games in Wanganui on 12-13 February.
An application was made to the ACC for elective surgery funding and some weeks went by before we were advised that this was rejected on the grounds that they considered the injury sustained in the accident in April was as the result of gradual process! Felt that was pretty unfair given the circumstances of the event in April and the second one in August.
Surgery was arranged for the week after the rowing at Wanganui.
At just before 8 a.m. Wednesday 21 February I was being given a general anaesthetic in theatre at Wakefield Hospital.
Coronal shot of R shoulder showing worn supraspinatus:
Report indicated a complex tear of the anterior supraspinatus 15mm AP and 17mm longitudinally, having "a full thickness component".
The surgeon told me that it was something that he could fix if I chose to have it repaired. Given the limitation on overhead activity I decided to have the repair surgery, but not until after the indoor rowing events at the NZ Masters Games in Wanganui on 12-13 February.
An application was made to the ACC for elective surgery funding and some weeks went by before we were advised that this was rejected on the grounds that they considered the injury sustained in the accident in April was as the result of gradual process! Felt that was pretty unfair given the circumstances of the event in April and the second one in August.
Surgery was arranged for the week after the rowing at Wanganui.
At just before 8 a.m. Wednesday 21 February I was being given a general anaesthetic in theatre at Wakefield Hospital.
John
Workout
- Seated leg press: to 2x12x200kg
- Leg extensions: 10x103kg
- Linear Hack press: 12x80kg, 10x100kg
- Horizontal calf machine: 10x160kg, 10x190kg
- L-armed DB power snatch: 10x20kg, 8x26kg, 6x30kg, 1½x34kg
John
Workout
- Treadmill: 5kph, 0% to 15% incline, 25min, 173m climbed
- Seated leg press 12x200kg
- Leg extension: to 2x6x143kg
- Horizontal calf machine: 12x170kg
- Abs crunch machine: to 40kg
- Iso pulldown machine (Left arm only): to 6x80kg
- One-armed DB power snatches: 10x20kg, 10x26kg, 8x30kg, 5x34kg
John
Workout
Treadmill:
- 5min @ 5kph, 0%
- 10min @ 5kph, 5%-15%, 30-sec increments
- 10min @5kph, 15%
- Warmdown at 5kph
John
Stitches Out: Repair Day + 13
Went to my GP to get the stitches taken out this morning. Just a single strand pulled out through the length of the wound. Kept a bandage over it until early evening then went to the gym to do some more *yawn* treadmill walking. Shoulder became a little tired during the workout so I rested my forearm on the treadmill handle for part of the time - only lightly of course, so as not to adversely affect the benefit of the exercise!
John
Wednesday Night Workout
- One-armed dumbbell power snatches: 10x28kg, 8x32kg, 6x36kg, 6x36kg
- One-armed iso pulldown machine: up to 10x80kg
- Horizontal leg curl machine: 12x32kg, 10x46kg, 8x60kg, 6x81kg, 4x88kg, 12x74kg
- Kneeling leg curl machine: 12x50kg superset
- Horizontal leg press: 12x110kg, 10x140kg, 8x180kg, 8x200kg
Probably could have gone one weight heavier with the low-rep sets of leg curls. Only just discovered the kneeling leg curl machine tonight - after using the gym for almost six months!
Started to lose focus with leg presses so couldn't be bothered dropping weight for a high-rep final set. Also had a break from the treadmill tonight - first time in five consecutive days I think.
John
Shoulder: Repair Day + 14
First day since stitches were removed. Shoulder feels a little tight sometimes. The scar tissue I think, rather than the tendon repair. On a couple of occasions I found myself forgetting to keep my arm below shoulder level. Did lots of pendulums and isometric resistance exercises thoughout the day.
John
Cardio
Tried out a stationary bike at the gym for the first time in years! 11.5km in 25min. Cadence average about 85, resistance level 13 (out of 25). Bike is a LifeFitness model 95ce.
John
Workout
- Stationary bike: 16.77km, level 13, 30min + WD
- Horizontal leg press: to 10x195kg
- Horizontal calf machine: to 10x190kg
- Iso lateral wide pulldown machine: to 6x90kg
- L-armed DB snatch: 10x28kg, 8x32kg, 4x36kg, 4x36kg
- Stationary bike: 6.29km, level 13, 10min + WD
John
Workout
6:50am cardio. Wow. That is so early for me!
- Stationary bike: 17.05km, level 14, 30min + WD
- 45° leg press: 12x120kg, 12x160kg, 10x200kg, 10x240kg
- Horizontal calf machine: 12x145kg
- Stationary bike: 14.15km, levels 14-16, 20min + WD.
John