The Infirmary

[L33SH]

Great success, hopefully it continues to improve.

yep, she has given me lots of strengthening exercises to do and said I could try bench again in a few weeks!!!

[-FIGJAM-]

good news for you!!

[L33SH]

good news for you!!

yes I cant wait

[rev210]

Hahaha awwwww Dan!

If it helps I'm feeling the exact way about my shoulder blade atm

The thought of slicing it open is actually relieving to me lol

However, since my last physio visit on Friday (this physio was a hundred times better) it's actually feeling better than it's ever been. She said she hasn't come across someone so stiff in the thoracic spine before She loosened me up and manipulated me. I had an intense migraine for 2 days but feeling a lot better today; just constant cracking.

Thorasic spine mobility v important.

This wisdom makes for bullet proof lifts

[Birds]

So an update on my shoulder shit!

I consulted an orthopaedic surgeon about my shoulder issues, who had me get another ultrasound and saw nothing out of the ordinary (I really wish someone would just spot something immediately obvious about my shoulder so we knew exactly where it was coming from!) besides some slightly inflamed tissue beneath the acromioclavicular joint. Rotator cuff looked healthy and my external / internal rotation is fine. I asked him if he thought we should do an MRI. His answer was that an MRI can be a bit like casting a net out into the ocean: it will show a bunch of potential irregularities that may not be the source of the issue and therefore of little use in this particular case.

His suggestion, based on his/my/physio's opinion that the acromioclavicular joint could be the source of the pain/inflammation, was an ultrasound guided cortisone injection to be used A. as a diagnostic tool and B. as a potential fix. The theory goes, that if we can locate the source of pain by stopping inflammation, then we at least have a narrowed down place to look for surgical options...unless the cortisone itself fixes the issue altogether.

If you haven't had a cortisone injection before, it's a rather weird experience. Long needle goes into shoulder, they wiggle it around inside you until they find the sweet spot, then inject a shitload of liquid into a space that doesn't exist, feeling like they're blowing a balloon up inside you. No real pain, just a lot of pressure. Though I'd just had a wisdom tooth out and that gave pain a new meaning, so perhaps comparably it was nothing. Straight after injection I go back upstairs to the surgeon, who tests my shoulder mobility and strength.

Got told to give the cortisone a couple of days to do it's thing and then try exercises that would normally inflame the shoulder; obviously nothing horribly strenuous, but enough to activate the joints and muscles for what would normally cause inflammation.

So I gave bench press a go and, that night, no real pain or inflammation. The next day also went quite well. Cortisone is obviously doing it's job of staving off inflammation, but I guess my concern now is if the drug is masking the underlying issue at hand that would otherwise be inflaming tissue...given it is the body's natural response to injury. I worry that I may develop bone spurs or something because I have no real telltale, besides regular ultrasound and tests for mobility, that I may be damaging the shoulder. I am, however, consoled that nothing is strikingly obvious to the GP/physio/surgeon who have all seen an ultrasound of the shoulder, therefore I haven't done anything major yet in terms of damage and movement remains quite healthy.

Have retained 90% of my bench strength, with 90kg for 6 reps, which isn't bad considering I've done no shoulder exercise for 6 months. Could push harder, but honestly I'm just glad to be exercising shoulders and chest again. Also gave my favourite shoulder press a go just to test the movement and everything checked out on a light weight. Will continue with it as I see fit and able.

[Birds]

Also, just a refresher: I believe this injury developed from going too hard too soon on the heavy bag when I took up boxing, as prior to doing this I have never had a shoulder injury in the 10 years I had been exercising. I was putting all my weight behind my right crosses and practising hooks with little in the way of tuition. Combine this with my routine of working shoulders heavily 4 times a week, and it's no surprise I developed a clicking in the right shoulder that didn't get worse but also didn't get better.

Then one day a warm up on incline press gave me a nasty pop followed by severe inflammation of the supraspinatus. I slowly regained mobility in the shoulder over a few weeks, however I retained some slight chronic pain in the shoulder that would be worsened with upper body movements at the gym, particularly shoulder exercises. Many physio visits, specialist consultations and finally cortisone...and here we are.

Moral of the story kids: take care of your farking shoulders. They are weak joints with strong muscles so they really need all the support and proper training you can give them. Don't skimp on supporting muscle exercises and for God's sake, if something seems out of place or hurts a little bit, don't exercise on it!!!

[No Crust Racing]

This is good news Birds!

Coming back after 6mths with over body weight for reps is great.

As for me, I'm convinced my leg issue is actually a lower back issue, like right down low above my butt crack.

I've been paying close attention while doing the work the Physio asked for and I'm really noticing some tightness and discomfort in there.

[No Crust Racing]

I should say related rather, may not be the cause but definitely related.

[No Crust Racing]

Saw a chrio today. Copy/paste from my thread for anyone else.

She took xrays to examine and said I had a functional leg length difference (only notable when not standing/loaded up) which implies soft tissue discrepancies - no surprises there. Also my pelvis is tilted forward, putting pressure on the lower disc(s) which she feels may be impinging the nerve, she also showed me that the second lower disc when looking from the front is not sitting even, so there are other imbalances in my pelvis. Also noted that my bad foot wants to rotate outwards and roll inwards, which could be a cause or a symptom of pelvis issues.

She made some "adjustments" on some special contraption of a table but I didn't feel much going on. The table raises up in sections then she pushes down and the table drops down and resets.

Keep stretching, keep walking, jogging if I want and can tolerate, no weights for now (as in squats/DL), do light core work, planking etc.

Going back in a week to see if there's any difference, if not she concurred with my plan of attack of seeing a podiatrist next.

[rev210]

that foot situation contributes to sciatic nerve problems for sure. Podiatrist will sort it. Possibly you had it comming with the running you used to do. If you need orthodics and run without them , the forces do their nasty work over time.

[No Crust Racing]

Interesting in that the bad nerve side is not the busted foot side.

[Birds]

How's all your shit going, Dan?

I decided to visit a well recommended osteopath/physio, to get an all over body check and a fourth professional opinion on my shoulder issues.

This guy was probably the most knowledgeable sounding of the professionals I had seen (including my GP, my physio, and a well regarded orthopedic surgeon). Whilst his opinion largely sat in line with a lot of what the previous guys had said, he was by far the best at explaining it all to me. It was also good to get another opinion on the matter, as you can never have too many people tell you that you're safe to keep training. His opinion was as follows:

I have good mobility all round. Good posture and spinal curve. He sees no reason for me to have regular treatment from anyone, even a masseuse. This is, however, atypical of the osteopathic belief system that the body can heal itself of many ailments on its own and shouldn't depend on regular treatment from others unless significant injury or pain.

I told him about my clicky joints, e.g. hips, knees, shoulders etc. He said "It's completely normal, as long as there is no pain, some people are just built like this and it often comes with age and general wear and tear". Clicky-joint-syndrome, for lack of a better term. He explained a lot of them as tendons simply hopping over bone, which isn't an issue, provided that there is no pain from it. As for the shoulder, he believes that to be a subluxation (slight and regular dislocation of a joint) of the rotator cuff. He says there's nothing I can do about it, besides strengthening the supporting muscles and taking care with my technique; that I should just live with the muscle inflammation I get from it and dose up on nurofen/ice when it gets bad. We can't do surgery, cause we can't pinpoint where the issue is and it's not enough of an issue to warrant it, as he is satisfied with my shoulder mobility and strength. He didn't see the need for regular ultrasounds to monitor the area either (though I may still do this every few months).

An interesting opinion he had on lack of flexibility (in fingers, for example), was that it can be a good thing for what I'm doing (weight training). He said it gives the body a degree of firmness and rigidity that actually protects it from injury. Anyone agree/disagree with this? I hadn't thought of it before and always thought "more ROM/mobility the better", but with the way he explained it, it kind of made sense not to be overly flexible.

[Birds]

So yeah, that was good to get another all clear from a professional. Though in some ways I want nothing more than a professional to look at my scans or shoulder and say "there's your problem" / know exactly what is up. Looks like I just have to keep everything up until something is actually obviously wrong, cause people just keep turning me away lol

This latest dude was very good at explaining how joints work though, which gave me lots of confidence in his opinion, unlike the others (even if they all shared much the same opinion).

Following this, I'm now at a 112.5kg bench - only 5kg off my old pb pre-injury - so any luck I will see a new pb soon and this shoulder shit can be nothing more than...a slight pain in the bum (shoulder). Hah, and I thought you were Tom Clancy, Dan...

[No Crust Racing]

Slowly, physio says my back is feeling looser to him, a good thing, but because I'm using it so heavily lately with house projects etc it's hard to tell.

I'd say the frequency of which I get the sharp debilitating stab has lessened somewhat.

My glute medius strength has substantially improved through the band work he asked me to do which will help stabilise my pelvis.

I'm seeing him again tomorrow so I'll have another update then.

In the meantime I've just being doing regular bench, chins, dips and some calf raises and lunges to keep everything moving. Plus all the house project work.

[r31slpr]

Good to hear your doing a bit better dan.

Birds, I think your physio would have been talking about hypermobility, I'm not going to explain it, google is good for that.

I am borderline in some of my joints, but it can be a good or bad thing, its protected me from some injuries but caused a few as well.

For what its worth I agree with what your physio told you about lack of flexibility and strength training has definitely helped me with the joints that are affected by it.

[No Crust Racing]

Nothing really to report back, he said it continues to feel slightly better to him but it will be hard for me to tell as I continue to inflame it with various house projects.

Continue on as before.

I might try and take a little break over xmas from gym and projects and rest it.

[No Crust Racing]

Got my MRI back, looks like I've got a protrusion on the disc, is that called a herniated disc or is that something different?

Physio said we can work on "managing" it through core strength and wants me to get stuck in straight away while I decide if I want to go that route longer term or opt for surgery. He said there are some good conservative surgeons he knows in Melbourne who will do a microdisectomy (I think that's what it was called) and cut that 5mm protrusion off and sew me back up.

He said I'm the perfect candidate for it and should see immediate relief as the rest of my back is in good health. He also said he rarely recommends surgery and only suggests it if he thinks it will have a extremely positive outcome.

That said he's happy for me to work on managing it for the moment.

I'm assuming I did this that time I was squatting and something went pop and I was in bad pain, but I got over that eventually with rest and stretching. I realise it's not the disc that causes the pain, but the impingement on the nerve.

I've read a bit that said stop all exercise other than walking and it will heal slowly, but he said protrusions do not heal and that the upper body work I'm doing at the moment, flat and incline, chins and dips, will have no impact on it.

I think I have the prolapse in this image.

Thoughts?

Edited January 15, 2014 by ActionDan

[L33SH]

If it was me I would definitely go the surgery path

[r31slpr]

They way I read that sounds like protrusion is pressing on a nerve.

Sounds painful, hope you get it sorted soon.

[No Crust Racing]

That's correct on both accounts

My query is more for anyone who's been there and whether they managed to work around/through it/fix it etc or if surgery was really the best option.