Coping With My Shoulder Injury

It was an early Thursday afternoon in March.  In Columbia, that means near perfect spring weather: high 60 degrees, no humidity, a few clouds in the sky.  It was a perfect day for soccer.  As was my habit, I went out for the lunch time pick up game, hopping on my new commuter bike for the 10 minute pedal to the field.  There was a chance of late afternoon thunderstorms, so I threw my rain resistant pullover into my bag and headed on my way.

***

Memory is a funny thing sometimes.  There are some soccer games I have firmly imprinted in my mind, like the one day in late December when I scored 6 goals at the lunch time game, and stuck around to play a second, late afternoon game and scored 4 more.  I remember another day last summer when I scored the perfect hat trick (right foot, left foot, header).  There are other games like this, where I scored a a goal (or goals) that I remember clearly.   You always remember the goals; especially when you score so few.

But I don’t remember anything about this particular game.  I think it was a descent number of people, maybe 7 or 8 guys a side.  I don’t think I played poorly, but I must not have scored or done anything special because I don’t remember anything about the game.  What I do remember clearly is that as we were closing in on the end of the game, some dark, ominous clouds rolled in.  I remember thinking, “Maybe I should leave now and beat the rain.”  But I didn’t.  I kept playing.

About 15 minutes later, the bottom of the sky fell out.

Having ridden my bike regularly to get around town for about a year, this was not the first time I had to ride in the rain.  It’s not fun, but it’s not the worst thing in the world.  My mentality is to just power through.  It’s only a 10 minute or so ride back home.  Deal with it.  But this storm was worse than any I had ever ridden in before.  There was hail and strong wind.  The rain was torrential.  I thought for a moment of stopping in the tunnel under Lincoln St. and seeing if it passed or let up, but I just kept going.  I kept pedaling my way home, miserable, wishing I had left earlier to beat the rain, looking forward to getting into a hot shower and warming up.  I was less than 100 feet from home when it happened.

***

I live at the bottom of a steep hill.  Outside my office window, I will occasionally see kids (and wanna be kids) zoom down the hill on their bikes and/or skateboards.  On the rare occasions we get snow in Columbia, a favorite pass time is to watch people try and go up the hill in their cars in the snow, and then slide back down.  Last year, when we had snow and ice on the ground for a week, I watched the city bus get stuck on the hill.  They finally came to salt the road on my street after they were able to tow the bus out.  I diverge here to stress that this is a very steep hill.

For me, when I start that descent down the hill, I always slow myself by applying the brakes.  I’m all for facing fears, but I also believe discretion is the better part of valor.  On this day in March, I did the same as always, and applied the brakes.

Instead of slowing down, my back wheel slide right out from under me.  I hit the pavement – hard.  I landed on my left arm, and remember sharp pain in my elbow.

My first instinct was “get up and get out of the road.”  I knew there was a car behind me and I didn’t want to get hit.  There is probably also a pride component here that you want to get up like everything is OK.  Once I got to the sidewalk, I knew it wasn’t all OK.  I feared that I had broken something.  I felt a little woozy, maybe a mild concussion (I was wearing a helmet, but I’ve seen enough of the NFL to know a helmet doesn’t protect from concussion).  I knew I must have horrible road rash from sliding down the pavement.

Once I got in the house, I gingerly took off my clothes and got in the shower.

***

I’ve only had one broken bone in my life.  In elementary school I was pushed off a small platform and landed on my elbow, chipping a bone in my arm.  It’s different when you’re a kid, but I remember it being extremely painful.  All they did was put a cast on it for 4 weeks.  Relying on that experience from 25 years ago, I began a self assessment.  I touched on my elbow, where I felt most of the pain, but it didn’t hurt appreciably more.  Neither did any other place on my arm.  I looked in the mirror, and other than a little scrape on my back and elbow, there wasn’t in the way of road rash.

After a couple of hours, the pain subsided but I couldn’t really move my arm laterally.  It was difficult to get dressed.  The next day it hurt less.  I drove to the gym instead of riding my bike, and did a leg work out on the machines.  By Tuesday, I was riding my bike again, and exercising my upper body.  There was a dull ache in my arm, and I still couldn’t raise it laterally; but I worked around it.  I did lighter dumb bell presses instead of the bench press.  I did neutral grip shoulder press.

My rule of thumb is that if an injury isn’t better after 7 days, then it’s time to figure out what’s going on.  This doesn’t mean going to the doctor, but self-research.  This means digging into The Athlete’s Book of Home Remedies.  I read every entry on shoulder injuries, looking for ways to rehab the injury myself.  However, every single entry on shoulder injuries contained this some variation of this message:  GO TO THE DOCTOR.   After another week and no progress, I bit the bullet and called the doctor.

***

Getting an appointment to see the doctor proved to be an ordeal in and of itself.  Rather than turn this entry into a diatribe on the state of medical care and insurance, let’s fast forward to almost 3 weeks later when I get to see an orthopedist.  After a few tests and viewing the MRI, he says it appears to be a torn labrum and partially torn rotator cuff.  I’m scheduled for arthroscopic surgery a week later on April 8.

Now generally speaking, I’ve been pretty healthy all my life.  Outside on the one broken bone I mentioned earlier, I’ve never had any major illness and have never had surgery.  While I was assured that this type of surgery is routine and is 99% without incident, I was still extremely nervous.  There was a guy who worked at my old job who had carpel tunnel surgery and died when the anesthesiologist made a mistake.  Anything can happen.  I was probably overly dramatic in a few of my messages to friends prior to surgery.

The day came, and I went in for surgery.  I remember going in for prep, and having the IV placed in my hand.  I remember being told they were going to put a nerve block in my shoulder, and that while they were doing so, my arm would flop up and down to make sure they had the right nerve.  I remember seeing my arm flop up and down, but not feeling anything.  I remember being rolled into the operating room, and the nurse telling me to count to 10.  I think I got to two.

I awoke in the recovery room.  The doctor came to me and started to explain what he had done, but realizing I was too groggy to process anything, he said “your labrum was torn to $&@# but you should be good now.”  Later on, after I woke up some more, the doctor returned and told me that I had a level 4 SLAP lesion and partially torn rotator cuff.  If I was any older, he would have had to cut my bicep tender, but as it was he was able to save it.  He told me it was a good thing I came in, as this would have never healed on my own.

I had some crackers and ginger ale, and then went home.

***

The surgery was on a Wednesday and the doctor told me I could go back to work on Monday, so I did just that.  In retrospect, this was a mistake.  That entire first week post surgery, I was tired and did not feel like myself at all.  I spent most afternoons sleeping.  However, I pushed through and worked and continued to train people.

During this time, I honestly felt as though I had let people down by being injured, and being out of commission.  I felt as though people were counting on me, and that I had let them down by being injured and not being able to give 100%.  I recognize that this is somewhat irrational, but this these were the feelings I had.  I know that I was still able to design effective programs for people and that they got a good workout, but I was disappointed in myself for not being able to do more during those post surgery weeks.

Worse than the physical pain was the mental and emotional anguish of not being able to do the things I wanted to do because of my injury.   Something as simple as putting your hands behind you head as you relax was something I couldn’t do.  It made me angry and frustrated.  If nothing else this helped me sympathize with older people who seem to be grumpy all the time.  No doubt when you’re in pain all the time, and can’t do with your body what your minds says you should be able to do, it makes you angry.

I spent a lot of time replaying the scene of my injury over in my mind.  I kept wishing I had left earlier, waited out the storm, not tried to go downhill, etc.  I was spending a lot of emotional injury on regret.  It wasn’t healthy, and a friend told me in essence “there really isn’t anything you could have done.  Just be glad you didn’t get hurt worse.”

***

Occupational therapy started a week later, and it was a tremendous relief.  (Although, the therapist echoed the doctor’s comments in saying “WOW!  You really messed up that shoulder!”  This didn’t make me feel too great.)  It was exciting to again be able to use my arm and to know through this physical activity I would get better.   Pushing through the pain was not an issue for me because I knew that at the other end was a return to the level of activity that I yearned to be at.

Sadly, many of the people who I saw come in did not share my zeal for healing through exercise.  I watched as many around me complained, did not push themselves, did not do the homework, or just flat out did not show up for therapy.  I know this might come across as judgmental.  That’s not my intent.  Everyone has a different pain tolerance.  Everyone’s injury was different.   But it just hurt me at my heart to see others struggling to not make progress.

For me, the occupational therapy did wonders for my mental and physical well being.  There were tough weeks and days for sure.  I remember after 4 weeks, when I was cleared to no longer wear a sling and cleared to do additional exercise, I really over did things and was in serious pain for a couple of days.   But I continued to work at getting better both in the therapy office, at home, and in the gym.    The typical time frame for therapy after an injury like this is 12 weeks.  After 8 weeks, the therapist told me there was no reason for me to come back.  This gives me a sense of pride, not because I think I’m better than anyone else, but because I know that by pushing myself, working through the pain, working through the anguish that I was able to overcome.  That I can continue to overcome.

***

I sit here now writing this a little less than 3 months from when I had the surgery, but it seems a lifetime ago.  My shoulder is still not 100%.  I still can’t externally rotate my left arm completely, which has made back squats impossible.  I’m still another 2 weeks out before I can attempt to do a bench press or a dip, per doctor’s orders.  But I continue to make the rehab exercises a part of my regular routine.  I stretch my shoulders every day, and do strengthening exercises every other day.

Despite the physical, mental, and emotional pain associated with this injury, I’ve tried to find the positives.  There are a few.  I have learned a new level of empathy for others who suffer from injuries.  I’ve learned to know my limitations – more than one friend reminded me that I’m no longer a spring chicken.  I’ve also been motivated by this ordeal to add an Orthopedic Exercise specialty to my training, not only so that I can help strengthen my own shoulder, but so that I can help others who have suffered similar orthopedic injuries to recover and get stronger.

I wrote this post for two reasons.

First, this has served as an emotional catharsis for me.  It’s been freeing to relive this event, as recent as it was.  It’s nice to remember that as slow as things still seem to be going in my rehab, I’ve truly come a long way and that I WILL get better.  As traumatic as this injury has been for me personally, I’ve learned some valuable life lessons that I hope will make me a better person and will better enable me to help others.

Second, my sincere hope is that someone out there who has had a injury like this, and is struggling with rehab, or the same emotions I did will read this story and see the light at the end of the tunnel.   I don’t think I’m alone in saying that I tend to be short sighted.  When it comes to some things, I tend to focus on the here and now.  But there is a long view.  If you are suffering from this type of injury, challenge, rough patch in life – whatever –  I say this to you: trust the process, put in the work, and keep pushing.  It will get better.

“In three words I can sum up everything I’ve learned about life: it goes on” – Robert Frost