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wshaffer

September 2021

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So, having "graduated" from physical therapy, I've now got the job of managing my shoulder recovery on my own. I've learned two things recently:

1) Some days I wake up with a very stiff and sore arm. (The locus of the most pain has actually shifted from my shoulder to just above my elbow where the biceps tendon inserts. My physical therapist told me that this is normal.) Doing 30 to 40 minutes of upper body exercises (lat pulldowns, push ups, bicep curls, triceps extensions, and horizontal rows) does wonders for loosening everything up and reducing the pain. The trick is getting through the first 10 minutes without either sitting down on the weight room floor and crying, or going and doing some leg exercises that don't *hurt*.

2) I can do YTWL's again! YTWL's are one of the best exercises I know for strengthening the rotator cuff muscles. I've tried doing them at various points during my recovery from this injury, and have always found either that the movements were too excruciatingly painful or that my range of motion was too limited to make the exercise seem worth doing. I tried a couple of sets this morning after the aforementioned 40 minutes of upper body exercises, and it was manageable.

Progress sometimes seems frustratingly slow, but there is progress.

Progress!

Nov. 15th, 2013 10:39 am
wshaffer: (Default)
So, today at my PT appointment, we measured my range of motion and compared the numbers with what they'd been on my first visit:
lifting arm straight up in front of me: range of motion increased from 130 degrees to 160 degrees
lifting arm straight up to the side: range of motion increased from 110 degrees to 160 degrees
holding elbow at side and rotating lower arm outward: range of motion increased from 30 degrees to 60 degrees
My PT doesn't record a numerical value for the "reaching up to scratch between your shoulderblades" motion, but he considers me now able to reach my "mid-back" rather than just "lower back".

I've still got some way to go, but that's a very nice rate of improvement!

As my reward, I get a new batch of exercises to add to the ones I'm already doing. Wheeee!

(no subject)

Nov. 8th, 2013 09:51 am
wshaffer: (not-helpful)
So, having gone over my MRI results now with one doctor and two physical therapists, I now understand that while I do have a small rotator cuff tear, it's not really the problem. The problem is the inflammation that my doctor talked about, more properly known as "adhesive capsulitis" or, colloquially, "frozen shoulder". Which might be the result of the rotator cuff tear, or the cause of the rotator cuff tear.

One of the things that I've found funny is that both of the physical therapists I've seen have gone out of their way to tell me how awesome it is that I've started treatment this early. Having read this article, I now understand why: by getting a cortisone shot and starting physical therapy early, I might have cut my recovery time down to months instead of years.

I'm trying very hard to look on the bright side of all of this. I think I'm mostly succeeding.
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Ow!

Jan. 25th, 2013 10:17 pm
wshaffer: (Default)
So, when it comes to climbing, my toes have always been my Achilles heel* (er, so to speak). I tend not to point my toes properly and put too much weight on the ball of my foot, which means that by the end of a climbing session, the base of my big toe is sore.

I had hopes that getting my own pair of climbing shoes (rather than the rental ones I've been using) would remedy this. And it sort of did. My new shoes squish the toes together a bit and really force the foot into proper alignment. The ball of my foot didn't hurt at all as I climbed tonight. However, my toes, not used to bearing the brunt of all my climbing, were in a lot of pain - enough so that that was basically the limiting factor in my climbs. I'd come down off a wall when I couldn't bear the thought of putting weight on my feet anymore.

Now that I'm home and back in normal shoes, my feet feel fine. I think it's just a combination of my needing to break in the shoes, and my feet needing to adjust to the demands of this different mode of climbing. I'll give it some more sessions to adjust, and if it doesn't get better, I'll go to Planet Granite's shop and ask them to help me find some non-painful shoes.

* Well, apart from my other Achilles heels like poor flexibility, lack of upper body strength, and a mild fear of heights. Yet, somehow, I love this sport.
On Saturday morning, I ran in the Willow Glen 5K, the first race I've really run since running the Willow Glen 5K a year ago. I wasn't expecting to do particularly well - for the past month or two, my running training has been interrupted both by travel and muscle soreness from lifting.

In addition, I had to contend with sore feet from climbing on Friday. Ah, the joys of being a multi-sport "athlete". ;)

So, I walked a couple of sections of the course, and ended up finishing a couple of minutes slower than my time from last year. But, I finished. And I had no hip pain! Take that, trochanteric bursitis!

Now I need to pick my next race to train for!
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So, I realized that I've been (not entirely consciously) holding off on doing another fitness report until a) I could get my body fat percentage measured again, and b) I could announce that my stupid bursitis was ALL GONE.

Well, a) was just a matter of waiting for the next convenient date when the folks with the tank were at my workplace. B) is a more vexed question. As far as I can tell, the actual inflammation of the bursa is long since healed, but I'm still prone to getting a slight ache in my left hamstring and/or tensor fascia lata if I overdo it. Determining what constitutes overdoing it is a process of trial and error, because I seldom feel pain while actually exercising. The overall trend is towards less pain and faster recovery when I do get pain, so I'm hopeful that some time in the not too distant future I can call this injury a thing of the past.

What I'm doing )
My goals )
My progress )
Gina Kolata has one of her characteristically delightfully skeptical articles on advice about running form in today's New York Times. My favorite bit:

When the researchers tried to figure out how to prevent the injuries, they learned that the only thing associated with running injuries was, in fact, running. The more people ran, the more likely it was that they would become injured.


Shoot. How could I have overlooked this foolproof method for preventing running injury?

However, Pete Larson of Runblogger has a good post pointing out that while the plural of anecdote is not data, scientific studies of running injuries have limitations, too: they're averaging over very diverse populations of runners, and not necessarily examining all the possible variables.

In terms of my own anecdotal injury experience, since reading that article on hip abductor pain that I linked to last Friday, I've been doing 2-3 sets of either lateral band walks (link to video here: http://youtu.be/ZdJ5l5Km3B8), fire hydrants (link to video here: http://youtu.be/1Cb8thnh2WU), or lateral leg raises (video here: http://youtu.be/LW_yy8KRi2s) each day. (Cranking Sir Mix-a-lot on your iPod while doing these is optional, but recommended.) It actually seems to be helping - I did a 2.5 mile run/walk on Sunday, and another today, and have experienced no hamstring pain and only slight soreness in the TFL. (Both gluteus medius muscles are sore, but in a "you worked us out" kind of way. Though I might switch to doing the exercises every other day just to make sure they get enough recovery time.)

5 days is not really enough time to build significant muscular strength, so what I'm observing is almost certainly due to either a) increased neuromuscular activation, b) the placebo effect, or c) stuff just getting better on its own. Still, it's motivation enough to keep going.

Linky stuff

Nov. 10th, 2011 02:52 pm
wshaffer: (voyage)
I have a couple of posts of actual substance fighting their way to the top of the mental queue, but they'll probably take a while to get there. So, have a few brief notes and links instead:

While I have to admit that the geek in me loves the idea of the music genome project, Last.fm has recently been kicking Pandora's butt at actually introducing me to new music that I like. Because Last.fm has so much more music available on it. Although this is forcing me to confront the fact that there are an alarming number of German Sisters of Mercy clones, and that I kind of love them all. Sometimes it ain't about originality.

Somebody at snorgtees is determined to put increased pressure on my already overflowing t-shirt drawer. Do I want the I heart heart Gallifrey shirt? Or the Knock Knock shirt?

This article describes what's been going on with my left hip far better than anything else I've come across in my internet researches. Trochanteric bursitis? Check. Tight tensor fascia lata? Check. Sore gluteus medius? Check. I think it would be smart to add a few gluteus medius specific exercises to my routine for the next few weeks. (And to train myself to stop crossing my left leg over my right knee when I sit.) And if I do end up having to go back to the orthopedist, I'll show him this article and see what he thinks of it. (To his credit, when I saw him last, he did do the standard test for gluteus medius weakness, which is to see if you can hold your pelvis level while standing on one foot with the knee slightly bent. My guess is that I'm kind of a borderline case - strong enough to pass the test, but not quite strong enough to hold up to a long running session.)

Fit and Feminist has a lovely post on runner Lauren Fleshman, posted just after I stumbled across this Nike ad featuring Fleshman. I sort of love the line, "I'm not a small pink version of a man. Don't give me small pink versions of a man's running shoe." Even though I'm not entirely sure what it means. (I've been giving some serious thought to buying myself some men's running shoes, because so many women's running shoes don't come in wide sizes. I've read articles claiming that women's feet are different from men's, and that women's running shoes are designed to take into account these important differences. I am somewhat skeptical.)
Trying to explain the World Fantasy Convention to my personal trainer, a man who by his own admission seldom reads books, was...interesting.

I should have been pleased that I managed to get in two decent strength training workouts while traveling last week (especially since I did one of them without access to a gym and using only resistance bands and bodyweight exercises), but I was quite frustrated because I was having a mild recurrence of the knee pain that I used to have before I started running. Said knee pain makes squatting to any reasonable depth painful; Squats are a key part of my strategy to improve my hip strength and mobility so that I can run without hip pain; running fixes my knee pain. You see the Catch-22 here?

I ended up substituting weighted step-ups for the squats, which seemed to help my knees a bit. Yesterday, I very cautiously went for a short run. Today I could squat to full depth without knee pain. My left hip feels...not sore, but a bit tight, as if everything there is not quite back at 100%. I'm hoping that for now I can get away with a short run once or twice a week to keep my knees in shape while my hip finishes healing. Or if that doesn't work, maybe I can do a few sessions of vigorous stair-climbing.

It is possible that if I strengthen my hip and thigh muscles sufficiently, I'll be able to have pain-free knees without giving them a good high-impact pounding regularly. For now, I'm pleased, but baffled, that a good high-impact pounding seems to work so quickly and reliably.
Due to getting caught up in work yesterday morning and having to hustle off to the gym, I didn't drink my usual whey protein shake before heading off to my workout with my personal trainer. I'm only mildly sore today, so notwithstanding my previous data on the subject, it appears that now that I'm reasonably well acclimated to strength training, the extra protein isn't critical for preventing muscle soreness. (Of course, it's always possible that I'd be even less sore if I'd consumed the whey protein. It's a problem when you use yourself as a clinical trial of one - no controls.)

Whey protein is still very handy as something that I can eat shortly before an intense workout without being in danger of it making me sick. But it's nice to know that if I miss it once in a while, it's not catastrophic.

On the downside, something that I did in my workout yesterday irritated my left hip a bit. It would be a hell of a lot easier to follow my doctor's advice of "Exercise as much as you can, but don't do anything that causes pain," if I didn't have to wait 18 hours to know that at least one of the 6-10 exercises I did was apparently a bad idea.
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Went for a short run yesterday morning. Felt a bit sore afterwards. Bah. Had my follow up appointment with the orthopedist today.

He poked and prodded me and had me move my hip in every possible direction. If my case is unusual at all, it's in that most of my pain is now in my butt and in the muscles at the top of the front of my thigh. This is slightly atypical for bursitis, but I don't have any of the other symptoms that would indicate torn cartilage, or sciatica, or another exciting nerve disorder that I've forgotten the name of. He did say that if I continue to have pain in my butt, I should come back in a couple of months and he'll do an MRI to make sure I haven't torn a gluteus muscle, but neither of us thinks that very likely. (If I'd torn a muscle, it ought to be giving me hell when weightlifting.)

Otherwise, I just have to be patient, keep my running mileage low for a while longer, and keep weight lifting and cross training as much as I can.

I'm thinking that maybe I'll devote the month of October to seriously working on my performance on the rowing machine. As much as it sucks to not be running, what I think I miss the most is having a clear plan for what I'm going to do on the days I've allotted for aerobic exercise, and having a set of well-defined fitness goals that I'm progressing towards.
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I did a really interesting exercise with my trainer in today's session: basically, we did step ups, but rather than doing them for strength (slow, controlled step up and down), we did them for power/speed (pop up and back down as fast as you can). I already knew that my left leg was weaker than my right, but when the exercise is done this way, the difference is striking: not only do I generate less power with my left leg, and tire faster, but my balance is noticeably worse. (Like, "How do I not tip over when I got up stairs?" worse.)

I don't know whether this weakness is the cause or an effect of my recent hip injury, but it's something I'm clearly going to want to correct. Fortunately, I can do step ups anywhere there are stairs, so it ought not to be too hard to work more of them into my routine. (I've been trying to do more glute and hip flexor exercises to help with the hip bursitis, and they all involve getting down on the floor and doing things that look either undignified or obscene. I have a hard time doing them where other people might see me.)

On a more triumphant note, I overhead pressed 18 pounds today. That may not seem like a lot, but I can remember a not-too-distant time when overhead pressing 10 pounds was a struggle.
...or perhaps hipfully pained.

About a month ago, I went for a run, and afterwards my left hip and thigh were sore. I took a week or so off from running, went for a short run, felt fine during then run, and then later - pain in the hip again. Iced it, foam rolled it, took a week off from running, felt fine, went for a short run, ow. Repeat for a few weeks until I decided that I was clearly incompetent at self-diagnosis and treatment, and made an appointment with an orthopedist specializing in sports medicine.

So, the doctor poked and prodded at my hip while he had me sit, stand, and lie down with my leg in various positions. Apparently the fact that the pain was all on the outside of the hip rather than in the groin was very encouraging. He took a couple of hip x-rays, which were normal. (Thus relieving me of my not-very-probable fear that I'd somehow given myself a pelvic stress fracture and that my hips were going to crumble. And my other not-very-probable fear that he'd tell me I had osteoarthritis of the hip and would have to stop running. And my other other not-very-probable fear that he'd tell me I had some kind of weird congenital hip malformation that had somehow never been previously diagnosed and that I would have to stop running. Yes, folks, I lie awake at night worrying that mean people will make me stop running. How did this happen?)

Turns out that I have something called trochanteric bursitis. ("Trochanteric" is a word so bizarre that even autocorrect can't mess with it.) Basically, there are little fluid-filled sacks in your joints called bursae, and the one in my hip is inflamed and rubbing on my hip bone. The doctor gave me a cortisone shot, a prescription for anti-inflammatories, and advised me to lay off running for a few weeks but to feel free to do any other form of physical activity that doesn't cause pain. And to stretch my hamstrings.

So, this kind of hoses my plans to run a 10K in September, but the long term prognosis is good. ("I hardly ever have to do surgery on people like you!" the doctor told me cheerfully.)
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DOMS of Doom!

May. 22nd, 2011 05:35 pm
wshaffer: (not-helpful)
So, what I said on Friday about my quadriceps seceding? Yeah, totally. Yesterday, both getting up from a seated position and getting into a seated position were sufficiently painful that it usually took a couple of attempts to do either. I spent some of my relatively immobile time reading review articles like this one and this one to see what the latest in medical science has to say about the treatment of Delayed Onset Muscle Soreness (DOMS), which is the official medical term for why your muscles decide to hate you after you do exercise that they're not used to.

Alas, modern medical science mostly says, "Suck it up, cupcake!" Light exercise of the affected muscles provides temporary relief, but doing it is no picnic. Non-steroidal anti-inflammatory drugs have been shown in some studies to provide relief, and in some studies not, and in some studies have been shown to delay healing. However, the good news is that in a worst case scenario, I should be pain-free within 96 hours after exercise, which means that I'll get at least a day of being able to get out of a chair like an able-bodied person before I go weight train again on Wednesday. (Don't worry! The post-exercise soreness for my second session will be much less bad - I've already trashed all of my weakest muscle fibers!)

There was a period yesterday during which I spent quite a lot of time contemplating whether I wanted a glass of water badly enough to endure the pain of standing up and walking to the kitchen to get it. This must be what people mean when they talk about a physical disability being mentally exhausting - it's bad enough that you can't just do what you want to do, but having to go through the whole, "Well, the water will be good for me. On the other hand, maybe I should just wait until I have some other reason to get up and then I can accomplish two things while only having to get up once..." is particularly draining.