Shoulder Rehab:
The Long Road Ahead

By Terry Laughlin

Nearly five months after I initially injured my shoulder, while weight training
in September, I finally have an accurate diagnosis – but only after my orthopedic surgeon made an incision and probed an athroscope beneath the skin and into my right shoulder joint, last Monday, and it’s somewhat more discouraging news than I had hoped for.

As I’ve recounted previously I felt an intense stab of pain and disabling weakness while doing a bench press on Sept. 30. I was lifting only moderate weight (130 lbs) and with close attention to form, but…stuff happens, particularly when you have 53-year old shoulders. I continued my swimming and weight training over the next month, modifying to avoid pain, and hoping that it was “just a strain” that might work itself out if I kept my activities gentle and avoided movements that hurt. I did regain some capacity, but even routine activities – like flipping a light switch – hurt quite a bit, so I finally consulted my family physician at the end of October. After some range of motion tests he diagnosed an inflamed bursa, prescribing three weeks of rest, ice and anti-inflammatories. That brought little relief so he sent me to see an orthopedist, who also did range of motion tests and an x-ray, arriving at a diagnosis of a possible labrum tear.

He recommended I resume swimming and weight lifting, but in pain avoidance mode, and begin daily shoulder stabilizing exercise. Over the course of several weeks, I was able to swim more and slightly faster, with less pain, but everything else still hurt. So back to his office I went, for a cortisone shot and a prescription for three weeks of physical therapy. Again, I was able to increase my swimming a bit, and swim with moderate intensity, but no relief on other fronts. Since the PT seemed to be doing nothing for me, I instead began getting a weekly deep-tissue massage, because I’d begun experiencing significant “compensatory pain” in my upper back muscles, around the injured shoulder.

The massage effect was dramatic. Over three weeks my swimming became markedly more comfortable and stronger. Where I’d previously been pleased with times of, say, 2:50 in a set of 200 Free repeats or 7:00 in a set of 500s, I now began swimming as fast as 2:30 and 6:30, and with no discomfort. I’ve previously described how the extra care I exercised to make sure my extended arm was in a solid, stable position before stroking, not only alleviated pain, but make my stroke better.

And finally, the HMO that provides my medical insurance approved an MRI exam. When I reviewed the MRI with my orthopod on Feb 7, it did seem to suggest (MRI’s are seldom definitive) that the labrum was detached. Because of that and because routine activities were still painful and limited, we decided to schedule surgery for Feb 14.

The surgery went smoothly, but when I visited my surgeon the next day for a follow-up, I finally got the whole story. Once he was able to look directly at the structures in my shoulder through the scope, he could see the real problem –a complete tear of the rotator cuff. This makes it seem nearly miraculous that I was able to swim so well and with virtually no pain over the past few weeks – strong testimony to the soundness of my technique.

However, the recovery process is far more lengthy than for a labrum repair. He anchored the torn muscle back to bone with a self-dissolving staple, but it will take three months for natural attachments to regenerate, during which time I can do no swimming. It will require a great deal of patience for me to stay “dry” for three months, but I expect to learn many lessons which should prove useful to other dedicated athletes with “aging body parts.”

I’ve already begun working on maintaining fitness with stationary cycling at my gym – I did 45 minutes yesterday, which seemed to last forever, while 45 minutes of swimming always passes far too quickly. It’s critical to allow this injury to heal fully so I’ll be as patient as possible, while also using all available ingenuity to maintain a level of strength and fitness that will allow me to resume swimming well when the time comes. James Farmer, an orthopedist who wrote recently on Mindful Swimming for Total Swim, has estimated that I could be swimming reasonably well within six months of the surgery. That will be mid-August, well into the open water swim season. That provides me with a galvanizing goal – to be able to race respectably in the US Masters 2.5K Championship in Chicago on Sept 10 and 10K Championship on Oct 22 in Fort Myers FL. I’ll maintain a chronicle of my rehab and resumption of training in Total Swim, reporting on what I learn along the way.