Shoulder Injury Diagnosis – Old Before My Time
MRI Scan Results
I’ve finally had the results back from the MRI scan on my shoulder and a diagnosis. Essentially there’s some fairly extensive arthritis of my acromioclavicular (AC) joint. If you remember back to the New Year when my shoulder pain first occurred then I thought at the time that it was an AC joint issue. Well, it seems as though that is indeed the case. However, it’s not soft tissue damage or a ligament tear but a longer term, gradual build up of osteoarthritis. This is the ‘wear and tear’ arthritis that over time destroys the smooth outer covering (articular cartilage) of bone. As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. During movement, the bones of the joint rub against each other, causing pain.
I don’t have a copy of the actual MRI scan, but it looked exactly like this:
(Taken from this website which has a good bit of info on AC Joint osteoarthritis: http://www.shouldersurgery.com.au/ac-joint-arthritis.html)
AC Joint Arthritis Treatment Options
What is a little disconcerting is the fact that most sources say: “Osteoarthritis usually affects people over 50 years of age”… I’m still ‘only’ 45. But as Anna pointed out all of the swimming and surfing that I’ve done over the years probably means that my shoulder has seen twice as much use as most 50 year olds’ shoulders.
The consultant said that it was fairly extensive and probably needs surgery. This would involve cleaning away all of the frayed, rough arthritic material from within the joint and also shaving off some bone from either side of the AC joint so as to stop any rubbing which should ease the pain. That sounds a little drastic to me though so I’m going to start with some Corticosteroid injections in the shoulder. This can dramatically reduce the inflammation and pain. However, the effect is often temporary. I shall hopefully have some physio along with these injections to start with and see how it goes.
Even that sounds a little scary to me as the pain has subsided considerably over the last month or so and I’ve even been able to swim again. The pain hasn’t gone completely and there is almost always a deep ache in the shoulder and a feeling of heat that extends into my neck. I’ve also got a much reduced range of movement in my left arm, especially when trying to get my arm behind my back.
Swimming with AC Joint Arthritis
However, despite the pain and reduced range of movement it isn’t really hindering my everyday life any more. I did after all manage not only to complete a Half-Ironman Distance triathlon at the weekend (I didn’t tell the consultant this), but did quite well in the swim section – which is where my shoulder is most needed in such a race. My performance in this swim is made more bewildering by:
- The fact that I didn’t start at the front of the pack so had to swim my way through every one else.
- The presence of a short run in between the two laps of the swim which I took very slowly and where I was overtaken by two people
- The fact that I took the swim REALLY easy. I essentially forced myself to just pootle around so that I would come out of it feeling as though I’d done nothing
Despite this I was still 1st out of the swim in my category and 6th out of the swim overall.
With that in mind it makes the decision about what treatment to accept for my shoulder a difficult one. Yes, there is still some pain and from what the consultant has said, that isn’t at all surprising given the extensive nature of the osteoarthritis. Yes, I have a reduced range of movement. But, at this precise moment in time it isn’t really having a negative impact on my life.
Answers and more Questions
Surgery sounds quite extreme to me even though it has the best prognosis and might be the only option in the long term. Corticosteroid injections and physiotherapy sound less extreme but probably won’t be very effective. Doing nothing is of course also an option, but maybe it’s best to get it sorted now before it gets worse? I think I probably need to speak to another consultant (with Anna there as well) to get a second opinion and to find out a little more about the procedures. I need to know how successful it’s likely to be, how well my shoulder will function afterwards, how long the recovery is likely to take and how it will affect things such as swimming, surfing, and windsurfing in the long-term.
I may finally have the answer as to what’s actually wrong with my shoulder. It may mean that I’m old before my time. But it also raises more questions and means I have to make some decisions as to what to do. I’ve never had any medical procedures done before and certainly no surgery so it’s not a decision to be made lightly, however blasè the consultants might be about such things.