When the nurse called with my diagnosis, I really wasn't ready, and had no idea what questions to ask. There was nothing dramatically wrong with my shoulder she said, although there was some impingement. Impingement? The next course of action was anti-inflammatory medication; they could do cortisone shots right there in the office, she said. I felt befuddled, but thanked her and hung up. There were two important things that stood out to me at that point:
- I didn't require surgery; and,
- My condition had a name... and a common enough name that they didn't bother explaining what it was.
I took a certain amount of comfort in both these things.
Impingement Syndrome, it turns out, is both complex and simple — simple enough that every medical person I've talked to about it knows exactly what it is; complex enough that I haven't gotten the same explanation twice. What I've pieced together involves the idea that it's a self-aggravating condition: when the rotator cuff (the muscles surrounding your shoulder) swell, they swell up against bone, which irritates them even more, and cuts off blood flow.
The second part is that, even through the shoulder is a ball-and-socket (like the hip), it's a much less stable arrangement — more like a golf ball on a tee than a mortar and pestle. Given that, an imbalance of force is more likely to topple that ball off its perch. It turns out that the muscles on my front side are fairly strong, but that the muscles on the back side of my shoulders are very weak.
So, my treatment has been two-fold thus far: treating the swelling, and treating the weakness.
For the first, I'm on Relafen (or rather, the generic nabumetone) which has the advantage that it's a more effective anti-inflammatory than ibuprofen, costs less (compared to taking 2400 mg of ibuprofen per day, anyway) and you only have to take it twice per day. Win, win, win. I've been on this for about two weeks now.
The second part saw me in to my first physical therapy session yesterday morning, where a kindly older fellow measured the strength of various muscles, and set up a program of exercises that I'm to do throughout the day. I have nicknames for most of these exercises now; Buddhas (sorry, Michelle — that's the name that came to mind, and it stuck!), chicken wings, Superman. The fourth involves a large black rubber band that I hook on over a doorway, and try to pull the house down. I don't have a nickname for that yet.
One thing that struck me while I was there was the very community feel to the place. Most of the people that were there for therapy seemed to know each other, and referred to each other and the therapists on a first-name basis. We were all in the same room, and talked while we had our nerves stimulated, or practiced putting nuts on bolts, or stretched rubber. It felt homey.
So that's where I am now: sore, but happy to be doing something.