Rotator Cuff Injury: Part One

Rotator Cuff Injury
Part One

This page chronicles my ongoing ordeal of dealing with a rotator cuff injury in my left shoulder. The first two sections are excerpted from the contest report for my most recent powerlifting contest. It was written on March 31, 2021. For the full report, see RPS Powerpalooza – 2021. The rest of this article was adapted from previous social media posts, with much new material added on June 25, 2021. I will post additional updates as the situation progresses. That is why this article is indicated as being Part One, as those later updates will begin Part Two.

Benches

Gear: Crain: power belt, APT: Black Mamba wrist wraps.
Warm-ups: 10s/15, 50/9, 65/7, 80/5, 95/4, 110/3, Gear: 125/1

Attempts:
Original: 145, 155, 165
Planned: 135, 145, 155
Actual: 135, 145, passed

Three weeks prior to this contest, on March 14, 2021, I injured my left arm in training. I was attempting a 1RM Cambered Bar Chain Bench, but I just could not lock it out. Consequently, I had to lower the bar down and set it on the safety bars in my power rack. It was not until I slid out from under the bar that I noticed my left arm was hurting. I didn’t think much of it at that time, but with each workout afterwards, it got worse, and I had to keep lowering what I was benching.

The “Original” line above is what I was on track for before this injury. But even that was down a bit, as I had benched 170 for my RPS record two years ago. At best, without the injury, I might have tried 172.5 on a fourth attempt...

With this injury, I knew I would not get anywhere near that. But I did the math, and to break my total record, I needed to get at least 135 pounds on benches, so I went with that for my opener.

For my warmups, I had found in training that, with the injury, I needed to do more sets than usual, so as to jump very little between sets. I also found it helped to first warm up with a pair of ten-pound plates. But even at that, all of the sets hurt a bit. But I was able to get through them without too much ado.

Therefore, I stuck with the 135 for my opener, and I got it. My arm only hurt a bit, and it was quite easy. I then went up to 145, what would have been my original opener. I got it, but barely. My arm really started to hurt near the lockout, when I had to work harder than I thought I would. I guess two weeks without hard training was just too much.

But still, I got the lift. But I thought it best to just call it quits right there, so I passed my third attempt. Very disappointing. But I am very thankful the arm did not bother me on squats and deadlifts, not in training nor at the contest. That meant I was able to train and compete full bore on those more important lifts. I truly thank the LORD for that....

Future Plans and Conclusion

I thank my Lord and Savior Jesus Christ for giving me the strength to make it through this contest and for it going so well, at least on squats and deadlifts. And again, I thank God my arm injury did not bother those lifts. But now I will need to rehab my arm and try to get my bench back up.

That might take a while. But still, I hope to stick with my original plan of entering a second contest this year, sometime in the fall. The September contest I entered last year might be too early due to the arm, but I am hoping for a contest in October or November. Nothing is on the schedules just yet, but I am sure something will be added before then, once the Coronavirus stuff is worked out....

Pre and Post-Contest

Backing up a bit, when the injury first happened, I didn’t think much of it. As indicated, I only noticed something was wrong after I slid out from under the bar. But to be sure, I iced it after that workout. Then for the rest of my workouts up until the contest, I would put heat on it before a workout and ice afterwards. My final bench workouts before the contest consisted mostly of just testing it to see what I could still do at the contest.

I also was not quite sure exactly what I had injured. That uncertainty is why I just said “arm” in my contest report. Sometimes I felt the pain in my triceps, sometimes in my biceps, and sometimes in my anterior deltoid (front of the shoulder). But as time went by, the pain seemed mainly to be in the triceps, but I still wasn’t sure if it was a triceps or shoulder injury. But for shorthand sake, for now, I will refer to the problem as being in my arm.

That said, at the hotel, I was hoping to put ice on my arm and shoulder after I arrived and was done unpacking, as I knew it would be sore by then, and then again after the contest. But thanks to Covid, there was no access to the ice machine. There was a sign on the lobby door that the lobby was closed, where the ice machine was located, and the sign said that the attendant would not fill ice buckets for guests! That was just one of many problems I had at the dive of a hotel I stayed at.

In any case, I took a hot shower before leaving the hotel for the contest, as is my usual practice. That is to loosen me up so that it I can hit depth on squats. Due to my Stiff Person Syndrome (SPS), I am often stiff in the mornings, but a hot shower always does the trick. This time, it probably helped my arm and bench, so that, as indicated, I only benched 20 pounds less than I had originally planned.

After the contest, I took a week off of training as usual. But I didn’t exactly rest, as I had lots of wash to do. Due to my Multiple Chemical Sensitivity (MCS), I need to double-wash everything I have with me at the hotel and at the contest that is washable and to wipe off and/ or hang outside everything that is not washable. That is to remove any smells on them that would cause me problems later. Throughout all of that work, my arm bothered me some, but not too much. But I would ice it after I was done with that’s day wash loads.

By the following Sunday, which was Easter Sunday, I was still recovering from the contest and was quite exhausted from all of the washing, so I skipped my family’s Easter gathering. But I did work out, though at a low intensity. That again is my normal practice after a contest. Then over the next month or so I will gradually increase the intensity until I am back to full steam a few weeks post-contest. This time, I started with even less intensity than normal on benches and related lifts and anything else that seemed to bother my arm.

Along with any kind of pressing movement, also bothersome was any kind of curls, regular and reverse curls. When I tried to do them, I would get pain in the anterior delt. But strangely, I could do rows without any pain. But that was the only major upper body exercise I could do. But thankfully, I could still do squats and deadlifts and other lower body work pain-free.

But on upper body work, assuming this was a normal muscle injury, I figured I could then gradually increase the weights and intensity over the next few weeks and months on all of the various problematic exercises. I would also do rehab exercises for both the triceps and anterior delt. I would also continue to use heat before my workouts and ice afterwards. With doing so, I figured eventually all would be fine.

Worsening Condition

However, that is not what happened. Instead, the pain in my arm got gradually worse, and I had to gradually decrease the weights I was lifting. Lowering the bar on benches seemed to be more problematic than raising it. The pain also got worse the closer the bar got to the chest, while pausing at the chest was especially painful. But of course, that is what you need to do at a contest.

By mid-April, it was to the point that I could not even lower the bar to my chest! It just hurt too much. Also, I was now having problems sleeping, as pain in the arm would keep me from falling asleep or wake me up after I fell asleep.

Moreover, I could not sleep on my left side. That was especially problematic, as for over twenty-two years, I have not been able to sleep on my right side, ever since my bicycle accident. Now, with also not being able to sleep on my left side, I had no choice but to only sleep flat on my back. If I rolled over on either side, that shoulder would begin to bother me and wake me up. And there was now many times when laying on my back and not being able to fall asleep, I felt like I could fall asleep if I could just roll over on my side, but now I could not do so on either side. As a result, I lost lots of sleep at this time.

In addition, as my arm pain worsened, I had to keep changing my training routine, trying to figure out what I could and could not do. All of this really cost me much work time, between writing and rewriting my workout charts and being too tired to get much work done.

Hospital Visit

This is when I first called my doctor. That was on Monday morning, April 12, 2021. I talked to the nurse, and she said she would talk to my doctor and get back to me.

I went ahead and squatted in the morning as usual. For my afternoon workouts, where I usually do bench work, I had given up on doing so. Rows had now become my major exercise, since it was the only major upper body exercise I could do. The nurse called me at about 4:30, when I was just starting my work sets of rows. She said my doctor had said to go the hospital emergency room and have the doctor there examine me. She also said I would probably have X-rays taken.

I can only figure my doctor could not fit me in for a visit, so I had to go this more expensive route, not to me but to my insurance company, but still, it seemed quite strange. But stranger was that I knew I had not broken a bone, so an X-ray made no sense. What I needed was a CT scan or MRI.

In any case, it was a very cute medical technician that saw me. She did some movements with my arm and did not seem to think it was that serious, as I still had mostly a full range of motion (ROM). She then had X-rays taken, though both she and I knew they would be negative, which they were. But she said she could not order an MRI. Only an orthopedic surgeon could so in a case like this. She then referred me to such a surgeon in my area.

However, she said that she did not think I would need surgery, given that again, I had a mostly full ROM. She said most likely the surgeon would give me a cortisone shot and refer me to physical therapy (PT). I told her the last time I went to PT, it was obvious I knew more than the therapist did. She just laughed and agreed with me, as she could see how muscular I was. Mind you, normally when I go out, I wear a lose fitting, short-sleeve T-shirt, as I find that most comfortable. That hides my musculature. It is only when I am working out that I wear a tight-fitting, sleeveless T-shirt, as that way, the shirt does not get in the way of lifting.

I didn’t bother to change before I left for the ER, so I was still wearing the latter. Add in that I was in the middle of workout and thus still somewhat pumped, and that must have given a good impression. In retrospect, I think the cute medical technician might have been flirting with me some, but I was too focused on my injury to notice at the time, but I kicked myself afterwards for not flirting back.

In any case, the medical technician prescribed an anti-inflammatory, so I began to take that and continued with the heat and ice. I also experimented with various ointments. That all seemed to help some, but not much.

Orthopedic Surgeon and Covid Vaccine Appointments

The next day, I called the surgeon’s office and made an appointment for that Friday. However, before I did, I had made an appointment to get the Covid vaccine on that Thursday at a drive-through clinic at a shopping mall near my home. I had scheduled to get the Johnson and Johnson shot, but then literally hours after I did, the CDC put a hold on the J&J vaccine due to the blood clot issue.

It was all still up in the air what would happen with the vaccine clinic when I talked to the receptionist for the surgeon’s office. But she told me that I could not get a cortisone shot within two weeks of a Covid vaccine.

I then learned the vaccine clinic had switched to the Pfizer vaccine. That of course meant I would need two shots three weeks apart. And with needing at least two weeks before or after that shot to get the cortisone shot, that meant I could not get the cortisone shot until two weeks after my second dose of the Covid vaccine.

When I got that second dose, the person giving me the shot first asked if I had had any shots in the past two weeks. It would seem the same rules applied to the vaccine as to the cortisone shot, so it was good I planned on waiting for the latter. That was probably for the best anyway, as I planned on being extra cautious during those five weeks, not wanting to get infected with Covid while I was in the midst of getting the vaccine. That to me would be the worst of both worlds. For further details in this regard, see Why I Decided to Get Vaccinated.

In any case, due to all of this, I canceled the surgeon appointment for that Friday but later rescheduled for Friday, May 28, 2021. That would be the earliest I would be fully protected from Covid and the earliest I could get the cortisone shot.

Orthopedic Surgeon Appointment

At that appointment, I did indeed get a cortisone shot and the surgeon did indeed recommend PT, and he did not seem to think I would need surgery. At least, he hoped I could recover with just the PT. Thus, the medical technician was correct on all of her predictions. I told the surgeon what I told the medical technician that I would probably know more than the physical therapist. I also tried to explain to him about my MCS problem and that it always bothers me immensely at a rehab center. But he showed no concern whatsoever in that regard. In fact, he just dismissed my myriad of health problems as not mattering at all. I just could not get through to him how problematic going to PT 2-3 times a week as he recommended would be.

Instead, he just insisted I would need to get in certain number of PT treatments before my insurance would pay for an MRI. And he could not operate without one, so I had to go to PT just in case surgery proved to be needed. If I did get the surgery, he said that would mean months of recovery. With now being 60 years old, that could be the end of my powerlifting career.

In any case, the most important point is he diagnosed me with a rotator cuff tear. The ER technician had not mentioned that possibility, and I had never thought of it myself. It would seem all of the boring rotator cuff exercises I have been doing over the many past years to prevent just such an injury did no good. Very frustrating.

Moreover, since the injury, I was operating on the assumption that it was a triceps or anterior delt injury and was doing rehab exercises accordingly. But some of those exercises, like lateral raises, were in fact the worst thing I could have been doing, as they only aggravated the rotator cuff.

That said, the cortisone shot helped in that it reduced the pain at night, so I could at least get some sleep. But it did nothing for the pain otherwise, including during workouts, so I still could not do benches. That means it would have made no difference if I had gotten the shot before my recent contest, as I probably would still have had to have passed on my third attempt.

Physical Therapy

My first appointment with the physical therapist was on Thursday, June 3, 2021. This therapist, Jennifer, is my second cousin. I was not able to go to her the last time I went to PT, as my insurance at that time did not cover her office. But my new insurance this time did, and I was glad for that.

I’ve been to Jennifer before, and she knows her stuff, so I was a bit hopeful. However, my prescription was for 2-3 treatments a week for 4-6 weeks. I knew going that often given my health situation would be very difficult on me, so that had me concerned.

At that first PT appointment, Jennifer did all of the same ROM tests the medical technician and the surgeon had done. She then showed me some stretching and strengthening exercises to do. Some of them I was already doing. I also went over with her all of the upper body weightlifting exercises I can do in my home gym and asked her which ones I could do and which ones I should avoid.

Not surprisingly but most frustrating was bench presses was the main exercise I should not do, along with any other kind of pressing motion. She also said not to do any kind of curls nor any kind of overhead work, like lat pulldowns. But we came up with enough exercises I could still do to put in some semblance of an upper body workout. But it was not much.

Given my health situation, Jennifer figured that once a week at her office would be enough. I could then do the therapy exercise at home, preferably 2-3 times a day, every day. I faithfully did just that over the next month. I would do the exercises first thing in the morning, after my afternoon workouts, and sometimes in the evening.

Also, at therapy, they would have me do the same thing I was doing at home, using heat at the start of the session and ice at the end. I used the same pattern at home when just doing the PT exercises even when not after a workout, heat before, ice, after.

My insurance approved a total of eight PT sessions. With only going once a week, usually on Thursdays, that would take me to July 22. I figured I would know by then if I would need surgery or not.

However, I would seem to make progress in my ROM and strength, but then a slight mismove would cause pain in my arm, and it seemed like I had to start over. It was one step forward and one step back, so I was getting nowhere.

Then the week of June 20, 2021, the pain in my left arm got much worse. I felt the most intense pain I have felt in over 20 years. At the end of my workout on that Sunday, when I moved my arm a “wrong” way, it felt like I had been stabbed in the triceps. The pain was so intense, I crumbled to my knees and knelt against my workout bench for several minutes, grasping my arm. I felt like I was going to pass out.

I had a similar experience, though not quite as intense, near the end of my next two workouts. As a result, it got to the point that I could barely use my arm and was back to not being able to sleep due to the pain. I guess the cortisone shot I got had worn off. It lasted all of five weeks. What a waste.

Meanwhile, for the first time, my arm really bothered me on squats. As mentioned, up until this point, I could do squats and deadlifts without significant pain. But now it was just deadlifts I could do pain-free. To do squats at all, I needed to make a couple of minor adjustments in my form. That could be problematic long term.

At my next PT appointment on Thursday, June 24, I told Jennifer about what had happened that week. She didn’t seem quite sure what to say about it. But she suggested to stop doing some of the more vigorous PT exercises she had just started having me do. I also suggested that maybe it is best to only do the exercises in the morning, as after workouts, my arm is already sore, and the PT exercises seemed to aggravate it too much, and she agreed.

She then checked my ROM and said that despite the setback in pain, I seemed to have improved. Then she worked on my arm some with massage, stretches, and trigger point therapy. Afterwards, my arm was quite sore, and that led to yet another sleepless night.

Contributing to that lack of sleep was that, just as I feared, it was really bothering me at the rehab center in terms of my MCS. And each time I went, it was getting get worse. That is often the pattern for me—the more I am exposed to something I am sensitive to, the more I react to it.

By this, by my fourth appointment, I was reacting quite strongly, so I felt terrible all that evening, through the night, and into the next morning. It was not until the next afternoon that I began to feel normal again. But my arm was still so sore, I thought it best to take a couple of days off of the PT exercises altogether.

At this point, I knew I had a lot of deep thinking and prayer to do to figure out what to do about this whole situation. I knew my MCS would get worse each time I went to therapy, I was not progressing with my rehab, but I really do not want to get surgery either.

Surgery Concerns

I can do most of what I have been doing at PT on my own at home, the heat and ice, and the PT exercises. It is only the massage and other work that Jennifer is doing on me that I could not do myself, and I am not sure that is worth going through the MCS reactions I experience from the rehab center to go to it for my final four approved appointments, The only reason to finish the planned total of eight appointments is so that I can get an MRI. But that really is only necessary if I were to get surgery. But I am not sure if I will ever want to get it.

If I get surgery, that will mean weeks of being in a sling and months of rehab. I am really concerned about that for several reasons.

First, if I go that long without doing not only benches but also squats and deadlifts, I will lose a significant amount of muscle, and at my age, it is unlikely I will ever be able to get it back. In fact, after just 3-1/2 months of not doing heavy benches, curls, and the like, I know am already losing muscle in my chest, shoulders, and arms.

That is why I mentioned about looking good in a tight-fitting, sleeveless T-shirt. I was not being vain. I was leading to this point that I probably already do not look so good. A few more months of not doing benches and curls, and I will look like I never even lifted weights. Add in not doing squats, deadlifts, or even rows, and I will be fast on my way to being a weak old man. Not only would that mean no more powerlifting, but it could make normal daily tasks difficult, and more so as I continue to age.

Moreover, I know from previous experience that when I am unable to work out with any degree of intensity, I tend to fall off of my normally healthy diet. That then leads to a decay in my health, making regaining that lost strength and size even more difficult. And that weak old man status will be a very real possibility. Plus, I also know from experience that without working out, especially if I am not able to do squats, the stiffness from my SPS will return. That could leave me barely able to function.

In addition, the surgery itself could be problematic in that I could be sensitive to the anesthesia, leading to lasting side effects. At the very least, being in a hospital usually causes me even more problems MCS-wise than at a rehab center. It was not too bad when I went to the ER because they were not busy. In fact, I was the only one in the waiting room, and as far as I could tell, in any of the exam rooms. That is why I got out of there within a couple of hours, far quicker than I expected. But surgery would probably be in the morning when a hospital is always quite busy.

Then there would be the rehab afterwards, probably far more than the eight sessions I am scheduled for now. All of this together could very well lead to a rapid decay in my health in general.

Moreover, if I get surgery, I might not be able to get any work done for several weeks, due to not being able to use my left arm to type with. Add in the decaying health, and it could very well be the end of writing career altogether. But then, even now, my left arm is beginning to bother me when I am working. That is possibly because I use my left hand to work the mouse. I am right-handed, but after my bicycle accident, when my right arm was in a sling, I got used to working the mouse with my left hand.

Even after the right shoulder healed, my ROM was and still is reduced. As a result, reaching out for the mouse is uncomfortable given the extra distance due to the Num keypad being in-between the keyboard proper and the mouse, so I stuck with using my left hand for the mouse. But now, I might have to go back to my right hand and somehow deal with that uncomfortableness.

Finally, from what I have read, the surgery might relieve the pain. But to get to the rotator cuff to fix the tear, the surgeon needs to cut through the outer muscles, like the anterior deltoid. As a result, the shoulder is never as strong as it was before. That is the case with my right shoulder. It is still weak ever since my bicycle accident. That is why my bench is not so good in comparison to my squat and deadlift. If my left shoulder is permanently weaker as well, that would really hinder my training.

These are all genuine concerns and why I said I have a lot of serious thought and prayer to do.

Possible Next Contest

Going back to the excerpt from my contest report that opened this article, if I do not need to have surgery, then I would still like to enter a contest this year (2021). Although my bench will be way down, as long as I can still squat and deadlift, I could still set records in those lifts, personal and otherwise. I say that, as both of those lifts are going very well, as my new training routine seems to be working well. That makes not being able to bench that much more frustrating, as it would probably be the same with benches, if it were not for this rotator cuff stuff.

But as it is, I could just put in a token bench to stay in the contest, and a total record would probably be out of reach. But still, I think it would be worth it to do squats and deadlifts. But if squats continue to be problematic as well, then entering just deadlifts might not be worth the hassles and expense of a contest.

But assuming I can still squat and am able to get back to benching, as mentioned, the September contest I entered last year would be too early. Since I am not benching at all at this writing (late June), I would want some time to train it so as to at least be able to do a bit more than just the bar.

After that, the only other contests I know of in my area is a RPS contest on November 6 in Canton, Ohio and another RPS contest in Lancaster, PA on December 4. I would prefer the former, as it is only a two-hour drive from my home in the Pittsburgh, PA area, while Lancaster is a four-hour drive. And early December can be a bit dicey in terms of winter weather already rolling in.

However, believe it or not, the November contest is already sold out! In fact, it was sold out weeks ago. But I contacted the meet director, and he put me on a wait list. My name already came up. But I told him about my dilemma. He said he could hold the spot until the end of July. Meanwhile, registration for the December contest opens on August 1. I am sure it will sell out very quickly as well. What is happening is with few contests happening due to the pandemic, the few that are occurring are all selling out quickly.

In any case, what all of this means is, I need to make a decision by the end of July about getting surgery and if I think I can compete again this year. If I let both of these contests pass me by, it will be at least 2022 before I could compete again. And again, if I have surgery, that may be never.

Final Observation

Before closing this Part One of this article, I want to make one final observation. All of this is happening because I attempted 2-1/2 pounds too much on that bench set back on March 14^th.

I say that, as I had just done a double with 160 pounds. It was a very tough set, and I barely locked out the second rep. I debated on whether I should go up by 2-1-2 or five pounds for my final set, a planned single. I went with the five pounds to 165. As indicated, I was just not able to lock out the bar. There is no doubt in my mind that if I had just gone up by just 2-1/2 pounds, to 162.5, I would have been able to lock it out and to rack it as usual.

But as it was, since I couldn’t lock it out, I couldn’t rack it on the hooks on my power rack, so I had to lower it all the way down to the safety bars. And with that extra stretch from the cambered bar and having to lower it to a full stop on the safeties, that is most likely what caused the injury. I don’t think it was due to straining to lock it out, as I didn’t notice any pain at that point. Again, it wasn’t until I had lowered the bar and slid out from under it that noticed the pain in my arm.

Another way to look at it is this injury was caused by my MCS. I say that, as if it were not for that problem, I would probably still be working out at a commercial gym. Either that or I would have a workout partner in my home gym. Either way, when I was not able to lock out the weight, the spotter would have helped me rack the bar, and that would have been that. Again, no injury.

But with my MCS, there is no way I could handle going to a commercial gym four times a week, as that would be just as problematic as going to the rehab center. And there is no way I could have someone come to my home to work out with me four times a week, as he would bring smells with him into my home that would cause me problems then and later. That is why I never have visitors to my home and work out alone in my home gym.

Thus, it was either a minor mistake or a preexisting health problem that caused this entire situation to happen. Either way, very frustrating!

Conclusion to Part One

The preceding is the situation with regard to my rotator cuff injury as of June 25, 2021. After I see how some of this plays out, I will post updates as the beginning of Part Two. I will indicate on this page and announce on the What’s News? page for this website and on my social media accounts when an update is available. See the page My Social Media Pages on my personal website for the social media I am active on.

See Rotator Cuff Injury: Part Two for the continuation of this story.

The above article was posted on this website June 26, 2021.

Dealing with Health Difficulties
Rotator Cuff Injury: Dealing with Health Difficulties

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