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February 22, 2012

Shoulder pain can kill you, seriously read this

NEAR DEATH BY SHOULDER not written by Agatha Christie


“How the hell did this happen exactly!” my brain screamed.  Anger initially prevailed over panic as my kayak wedged upside between 2 rocks and underneath a 400gallon per second rush of class 4 whitewater.  “Goddamn shoulder.  This right shoulder has been screwing me for months and now it is going to kill me.” 

The moment of truth had passed about 20 seconds earlier.  We were running the Green River outside of Seattle.  This was my fourth trip through this beautiful piece of the Cascades.  My body had become a fairly finely crafted kayaking machine over the previous 8 years of kayaking the northwest.  I was ready for the Green.  There was no planning.  Like the steep part of the mogul run, getting through the Green River down to the sedate outskirts of our fair city required rhythm and skill.  I had neither of these skills in any other sport in which I toiled over my previous 28 years.  I contend that I had become, dare I say, graceful in my custom made kayak of late.  I had done a short stretch of class 5 in Oregon just a week ago.  I was ready for this.  At the critical moment my own anatomy betrayed me.  On my big reach, the stroke I needed to have, I could not get my paddle beyond a small boulder.

At least I was conscious, I thought.  I have a fighting chance here.  My anger was slipping quickly into panic.  Think, please think, Mike.  How are you going to get out of this mess?  I suppressed the notion of my questionable recreational sport of choice.  I could have likely gotten a golf game on this beautiful Saturday with my dad and brothers.  OK, more of this torrent of water is hitting the front of upside down kayak.  I had violently wrenched my body to the side three times without a budge.  I knew I was losing strength.  Could my adrenaline save me?  I bent forward until my helmet hit the kayak and threw myself backward with all my might. 

Daylight and air.  My last desperate maneuver worked.  I was thrown back into the toilet bowl vortex, never so happy to going backwards and out of control.

What the hell happened?  My analytical, possibly obsessive compulsive nature, did not relax upon my second lease on life.  I was happy to be alive, but I was disgusted at my own, I felt premature, brush with death.  Why did my shoulder betray me?

“I make a great living off shoulder pain,” the University of Washington orthopedic surgeon shared with me 2 days hence.  “Modern day plague” he contended as he jammed his finger into fire-poker tender area of my right shoulder.  “Did you know that 60% of 60 year olds have a rotator cuff tear?  Can you say job security?” he smugly asked. 

I am a free-lance writer and job security was not in my vocabulary.  I reluctantly came to appreciate the steroid injection he placed deep within my shoulder, but I needed to know more.  Why did my shoulder fail?

“The shoulder is a beautiful joint, with a 270 degree range of motion.  The most mobile joint in the body,” explained Dr. Michael Carroll, a family doctor in Traverse City Michigan who claims to be changing the way the world thinks about shoulder pain. “The problem with such a complex joint is that it requires so many parts to be working in the correct manner, sequence, and balance.  When it goes bad it tends to stay bad unless you restore proper function.” 

OK so how am I going to get my shoulder better?

The current antidotes to this are anti-inflammatory medications, physical therapy and surgery.  None of these sound all that hopeful.  A recent review article out of the University of Pittsburgh recently noted that 47% of kayakers suffer shoulder pain.  They glumly conclude that there is no definitive therapy that has been sufficiently proven to address the problem. 

A bit of direction comes from Dr. Carroll “You do not need to use a lot of resistance.  You want to build endurance more than power.”  Mr. Westrick, a kinesiologist with 20 year history of treating shoulder pain, cites research recently published in the Journal of Sports Medicine.  “Nighttime positioning is an important piece of the puzzle.  Many people with the muscle imbalance are hurting their shoulders with sleep position.”

Get the rotator cuff stronger and sleep in the correct position.  OK, how do we do this?  Mr. Westrick endorses a specific product.  “The Rotatoreliever is the one product that I can confidently give to the patient knowing that it is easy to use at home and remarkably effective.” This product apparently has a nighttime component and a unique exercise for daytime.  He states further “this product is getting a lot of attention with my physician colleagues.”

What about the surgery?  There have been numerous advances with surgical techniques that are well publicized, but the best case scenario I can find for recovery to kayaking is 4 months and most report 8 months. 

I am sitting here pondering the terror of my recent near death experience.  My shoulder still hurts when I reach, but the water calls.  I will do my own therapy: scenic flat water.   




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