Tuesday, September 15, 2009

Can you say acromioclavicular separation?

So, several weeks after my injury, an update:
Shoulder pain has diminished significantly, but I still have a bony bump consistent with an acromioclavicular separation. It is probable that this bump will be permanent, but in any case I have been treating the injury appropriately (with the possible exception of the swimming- more on that later).
Though the shoulder has been feeling better, I've been dealing with upper back pain that borders on incapacitating and has even been impairing my sleep. I've actually gotten this "snapping scapula" syndrome a number of times from swimming, usually from swimming excessively hard at the end of a workout when I'm not completely back in swimming shape. Usually it requires at least a full week off from swimming for the pain to subside. It's essentially due to inflammation in the bursa(e) that separate the scapula from the rib cage.

Now for the confession: I started swimming again two weeks ago, just after my first weekend back on the bike. The first couple of swims I did entirely one-armed. I did 1000m for the first one, and 1600m for the second. Recognizing that my last scheduled triathlon of the season is imminent, and feeling that being able to actually swim would be critical, I then started trying out the injured shoulder. I found that I could reproduce the motion of swimming with that arm without substantial pain in the shoulder (barely pulling with that arm), but swimming was definitely not helping the scapula pain. Interestingly, my body alignment is off a bit; I don't seem to swim completely straight. My next 2 swims were very deliberate workouts (2000 and 2500m), in which I was extremely careful of the injured arm. I could feel the injured arm getting better and better (though the scapula pain was not, of course, improving). So, last Thursday I swam for real. I swam 3000m, forcing myself to fully extend the injured arm (but still being careful on the pull). Afterwards, it was clear that my shoulder had been adversely affected by the workout. For the first time in quite awhile, my shoulder was noticeably more painful that it had been the day before. When continued symptoms over the next few days made it clear that I had regressed, I decided not to swim again in the 8 days remaining before the race, and to see what value "healing up" might bring. At this point, I can't really add any fitness before the race, so I might as well try to go into the race as healthy as possible.

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