Acromioclavicular is my new word for today.

[flexagon]

Physical therapist visit today. Apparently what I really pissed off last week is not my deltoid but my AC joint, the joint between the clavicle and a funny little wrapping-to-the-front bit of the shoulder blade. The PT thinks that it's inflamed (but no worse) and will get better over the next couple of weeks (which I was figuring out myself, based on it getting better quite a lot over the last week). This is fantastic news, actually, and I even learned about a joint I didn't know I had.*

But he still wants me to come for twice-a-week physical therapy for a couple of weeks, and he has issues with my posture. I need to be doing more lower/middle trap exercises, apparently, to keep my now-very-tight pecs from dragging my shoulders forward. And I need to stretch out my upper traps more. Fine, okay, but the trouble is that I need a doctor's note for insurance to pay for actual PT, and I don't have a PCP and I've been putting off getting one. The PT also seemed kind to have a scolding demeanor and not take my current work/goals very seriously (though I might have just been feeling touchy because of the things I've been doing on the injured shoulder). I tried to explain that when I'm working out alone I can take infinite care with my form, and that in fact my workouts didn't cause or particularly exacerbate the problem... but I got the sense I was being scolded for continuing, even though the things I backed off on due to pain are the same things the PT told me to back off on. My conclusion is that pain's a perfectly good guide on what to do and what not to do.

Option One: pay for today's visit out of pocket, don't go back, implement PT's suggestions as part of my usual workouts. Feel guilty about not doing as suggested by professional.

Option Two: call potential PCPs tomorrow, see if they can take a new patient. Actually see one (this will no doubt result in a small cascade of follow-on appointments -- when was my last PAP smear again?), get doctor's note, go back to PT to get scolded about posture. Feel guilty about wasting the insurance company's money, feel guilty about posture, feel guilty for not feeling guilty about hardcore strength work.


*http://en.wikipedia.org/wiki/Acromioclavicular_joint. Looking at the picture, I've pretty clearly irritated the superior acromioclavicular ligament. Better that than the other ACL!

Comments

[savage-rose.livejournal.com]

That scolding thing is the number one reason I hate going to the Dr.--I know I'm going to get grumped at for SOMETHING and I feel anxious about it, which raises my BP, and then there's something else to grump about even though it's normal not at my Dr.

Whatever you feel guilty about, don't feel bad about the insurance money--they waste more than we'll ever see in their day-to-day bs. Do what feels right for you. You'll make the right choice.

[miyyu.livejournal.com]

If you're being scolded, you need a new doctor. Shop around, it's like any other service professional these days.

[flexagon]

Hey, look who's back online. :-) Doctors usually love me, so I wasn't really prepared for the scoldingness of this PT guy. I think I'm going to get off the hook guilt-wise though; I called around and it looks like I can't line up a PCP all that quickly anyway.

I have to agree with miyyu, though... you may want to find a new doctor.

[niralth.livejournal.com]

Speaking as someone who has had several abnormal paps and a painful procedure to stop potential cancer, please go get regular paps. Thanks. :)

[miyyu.livejournal.com]

I concur! I see it as part of the maintenance package that comes with being female. You just do it because you have to.

[flexagon]

I agree. I'm not a complete slacker on this front. I got one annually for about 12 years running; then I read somewhere that the recommendation had downgraded to every 3 years for monogamous women under some age who had never had an abnormal one, and lost track somewhat.

I think it's been only a couple of years, still, and was going to call today but I see it's already past "business hours" again.

[apfelsingail.livejournal.com]

Hm, it's good to have a PCP on call in general before you actually need one. Was this a sports physical therapist?

I've been told the shoulders forward posture thing is actually fairly common for circus folk. Solution is mainly stretching/additional strengthening, like he said. Still good to catch early before it pulls stuff out of whack.

So so glad it's just inflamed! That stuff is scary. You also icing and maybe taking some anti-inflammatories?

[flexagon]

Well, I've had a PPO for as long as I've had real health insurance, so I've never needed a PCP before.

That's interesting about circus people and the forward shoulders! I have to say, though, I tried some of the exercises prescribed by the PT this morning and they hurt the inflamed joint a lot more than the hardcore strength stuff I'd been doing before. I wonder if some of the slump is coming from pain avoidance, at the moment. I do one exercise already that should be hitting the mid-traps pretty hard. Anyway, I have no problem working in some more stretches and back exercises... it's clearly a good idea, if not related to the problem at hand. Er, at shoulder.

It's hurting less every day now, and yes I'm taking anti-inflammatories. :-) I had been using heat when the muscle pain outweighed the joint pain; but I might ice tonight.

[nevers.livejournal.com]

if you think you can coach yourself through rehab based on what you just learned, do that. i bet you can.

i did a lot of work stretching my pecs when i had shoulder pain. every time i went to the bathroom at work and sat in a stall (only works if your workplace has stalls...) i would put my hands on the sides of the stall and press my chest forward. among other stretches. i also recommend http://stronglifts.com/shoulders-dislocations/

did the PT suggest specific lower/mid trap work?

it's hard to find a doctor of any sort who takes athletic hobbies seriously. it took me years to find doctors who were on my team, eager to get me doing what i love to do with health and strength. doctor shopping is a wretched pursuit but it does pay off. i don't think it's worth continuing with this person unless you can be clear that you're doing it for the information only and will let anything else roll off your back.

and yes, call a PCP anyway.

[nevers.livejournal.com]

also scapular wall slides if you don't already know about those.

[flexagon]

Ooh, I don't! What's a scapular wall slide?

The PT suggested really light, high-volume straight-arm pull-down things, and rowing exercises. And neck stretching, intermittently all day, which I have to admit is a fabulous idea. I've asked Toledo if we can roll a few such exercises in with Phase II of my training with him... I don't want to be doing strength stuff he doesn't know about, and I for sure won't have time/energy to do more than he's gong to give me anyway.

It is frustrating as hell to not be taken seriously. I'm not used to it, which probably means I'm privileged or overprivileged...

[islenskr.livejournal.com]

OH, man, I agree with nevers *completely*: I had a really hard time finding doctors who took me seriously, too. One even asked me if I was sure I should be doing beginning acro at "my age" (I think I was 34ish?)!!! I should have asked him if he should be practicing medicine at his age, but I was nice and kept my mouth shut.

I'm sure you'll find someone who can help!! *support*support*

[flexagon]

Thank you for the support.

I should have asked him if he should be practicing medicine at his age

Bwahahahaha!! Oh, I wish you had. If anyone ever, ever pulls such a line on me, I am now well-armed, and I promise I will say it. :-)

I'm really almost totally fine. The acute thing (the shoulder) is diagnosed, so it's not mysterious anymore, and is getting better fast. The posture thing is pretty minor in my view -- the PT didn't need to scold, he could have just suggested more mid-back exercises and pec stretches and I would have said "sure".