Andrew Schrauben

I went to my PT appointment this morning and if it weren't for the fact that I'm there due to an injury, I'd love to go more often! Seriously, it felt like I went to a museum or something - it was a lot of fun and I learned a lot. They even had all kinds of sports items - posters, pennants, even mock lockers for Steve Yzerman, Derek Jeter and Mia Hamm! My exam room had an autographed Jeter photo, photos of Tony Clark and Alan Trammell in action, and a "timeline of baseball history" poster. Awesome!

FYI, I have two injuries - a bad right shoulder that's been bothering me for a few years, and also a strained rib cage that I hurt six weeks ago. This PT appointment addressed the shoulder; there's not much that can be done for the rib cage aside from rest.

The therapist started by asking a ton of questions, then started prodding me all over on my back. She did mention that my back appears to be unaffected from my rib cage strain, so that's good. Then she hits my right shoulder and says "Whoa, there's quite a knot back there!" That was news to me; I'd never noticed anything like that. Next I had to move my arms around in various directions with the palm of my hand facing one way, then another, etc. Some of those motions caused a clicking sound in my shoulder, which I expected - it happens quite frequently. The last step in her diagnosis was for me to push against her hand with my arms in various orientations, e.g. push outwards one way, push down another way, push up yet another way, etc. One such configuration resulting in my arm shaking as I pushed up with very little force, although I didn't feel any pain.

At last, a diagnosis. We walked over to a wall chart depicting all of the muscle groups and she pointed out one in particular - the infraspinatus. That's the one that was all knotted up. She concluded that I don't have any tearing or significant damage to the muscle - sweet! The problem is that the muscle is quite inflamed, especially around that knot and especially where it connects to my upper arm bone (the humerus), which is where I can actually feel some pain if I push on that area.

The problem is that the inflamed muscle doesn't behave properly - when flexing the inflammation apparently weakens it and disrupts some of the nerves trying to control it. See how many muscles connect to the shoulder? It's a complex joint, so when one is out of whack and the shoulder moves, certain motions can be rather uncoordinated and cause the clicks that I sometimes feel.

The solution? Ultrasound! Seriously, the therapist wheeled an ultrasound machine into the room, set the timer to eight minutes, and proceed to rub the wand around on the back of my shoulder. She explained that the ultrasound warms up and relaxes the tissue. It worked! After the eight minutes she confirmed that the knot in my shoulder was gone. Wow.

Next I had to sit in a chair parallel to a table and rest my right elbow on the table next to me with my hand raised as if I were doing a casual wave. She then pressed her fingertips into that infraspinatus muscle and leaned into it so hard that she nearly pushed me out of my chair! While she's doing that, she asks me to raise and lower my hand a dozen times... dang did that hurt! Not sharp pain, but rather it felt like my shoulder was full of lactic acid. After I'd completed the dozen reps my hand was all tingly and pale white - it felt really weird. And I was done!

I'm scheduled to go back next week, and then 2-3 times per week after that for 3-4 weeks. I don't know exactly what they're going to do, but I assuming something similar to today. I was also given a few simple exercises to do daily. Amazingly, the entire day my shoulder has felt all limber! I guess I never realized such tightness had formed but boy that ultrasound must've done something. I still get the clicking, so I need to build that muscle back up to strength before that will go away.

How did this injury happen, anyway? Well, I used to be a fairly serious tennis player back in high school - the strongest aspects to my game were my uncanny quickness (rarely is the tallest guy on the team also the quickest, but somehow I did it) and my booming serve. I loved serving and practiced it often, even throughout college as a way to burn some energy. I also played rec softball in college. Needless to say, my right shoulder must've been pretty well developed.

Then I stopped. For several years I played neither tennis nor softball, then a couple years ago I started playing softball again. My mind remembered how to throw a ball hard, but my muscles didn't and over time my now under-developed shoulder muscles couldn't keep up with the expectations I was putting on them, and one became inflamed. Hopefully after all of this PT has run its course my arm will be strong enough again to hurl a softball a couple hundred feet again, without injury!