Friday, 30 May 2008

Injury and Inner Potential

Before we left for Sandycove I had a telephone conversation with Joni Storer (Channel aspirant same tides as me and violinist extraordinaire) the basis of the conversation was family, followed by worries about a nagging injury he had picked up to his shoulder. I remember during the chat me telling Joni not too worry, that I had sustained several injuries on my journey toward the goal of Swimming The English Channel, that I had nursed multiple ear infections, shoulder injuries, back spasms to name but a few. I clearly recall stating it would be a temporary set back and that with some rest and professional treatment he would be just fine.!

Then of course, I travelled to Cork and got battered by some rough seas over 4 hours or so of swimming. Only to return home and be in a great deal of pain with my left shoulder, it has been worrying me all week to the extent that I have not swam since Saturday, that in itself presents its own paranoia type feelings let alone the concern for recovery now that we have only ten weeks before my tidal dates.

On Tuesday I awoke in the worst pain my shoulder has felt since training began, I have been taking anti inflammatory medication but no pain killers as I didn’t want to mask the issue and end up causing further complications. Wednesday the pain had eased by around 10%, I had some treatment from Gary Hinchely at The Norton Physio/Sports Injury Clinic, a session of ultrasound and some advice/diagnosis. It is reckoned that I have either tendonitis or a partial tear to the rotar cuff, the prognosis is good so long as I take some rest. I looked up the injury online and thought I would include some of what I discovered, as I know many swimmers will get similar pains along their routes to France.
Rotator Cuff Injury Explained

A Rotator Cuff injury is a common cause of shoulder pain. Injury to the Rotator Cuff will usually begin as inflammation, often referred to as Rotator Cuff tendonitis. The Rotator Cuff muscles (Subscapularis, Supraspinatus, Infraspinatus and Teres minor) are small muscles situated around the shoulder joint. Although they have individual actions, their main role is to work together to stabilise the humeral head (ball) in the shoulder socket. People are often told that they have injured one particular Rotator Cuff muscle or tendon, with the most common diagnosis being Supraspinatus tendonitis. However, it is unlikely that the problem is with just one of the muscles in isolation. The world's top shoulder surgeons refer to such conditions as a 'rotator cuff injury' and consider the picture as a whole.

Although the Rotator Cuff can be injured by a single traumatic incident, this is not common. Injury to the Rotator Cuff will usually begin as inflammation (tendonitis) caused by some form of micro trauma (a small but continuous source of irritation). If the cause of the inflammation is not addressed, and continues over a long period of time, partial tears may develop in the cuff that could eventually become complete tears (a tear all the way through one or more of the rotator cuff muscles).

There are three main causes of micro trauma to the rotator cuff:

Primary Impingement The 'Coraco-Acromial arch' forms a bridge over the Rotator Cuff. It is made up of bones and ligaments and is lined by a sac of fluid called the Subacromial bursa. The space under the bridge that is available for the Rotator Cuff is called the Subacromial space. Many people will have a naturally small Subacromial space, which is just bad luck, but the space can also be reduced by conditions such as OsteoarthritisDegenerative joint disease, characterised by wear of the articular surface of a joint. This can occur due to repeated overuse, but the incidence and onset of osteoarthritis is increased secondary to trauma, such as major ligamentous injury or meniscal injury in the knee.','',250)" onmouseout=hideddrivetip() ;Osteoarthritis. Whatever the cause of this small Subacromial space, repetitive overhead activities (such as throwing a basketball or dusting high shelves) can cause the Rotator Cuff to become continuously squashed against the Coraco-Acromial arch, causing inflammation of the cuff.

Secondary Impingement Many people will have what is called shoulder instability (a lax shoulder joint). This laxity may have been present since birth or may be due to an injury. Often it will have occurred over time due to repetitive overhead activity, poor posture or inactivity. Due to this instability, the Rotator Cuff has to overwork to stabilise the shoulder, causing it to become inflamed. Eventually, the Rotator Cuff will become weak and tired, and will not be able to prevent the humeral head from squashing up against the Coraco-Acromial arch. Because this type of impingement is not due to a small Subacromial space, it is called secondary impingement.

Overstraining During forceful throwing actions (e.g. tennis service, pitching and throwing), the Rotator Cuff has to work very hard. With repetitive throwing, the cuff is prone to being overloaded, resulting in inflammation and tissue breakdown.


As a result of not being able to swim, yesterday I broke my promise of never running again and had an excellent ‘hill work out’ on a treadmill at the gym, I followed this by a short spinning session just so that I felt I had achieved some cardio training rather than sat on my butt.

That said…whilst sitting on my butt I have been considering some other beneficial and necessary training: Alison Streeter states that Swimming The English Channel is 80% Mental (who better qualified than Alison..simple answer…no one) therefore I have been spending my some time reading related books/articles and hope to visit a a therapist in the next fortnight regarding Inner Potential Therapy and Training, I am quite excited about this.

I have included some text that kind of gives you an idea of where I have been heading with this mental training and visualization.

A Room in Heaven

One day a human went to heaven in the way that humans often do. On arrival, the human was greeted by a host of angels and given a tour of all heaven's wonders. Over the course of the tour, the human noticed that there was one room the angels quickly glided past each time they approached.What's in that room? the human asked.The angels looked at each other as if they'd been dreading that question.

Finally, one of them stepped forward and said kindly, "we're not allowed to keep you out, but please believe us - you don't want to go in there."The human's mind raced at the thought of what might be contained in that room. What could be so horrible that all the angels of heaven would want to hide it away? the human knew that one should probably take the angels at their word, but found it very hard to resist temptation. "After all", the human thought, "I'm only human".Slowly walking towards the room, the human was filled with dread and wonder at what horrors might about to be revealed. But in fact, the room was filled with the most wonderful things imaginable: a beautiful home; nice things; great wisdom; a happy family; loving friends; and riches beyond measure.Eyes wide, the human turned back to the angels. "But why didn't you want me to come in here?" This room is filled with the most amazing things I've ever seen!"The angels looked at each other sadly, then back to the human."These are all the things you were meant to have while you were on earth, but you never believed you could have them."

(Taken from "You Can Have What You Want" by Michael Neil)

I will leave you with a quote from Lesley Broadhead, it’s a little like Mark 9:23 i.e. To he who believes anything is possible...

If you never set goals or if you never have dreams then how can they ever come true?

It's ok to want things - it's ok to expect things - it's ok to set goals.

Remember - focus on what you want not what you don't want - this is my golden rule.”


Anonymous said...

All that training put me to shame. I heard Hoffy get a bollocking for doing "too much" in the pool 2 weeks ago which made me feel so much better, not that he was in the S**t but that Im doing just about enough to keep things going in the right direction...Happy training and see you in Dover next week...Sam x

Lisa Cummins said...

Finally got that blog entry up...intended to do it y'day but I got called into work. So my ramblings are up there now...thanks to your lovely comment getting me moving on it this evening :P
Hope that the shoulder gets better long before you can get back to swimming?

Bruce Stewart (施樸樂) said...

Your writing about the shoulder pain was very informative. I have had some this last week, too. Maybe nothing like yours, but I wonder where it is leading. So I'll try to be more careful. Hope your shoulder gets better soon.