Thursday, 19 February 2015 22:16

A little older in the shoulder

Written by  Greg Collette
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For the last few weeks I’ve had a sore right shoulder.  I think it started at the gym.

I have been going to a gym of some kind for years.  I did a little boxing in my youth (light welterweight) and played rugby for a while (no 8) in the navy and have always liked to keep fit.

But then my kidneys morphed into Mr Potatoheads, and the gym became a bridge too far.

Eventually I began dialysis, and as my health improved, I returned to the gym and slowly got back some semblance of fitness.

However, kidney disease does take its pound of flesh.  Literally.  Over the years I have thinned down, and I find it takes a lot of effort to rebuild muscles and gain or re-gain weight.  This tendency to slim down over the years is called Sarcopenia (Greek, meaning “flesh poverty”), the progressive loss of skeletal muscle mass, quality, and strength as we age (up to 1% per year from age 25).  Of course, it’s not usually noticeable until we reach our seventies, but long term BigD tends to make it happen a little earlier.

So when I go to the gym, after my warm up, I tend to focus on muscle building via resistance exercises with weights, levers and the chest press.  Alas, about six weeks ago, I was straining to chest press what was clearly a petite level weight when something snapped in my right shoulder.  Uh oh.  Not good.  I stopped and decided to focus on a less strenuous exercise, like going home.

Since then my shoulder has been weak and sore, especially when I extend or raise my arm.  But most disturbing is that it aches when I dialyse.  Once the needles are in, I assume the position: arm extended a little, resting on a pillow on the arm of my chair so the needles can be seen and the blood can flow freely (we all know the position).  But now, after a few minutes, my shoulder aches and carries on, forcing me to move it constantly, and search for a more comfortable position.

Julie suggested I go to a physiotherapist she had found very helpful when she had a sore neck.  So I made an appointment.  I went to her yesterday and it was a revelation.  I was sceptical that she could help.  I had already decided that it was just a torn tendon or something, that would heal eventually, if I gave it enough rest (self-diagnosis is one of my secret gifts, though not yet evidence based, and exceeded only by my gift for self-treatment – also unproven).

But no.  After a range of questions about what exactly I was doing when it happened, the angles and movements that cause the most pain, and measuring the how far each hand could reach up my back (my right shoulder’s performance was embarrassing) she had the answer, and the solution.

Over the years as I sat at my desk, using my mouse to type, read, respond and relax, my shoulder has gradually moved forward, shifting away from its socket, compressing some muscles and stretching others, in particular the one under my shoulder blade.  That muscle may have been torn by my gym work, but the fundamental problem was caused by my posture, especially when using my mouse, and leaning forward to study my computer screen.

After some fairly brutal deep tissue massage and instruction about the how and when of future exercises, I emerged from the physio’s studio (parlour?), blinking at the light of day and the profundity of new knowledge about myself.

My shoulder will need a little more attention from the physio, together with regular bouts of rolling around the floor on my newly acquired roller (like a reverse rolling pin, with me as the pastry).  But I have every confidence that it will get better, and I hope to soon return to that chest press with bolder shoulder!

Stop Press:  On last week’s health and fitness segment on ABC Radio Overnights program I heard Gordon Lynch (Associate Professor and Reader in Physiology at the University of Melbourne) talking about some new research that could help anyone whose muscles are slimming down before their time, by Doubling Your Protein Intake (within the limits set by your kidney doctor**).  Studies at the University of Arkansas suggest that older adults may need to double up on the recommended daily allowance of protein to maintain and build muscle. The added protein seems to trigger our sometimes lethargic muscle-building cells into action.

So with a little more protein and some time back at the gym, I may not all get to look like Arnie, but maybe not his runt cousin either.

**People with early stage kidney failure but not yet on dialysis are usually on a reduced protein diet, to lessen the protein breakdown burden the kidneys.  Protein intake is regulated based on the stage of kidney failure (I put off BigD for years on a diet of jelly beans – which I now can’t abide).  But once we go onto BigD, this diet restriction no longer applies:  dialysis handles the waste, and protein, protein, protein is the order of the day (every day!).

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Greg Collette

Greg Collette

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