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You can have shoulder arthritis and still be fit and active

Posted on: March 18th, 2014 by Dr. Scott W. Trenhaile

It’s a terrible feeling.

You just know that if you don’t change your workout habits, you’ll end up not being able to work out.

I know because I was there.  My shoulder sounds like gravel, and I had a tough time changing my workout style, but I knew I had to make changes.

Let’s dig into the who and what of this very difficult, unclear area of fitness and joint health.

The Background: A patient comes to the clinic who has been athletic and active his entire life.  He’s dealt with injuries through high school, college, and beyond, and now, he likes to work out two to five times per week.

During the workup, we both are hoping this is just some tendinitis that he’s dealt with in the past, but soon, it becomes evidently clear that something is wrong.

The Scenarios:

1. It’s (probably) pretty terrible

The x-rays don’t look too horrible, but they do show that the shoulder has been damaged.  After conservative treatments fail (in this case), the patient will most likely get an MRI.

Here’s where it’s important to say that I don’t treat tests, I treat people.

But back to the MRI results, which say “concern for large cartilaginous defect in the humeral head or glenoid” (which means some of the covering on the ball or the socket is peeling off).

That’s pretty terrible.  The bones look fine, but the covering on the bones is bad–the precursor to full-blown arthritis, i.e. you’re going to need surgery.

The point: Articular cartilage defect on the humeral head is a bit of a problem (understatement), and it often makes it extremely difficult to return to the same type of activity that you may once have enjoyed.

A few exercises that would fit into that category would be:

  • Bench
  • Military Press
  • Incline, decline presses

Heavy lifting is very difficult to do with the shoulder after that diagnosis.

2. It is terrible.

In this situation, the x-rays are dramatically arthritic, to the point that the options are severely limited.

So the decision has to be made if the patient is already very arthritic, or if this is a pre-arthritis condition, and depending on that, how do you head off the arthritis and maintain an active lifestyle?

The Key to this is that certain activities will make your shoulder better and other things will make it worse, but you have to have the right mindset of (1) what are my problems and (2) what can and can’t we fix.

The Point: You can’t just have treatment of any kind–conservative or surgical–without resetting your expectations.

We tend to get engrained in what we do (me too!), which makes it difficult to retool our workouts after a major surgery or after developing arthritis.  Often, this can lead to quitting because of failure/poor surgical outcome or just giving up.

It’s the folks who can accept their limitations and intuitively work around them that thrive, succeed, and carry on.  It can be that drastic.

Take a look at these options that will still challenge you, but will also accommodate any new limitations.

Note: consult your physician before engaging in any exercise program

  • Do more functional fitness activities.
  • Avoid isolation, and do combined motions.
  • Use lighter weight with a Bosu ball with a squat, curl, press, squat down.
  • Keep your heart rate up with a circuit of exercises, never stopping.
  • Punish your core, which helps your appendicular skeleton perform better.
  • You can do some of the pressing like pushups on a Bosu ball with a Swiss ball underneath your legs.

Remember that you can make it hard without putting 150 pounds on each arm while you push up.

My cry is that it’s not over, but you have to switch gears.  You can still be happy with something else.

Recently, I had a baseball coach who always pitched batting practice, and he can’t do that anymore.  We had to have a hard talk about that, and I get it.  He’s being forced to give up something that’s important to him, but we age.  It’s a reality, and with age comes change.

It’s a fine line to walk between you can’t do anything and you can’t do everything…now that sounds like a massive road, but each individual is in a different lane on that road, and that’s the fine line.

So I hope you’re able to find a lane that’s appropriate for you.

(image via)