Unexpected consequences of climbing

[jaunthie]

So I went to the sports medicine doctor yesterday, and the doctor said...

Wait. Let me back up a little. This gets a little strange.

When I called into the clinic on Monday morning, the very nice receptionist asked me what was wrong, what the pain levels were, how I had managed to hurt myself, etc. The usual litany. I told her that it was my right elbow/arm/wrist, that it had been bothering me off and on for a while, but that something must have finally gone really wrong after Saturday's climbing session, because it was really out of whack now.

"Oh, you're a climber?" she asked, with a great deal of interest in her tone.

"Just recreational indoors," I clarified. "Not a serious one. Just a hobbyist, really."

"OK, right, but I'll tell the doctors anyway. They're always interested in climbers. Now where are you?"

*blink*

I realized that this very nice woman was trying to get me an emergency appointment right now, that very day. Evidently she thought I was *really* injured, to the point of needing immediate treatment. I quickly clarified that I was calling to *schedule* an appointment, not try and get into the clinic ASAP. She was extremely relieved, and very grateful.  Apparently her morning had been FULL of people calling with urgent issues that needed to be seen to *right that very instant,* and my calling ahead to make an appointment was a serious novelty. So we scheduled my appointment for Thursday, and I thought little more about it.

Except that my arm kept hurting, enough that it was interfering with my ability to type, which is to say, to do my job. And it hurt in certain motions if I wasn't careful, including for basic things like putting on a pair of jeans. And it ached more or less constantly, which gets really old. But still, it was hardly what I would call urgent, just annoying. I wore a wrist brace to remind myself not to use that arm for picking things up, and tried to rest and ice it when I could, and managed.

Thursday finally came. I went to the clinic, and through a series of coincidences, I wound up checking in well in advance of my scheduled time. I explained why I was there (again), got the usual first-time-at-this-place paperwork, and settled in to fill it out and wait for what I assumed would be quite some time.

Nope.  Apparently the nice receptionist wasn't kidding when she said that this clinic really likes climbers. They practically rolled out the red carpet for me. I hadn't been in my chair for five minutes before my name was called, and they summoned me off to x-ray the elbow. From two different angles, no less. Evidently my description of my symptoms and what they had observed had them concerned that I had somehow managed to break it (without noticing) or that something had gotten into the joint somehow.

So I was x-rayed, returned to the lobby, almost immediately called into an exam room, thoroughly examined by both the doctor and his resident in training, poked, prodded, and otherwise thoroughly checked over. I explained to all concerned that no, really, I'm a professional geek who occasionally climbs, certainly not some kind of pro athlete (particularly when the very enthusaistic doctor started talking about various kinds of blood injection techniques that are really popular with the pro crowd, etc.). Not that this last fact should have required any explanation; no one looking at me would ever mistake me for an athlete of any kind. Except that despite this obvious fact, the clinic folks, without exception, were taking my condition very seriously indeed. They all seemed quite excited by it, in fact. Not to mention absolutely determined to get me better as aggressively quickly as possible, which I am certainly on board with. My doctor not only explained what treatments were available, but what he was reccommending specifically for me and why, and why previous kinds of treatments were now NOT the way to go based on the latest research, etcetera.

And oh, by the way, he wanted me to start treatments ASAP. Like, tomorrow morning. And he gave me the paperwork to not only ensure that this happened, but that I was scheduled in with the best of the providers available.

Conclusion #1: If you are ever injured and need to go to a sports medicine clinic, and you happen to climb in any capacity, just mention that to the staff.  Apparently this is a sure-fire way to ensure the highest level of attention, at least at this clinic. I have to wonder if this place was founded by climbers, or if the staff is just all gung-ho for people who occasionally dangle off of walls.

Conclusion #2: Apparently my elbow (and yes, it is my elbow, although the effects are evident throughout my forearm and into my wrist) was much more seriously munged than I had thought. I hadn't thought I was minimizing anything, or for that matter exaggerating anything. But apparently my case was and is really interesting, and quite acute. Enough so that at this morning's session, I had yet another intern called over to observe the initial treatment.

But what is wrong with me, you ask? Good question.



Apparently I have an acute (and very interesting) case of classic tennis elbow. (Insert joke here about how I haven't picked up a tennis racquet since I was about 12 years old.) 

My current course of treatment is weekly sessions with a PT specialist, for theraputic massage (read: slowly scraping the skin and muscles of my right arm HARD with a series of dull plastic implements to break down and redefine tissue and encourage it to heal correctly, which is about as thoroughly unpleasant-feeling as it sounds) combined with a sequence of stretches and exercises to encourage proper regrowth. I had my first session this morning, and owie. But if it works, fabu. If it doesn't show signs of improvement within a few weeks, I was told quite strictly by my doctor to come back to him and we'd try something else. He's particularly interested by my case for some reason, at least in part because it *is* so acute (I have some actual restriction of range of motion in the joint thanks to how gummed up everything is, something I hadn't really noticed, I'm embarrassed to admit. I had noticed that it hurt, of course, but I hadn't actually been trying to flex it through the full range because I'd been resting it as much as I could), and in part because there's no obvious trigger for it. I haven't recently changed my routines. I haven't suddenly taken up climbing - it's been almost a year, in fact. A flare-up this severe usually has a notable trigger, or so I gather.

I am quite impressed by all the care, concern, and professionalism shown by the clinic folks. I am dutifully adjusting my schedule to accomodate the weekly PT sessions, as well as programming my computer to beep at me at hourly intervals for the exercises and stretches.  And on the good news front, my PT guy does *not* want me to wear any braces, and he *does* want me to use my right arm as much as possible without it sharp-stabbing-hurt or aches-too-much-to-ignore hurt. I can't go climbing as usual this weekend, but I am hoping to get the OK next weekend, as he wants me back doing my normal stuff as soon as possible. Ditto that on the typing, and the working out, and the running (which wasn't really affected, but still). 

But really. Tennis elbow?!?

*sigh*

Comments

[tylik.livejournal.com]

Which place is this? Sounds like one to know about!

No anti-inflammatories?

[jaunthie.livejournal.com]

No. The doctor explained that while that used to be the standard, recent research (including biopsies of affected tissue) indicates that anti-inflammatories can actually retard or adversely affect the healing process for this type of injury. He was *very* forthcoming, and seemed extremely happy to discuss all the advancement in research and various studies and so on. If I had expressed any interest in the blood injection stuff (the precise name of the treatment escapes me at the moment), he looked all ready to refer me over to the specialist at UW who's leading the charge in that direction. Personally, I am hoping that the massage and stretches and retraining of muscles works, as it's much more in line with my own preferences.

As for where, good ol' Ginny Mason. fisherbear and I have had many positive experiences with the doctors there.

[(Anonymous)]

A. Don't whack your elbow on anything, that hurts.
B. If your sports medicine people start making noises about steroid injections around the tendon give it some serious consideration because while it hurts like bloody hell for about three days it really does make it feel better.
C. Really. Don't whack your elbow.
D. I know a good acupuncturist.

--J

[jaunthie.livejournal.com]

A. So noted.
B. If they do, I will consider it - but they seem very anti-steroid for this particular case, at least for now.
C. Gotcha. ;-)
D. I know you do. And if the PT doesn't work on its own, I'll consider it. So far, though, I'm seeing notable improvement after just one session and a week of doing the exercises/stretches, so I'm hoping this will prove sufficient.