Shouldering the Burden

For the past six months, I have been bowling in pain. I was getting used to it and adjusting my backswing and hand position to minimize the discomfort. My shoulder was hurting. After 35 years of a high backswing, the wear and tear finally caught up to me. It was ironic to note that my approach looked 'more textbook' as I lowered my backswing and held a more closed hand position to alleviate the discomfort. If I had bowled the way the game is usually taught, I would have never seen a doctor, learned shoulder stretching and strengthening exercises, taken lots of anti-inflammatory pain medication and received one cortisone shot.

Shoulder Impingement Syndrome
Like most males of the species, I don't want to go to the doctor. I prefer to have some idea of why I need to visit so I am not surprised by a professional diagnosis. With the Internet, I can search on my symptoms, research possible causes and treatments, and determine if I need professional help. I am not a person who needs to visit the emergency room with a headache or nose bleed. WebMD listed this diagnosis:

Impingement syndrome is a common condition affecting the shoulder and is often seen in aging adults. This condition is closely related to shoulder bursitis and rotator cuff tendinitis. These conditions may occur alone or in combination.

Aging adults. I do note that most of my current ailments usually have those two words in the definition. It is usually an overuse injury. For my case, it was an overuse due to bowling and an aging adult. Google Health described my condition exactly as risk factors for being over age 40 and participating in sports or exercise that involves repetitive arm motion over the head.

Road to Recovery
Just taking the summer off from bowling did not make this problem go away. I still went to the gym and did strength training. However, I did diminish any exercises that resulted in shoulder stress. When my sleep patterns were affected by shoulder pain, it was time to go to the doctor. I still have doubts that most sport orthopedic doctors know the physical tolls on a body due to bowling. I was passing a lot of simple shoulder tests. I could raise my arm over my head. I could still do push-ups and chest presses. However, it hurt to raise my arm behind me. Typical shoulder impingement areas involve failing those first tests. Demonstrating a backswing that hurt was a new symptom. Luckily, the treatment is the same. The doctor started me with a conservative treatment; physical therapy and lots of anti-inflammatory medication. Even though it did not help with the pain that much, the medicine was needed to reduce the swelling.

Oral anti-inflammatory medications -- such as aspirin, naproxen, or ibuprofen, remain the most common treatment for impingement syndrome.

You must consistently take the medication for nearly eight weeks for it to be effective. You should do this under the care of a doctor because these medications can cause stomach irritation and bleeding.
Taking anti-inflammatory drugs for a short period of time may treat the symptom of pain, but it will not treat the underlying problem and symptoms will come back. There is no specific medication for this condition and response to any given medication differs from person to person. If one anti-inflammatory medication does not help within 10 to 14 days, then another one will be given until one that provides relief is found.

I was taking ibuprofen and Meloxicam for two months. In addition, I did common stretches such as trying to reach my thumb up my back. I used resistance bands to force the hand further up my back. I used a pole or towel to raise both my arms behind my back as far as comfortable. I also did a series of light weight shoulder activities known as Hughston Excercises. I used 3 and 5 pound weights. Since the muscles being worked are smaller muscles, you will find that these weights are more than sufficient, especially if you are having rotator cuff problems. After six weeks of these exercises, I was still failing one test. Holding my arms straight out from my body palms up, the doctor would push down on my hands. It was hard to resist his force with the injured arm. Every other impingement was much better except for the bicep tendon. This is the tendon that connects the shoulder and the top of the bicep muscle. My injury was specifically diagnosed as bicipital tendonitis. I received a cortisone shot at that location.

Bowling During and After Treatment
Why are you still bowling? A question that was often asked by relatives familiar with my shoulder injury. Well, the doctor didn't tell me to quit. I was going by the adage, if it hurts to do it, don't do it. It did not hurt that bad, but did get worse the more games I bowled. I had basically cut back to bowling one league a week and one tournament a month. With no practice, that meant 3 games a week with one week-end of bowling 4-8 games. As I mentioned earlier, I was doing basic adjustments that relieved the pain. The summary was that I was bowling more correct as I should have been doing. My arm was more of a pendulum with a shorter backswing. This took a lot of stress off the shoulder. The release and follow through were not forced but more natural. Forcing the downswing and follow through adds stress to the shoulder and bicep. You would only feel this extra stress if that area was injured. Letting the weight of the ball control the pendulum swing adds no extra stress to the shoulder joint. Those shots felt good and pain-free. I was disappointed if I did not strike on those deliveries. If I executed correctly and did not wince, I thought I should have struck.

I also had to quicken the steps of my approach to add ball speed. This would also alleviate my shoulder from forcing the delivery. As my ball speed is not that great anyway, I was struggling on house shots. I had to play more inside than I would have wanted for maximum scoring potential. The tournaments in which I participated were sponsored by Bowlers Advantage Pro Shop. This series of tournaments uses the Kegel Challenge series of lane patterns. These patterns are advertised as harder than house shots but easier than sport patterns. I have had the same success this year as previous years on these patterns. The slicker patterns play to my advantage with my slower, more deliberate style. I have made the qualifying rounds about the same percentage as previous years. However, the more I advanced, the less I had to give to the match. This is no excuse. I was defeated by the better bowler when I lost. I am not sure a 100% healthy me would have won. One thing that could have helped was the mental aspect. With my injury, there was no easy shot for me. While the rest of the league is shooting their normal average and honor score ratios, I am still working hard for a good set. I don't feel that I have as much area. I also feel a bad delivery will have bad results. I am prone to leave more pocket splits this year than in the past.

The Road Back
Now, I feel good. The competitive juices are coming back. I am still a little apprehensive. One inspirational story is San Diego Padres/San Francisco Giants pitcher Dave Dravecky.

The following season, a cancerous desmoid tumor was found in Dravecky's pitching arm. He underwent surgery on October 7, 1988, removing half of the deltoid muscle in his pitching arm and freezing the humerus bone in an effort to eliminate all of the cancerous cells.^[1][2] By July 1989, he was pitching in the minors, and on August 10, he made a highly publicized return to the major leagues, pitching eight innings and defeating Cincinnati 4–3.

He coauthored a book, Comeback, that chronicled his story of returning to the mound after his cancer diagnosis. The reason that I am apprehensive is that Dave's cancer came back and he broke his arm pitching during a game. His arm deteriorated and had to be amputated. Dave is now a motivational speaker after the success of his next book, When You Can't Come Back. I have this book. I think it is too early to be forced into retirement from a sport and activity that I have done for a significant majority of my life. There would be some serious emotions to handle if the decision is forced upon you. I am not ready, but am optimistic that it is not yet my time to give up the sport. I always thought my more simplistic approach would allow me to outlast and outbowl many of my competitors in the long run as we all became senior bowlers. Many of the younger bowlers apply too much stress on their bodies with their powerful deliveries. It is humbling to know that these type of injuries can plague even those who consistently exercise and stay in good shape.

There have been good signs. I have bowled a 300 game within 2 weeks of the cortisone shot, and went to the championship match of a Bowlers Advantage tournament. The good news is that I did not feel pain or sore later or the next day. I am starting to remember what I used to call 'normal.'