Shoulder Pain and Ageism

Photo by Dan Iggers.

Ten months ago, I started noticing pain in my right shoulder.  It has taken me that long to find a medical professional to take my complaints seriously.  Part of the delay is due to my move from Kansas to Indiana. However, part of the delay appears to be ageism.

Let me explain.

When I first reported shoulder pain in October of 2015, I was hoping to get some imaging on my shoulder and a referral to a physical therapist. That didn't happen.

Instead, my general practitioner told me: "At your age, you should accept that you are going to experience aches and pains. Just deal with it." 

Um, that seems ageist to me.  And unprofessional. "Aches and pains" isn't very specific or technical.

Because she took my lower back pain seriously a couple years prior,  I was surprised that she roadblocked my treatment for my shoulder. I actually suspect that she was getting pressure to "keep her numbers down" for referrals.  Again, I think ageism motivated her to block me whereas she might send refer a person in her twenties to a specialist for persistent shoulder pain.

Flashback to lower back issues

When my back kept going out in late 2014 and early 2015. I saw a DO for adjustments, but I wanted a systemic analysis for why the vertebrae in my lower back kept coming out of alignment.  I requested a visit to a physical therapist, and my GP granted that.

The physical therapist recognized that I needed to strengthen my core muscles as a way to accommodate for an injury deep in my right hip that caused my left hip to move forward--bringing my lower back muscles with it and therefore my vertebrae.  I did my "homework" and strengthened my core muscles.  I was actually able to move 63 boxes of books up and down stairs without throwing out my back.

Dashed hopes for addressing shoulder pain

Because I was restored to prior function of my lower back with a referral and physical therapy.  I was hoping for the same with my shoulder.  I didn't seek a second opinion in Kansas. I licked my wounds, metaphorically, for a while.  By March, we learned that my husband secured a new job in another state.  I would seek out a new doctor after the move.

By early July, I had an appointment with an orthopedic surgeon here in Indiana. Our new insurance does not require referrals from a general practitioner.  I was hopeful.

I decided to lead with the information that I am a mature athlete. I am not a competitive athlete, but I do spend between 5 and 10 hours a week working out--doing a mixture of cardio, strength training and stretching.   If I conveyed the image of being active in midlife, this might help the medical professionals see me as returning to prior function.

Those hopes were dashed in five minutes.

When the doctor entered the examination room, I introduced myself as "Karen, a mature athlete." He countered, "Well, I am the athlete here."  Yes, he has a commanding physical presence, but I did not see his muscular physique as the focus of the consultation.  I was trying to explain my shoulder, my pain and my goals.

The orthopedic surgeon asked me to stop talking and told me, "You have arthritis in your right shoulder.  That shoulder will be totally shot in 10 to 15 years. You should stop doing demanding forms of exercise and stick to stretching."  

I was shocked.

I tried to reorganize my thinking in order to ask him appropriate questions. I asked him to consider physical therapy as a workaround. But he just repeated what he said at the start and left the room.  We had no give-and-take conversation. He had read my x-ray prior, told me his conclusion, and treated my concerns as trivial and disrespectful to him.  He talked at me, he didn't talk to me.

I grieved for about two weeks. The first week, I didn't go to the gym at all. The second week, I went but tried to find accommodations for my "soon to be shot shoulder" on my own.

I am not a physical therapist or an exercise physiologist. I was out of my depth.  I actually left a yoga class in tears, thinking I would never be able to do a down dog, an up dog, a plank, a frog, or a wheel again.

After sticking only to spin classes for a week, I decided, "No one puts Baby in a rocking chair." 

I sought a second opinion.

I surveyed the fitness instructors at my local gym. Many of them recommended a local doctor who is a shoulder expert.

The second orthopedic surgeon listened to me describe my history of shoulder pain. He accepted my identity as a mature athlete. He found it reasonable that I would want to lift weights, practice yoga and participate in pilates.  He never once said, "at your age" to me.  He ordered an MRI with the expectation that I would next go to physical therapy.

He told me, "I can't be sure until I look at the MRI, but I think we can send you to physical therapy to strengthen muscles in your shoulder and get you back to lifting weights and practicing yoga." 

Hooray! He did not roadblock my path by labeling me "old."  I think it helped that the second opinion doctor is closer to my age whereas the other two medical professionals were 15 years or more younger than I am.  

If the second opinion doctor discovers that I do have an AC joint impingement in my right shoulder, which I can possibly rehabilitate.  Even if I do have permanent limitations in that shoulder, I will accept that, because the second-opinion doctor didn't display any ageism.

Related:

Three Karens on the Track
Outrunning Father Time and the Grim Reaper