Something isn't right

Through the winter and spring, I have focused on swimming as my main sport and mode of exercise.  I developed a workout regimen that included 5-6 swims and 2-3 lifting sessions at the gym per week. Sure, it was a tough schedule to follow, considering I had to be up around 4:40 am most days of the week to swim before work and then go to the gym after work several days a week, but it was well within my capabilities with the high level of fitness that I have gained over the last several years following my surgeries. It tested my commitment for sure, but my goals for the year were clear, I wanted to get stronger and I wanted to be competitive at swimming.

But...

My body had other plans.

In February, I began experiencing shoulder/scapula and elbow pain, primarily on my left side.  I worked with my coaches to really hone in on my swim technique to ensure that my stroke was biomechanically sound.  That helped somewhat.  

In March, I was completely surprised one morning at swim practice by knee pain.  It was mild at first and only bothered me in the pool, then it continued worsening until it was not only limiting my swimming but becoming difficult to complete my activities of daily living on land like walking, going up stairs, sitting normally, and sleeping restfully.  

In April, my shoulder/arm and knee issues became debilitating and rendered swimming and exercising nearly impossible.  I couldn't swim with my top or bottom half, the best I could do is use a pull buoy to float my bottom half and scull (drills that swimmers do to work on feel for the water and hand position) with my top half. I had this gut feeling of terror that something major was going on with my health again.  How these joints felt was eerily similar to how my ankles felt on the path to collapsing and requiring reconstructive surgery.  I've gone through two surgeries already and somehow found a way to come out well on the other side, I DO NOT WANT TO GO THROUGH THIS ALL AGAIN. Tears...tears...and more tears were shed.

While extremely hesitant to go to a doctor regarding joint problems again, I made an appointment with an orthopedic doctor to get checked out.  The ortho diagnosed me with IT Band Syndrome and Bursitis in the knee and Impingement Syndrome and Bursitis in my shoulder.  He also gave me cortisone shots in both places.  He didn't think that these new injuries were connected in any way to my ankles, and couldn't provide an explanation for why my ankles collapsed, the same as my former doctors.  I continue to be a medical mystery.

The cortisone shots provided a little relief, just enough for me to resume some level of training to prepare myself to compete in the US Masters Swimming National Championship Meet.  I had been training for this meet for well over a year, so I was thrilled that I was on the mend just enough to swim well.  I absolutely crushed my former times and exceeded both my own and my coaches' expectations of me for that meet.  My goal was to be competitively last in my age group for each of my swims, and I accomplished that and beat a few people along the way.  With my limited swimming background and my ankles/shoulder/knee issues, I was beyond proud of myself.  It was also the first time that I ever competed in a tech suit, the very thin, water repellant, and buoyant suits that go down to your knees, the ones you see olympic swimmers wear. I had reached the ultimate level of swimmer...

and then...

In May, less than two weeks after USMS Nationals, I couldn't swim at all.  All the pain returned in full force.  I was in so much pain that I couldn't sleep, that it was distracting me from work tasks, that it became tough to make it through each day.  Having tried and failed treatment by cortisone shots, I decided to completely back off my training and return to physical therapy. I was preparing to travel to the national conference in my field, the American College of Sports Medicine Annual Meeting in Boston, and then to spend the month of June in Thailand.  I had a short amount of time to stabilize my condition before embarking on these trips.  

I switched to a new physical therapist and a brand new sports medicine clinic for these injuries. My goal was to learn some rehab exercises that I could do while I was away.  In the first few minutes of meeting my new physical therapist, I knew I was in the right place.  From the questions he asked me about my health history and the thorough evaluation he performed, I felt like I couldn't be in better hands, the same way I felt with my original physical therapist who worked with me through the very dark days after both of my surgeries, before I moved.  Not every healthcare practitioner treats the person, many just treat individual symptoms as if they don't belong to a real living and breathing human, I could tell that I was working with someone that was going to treat me as a whole and not just my injuries. When he checked me for muscle imbalances and flexibility issues that could have contributed to the diagnoses that I was given by my ortho, he couldn't find a rationale for me having severe issues with those joints. He was impressed by the muscular strength and athleticism that I had built back, all on my own since ending physical therapy after my second surgery.

These were clues that I had been misdiagnosed, and that something else entirely was going on...