Fifth Prolotherapy treatment.

Sorry y'all for not having been more active, my laptop has been down for a month and I really didn't feel comfortable using my work computer to upload blog posts (government security and all).  Anyways, it's back and so am I.  Here's the vid I took right after my fifth treatment.  We had a major breakthrough in that it seems my ribs were "looking pretty rough" under the ultrasound.  When I had the injection at my chest it felt like a huge pressure/weight had been lifted. It was a type of pain I didn't even know was there because I was simply so used to it.

Anyways, here's the vid:

Six weeks out from first treatment

So it's been two weeks of doing the scapular stabilization exercises. After the first day of exercise, my muscles were sore/unhappy for about 5 minutes, but then everything went back to normal. I get the same experience after each workout, but each time it's to a lesser extent.  These past couple of times I've had no increase in pain after working out, so I think now I'm going to start getting back to strength/ROM, so that means I'll get to work with Indian clubs, in addition to some other dumb bell/barbell exercises.

I think I've been babying my body for a while now. I've been really conservative just because I want to heal up ASAP.  But when I expressed my concerns to the Dr. he just said to let pain be your guide and to keep moving.


Letting pain be my guide has been difficult, because right now I'm back to being in pain all the time.  The amount of pain/discomfort that I'm in is less than before I started this, but it's still there. So knowing that my muscles are still frayed, is it ok to use them, to push them? It seems from Doc's advice that it is ok.

The pain/discomfort that’s going on in my back is... evolving. It used to be just this big knot of pain, but now I can feel each muscle separately and feel the pain in each one.  It's like a room of people has gone from everyone screaming and you can't hear what they're saying to everyone is talking loudly and you can now make out each conversation. Hopefully after the second treatment it will be reduced to a quiet murmur.

Concerning my hip. It's been... interesting. When I mentioned to one PT that I still experience hip pain despite the fact that I haven't squatted/deadlifting for six weeks he asked if I've considered the possibility that it's a sports hernia. I have, in the past, been given that diagnosis, but I think that is not what I have.  The main reason being that there are times where I do not experience any pain. I think because there are things that I can do to relieve the pain, it's not a sports hernia. I may be wrong, I'm not an expert on the subject matter. However, I figure it my groin pain is stemming from some type of structural damage then it should be fairly constant. That's how it was before I had PRP injections to treat the torn labrum in my hip (constant pain no matter what I did).

As of right now, when my groin/pectineus acts up I also have a tight TFL and possibly glute medius and piraformis.  I roll out on a soft ball, and it is amazingly painful but when I get that release in the back of my hip, the pain in the front seems to go away, or at least diminish greatly.

So it seems that my current hip/groin pain is coming from tight muscles in the back of my hip, and those, in turn, may be tightening up because of the structural damage to my left hip capsule or to the fact that my left spinal erectors don't seem to work very well right now.  In either case, that first week after my first prolo treatment for the left hip/right spinal erectors, I had no hip/groin pain whatsoever.  ...I hope this hasn't been too confusing, if there's any questions just leave a comment and I'll be happy to respond.

I've starting running hard for short bursts on the treadmill, and it doesn't seem to cause any trouble whatsoever, so I'm thinking it would be ok for me to get into sprinting. There's a sprinting group that works out nearby. I'd like to join them but I'll have to tell them that in about three weeks I'll have to stop going for about a month.  We'll see what happens.

Beginning of the Vlog

Alright well here we go with the shoulder labrum tear.  I've decided to start a Vlog in an attempt to try to spread the prolo word through a different medium.  I'm still going to write about it, but the writings are going to be more of a supplementation to the videos.

Here's the prologue, where I lay down some of background for why I'm seeing Dr. Fullerton. If you want the absolute full history of my shoulder/neck problems they can be found here.

Simple shoulder help

Ok, so I was still a little mystified (albeit amazed) at how effective simply hanging from a bar for like 20 seconds multiple times a day is for my shoulder/neck pain.  One thing I've realized is that I've never really had a diagnosis for what's wrong with my shoulder.  I mean. I keep figuring out what muscles are tight (Scalenes, Sternocleidomastoid, etc.) and figured out some great stretches for them thanks to Kstar.

[Update 9/11/13: I'm not the only one who has blogged about how great this stretch is for undoing tight shoulders and rendering surgery unnecessary.  Here is the post about him coming across Dr. Kirsch, and here is a detailed explanation of his protocol that worked for him.]

[Update 4/20/14: OK so that guy who wrote those posts has since shut down his blog.  I've changed the links to the wayback machine and just for the sake of keeping the good stuff I've tacked on his protocol here at the end of my post.]

At first I thought it was simply from laxity in the supraspinatus from injuring my shoulder and then years of sleeping on it.  However, it seems like it's a little more complicated then that, or my self-diagnosis is completely wrong (nothing new in either case).  There were definitely some instability issues in my neck, which I've fixed through prolotherapy and sleeping with a soft neck brace.  However, there are still some issues, and they feel like they come from near the center of my back, like right between the shoulder blades.

Well, since hanging from a bar seems to help, I decided to investigate: 1) what shoulder issues does it treat, and 2) why does it treat said issues.

Here is the short answer, according to one website:

1. Hanging from a bar helps with impingement syndrome and frozen shoulder.
2.  "This exercise does a marvelous job of stretching all of the ligaments, muscles, and tendons surrounding your shoulder joints, along with many of the soft tissues that cross your shoulder joints but that travel a good distance away from your shoulders, like your biceps tendons, triceps tendons, latissimus dorsi tendons, and even the tendons of your front chest muscles"

For a much longer, in depth look at this I found a thread that is started by someone asking about Subacromial Decompression surgery.  A certain Dr. John Kirsch is a huge fan of this whole "brachiating" (You should check out his website here), and here is what he thinks:

When you hang, you are bending the acromion and stretching the coracoacromial ligament (CA arch). Then, when you do the full side lift weight lifting, the RC tendon will become thicker, more robust and healthier. Most hardly ever use their rotator cuff muscles and the tendons become thin and fragile.
After remodelling your own CA arch, there will be more room beneath the arch for the rotator cuff, bursa, etc.

I've never heard about the coracoacromial ligament before, but it seems to be fairly important, at least to Dr. Kirsch:

The CA arch is responsible for most of our shoulder troubles. It presses on the subacromial structures (rotator cuff, bursa, biceps tendon) and when contracted due to time and disuse, produces degenerative damage in these structures. By hanging from an overhead bar or similar support; and then doing forward, side and extension dumbbell weight lifting (palms forward or down) you can restore the health of the rotator cuff tendon and muscles. Each time you stretch the CA arch by hanging, you are making more room for the RC. Over time, the deformity of the acromion will remodel (Wolff's law), and the coracoacromial ligament will stretch becoming more compliant.

Dr. Kirch actually has a book out on this, "Shoulder Pain? The Solution & Prevention, Revised & Expanded".  I plan on buying it and giving it a look over, I don't think it's too long of a read.

I'm very, very interested to see how this plays out, if I actually do have shoulder impingement and if remodeling my CA arch will help out.  So far so good, my shoulder is feeling markedly better, and I'm really, really surprised.

Here's the guy who wrote the fight4inches blog:

Brachiating  which is essentially hanging from a pull-up bar like a monkey. Not my idea (see Part 1 of this blog). I try to hang daily for 3x rounds of max duration from a pull-up bar. I often start off w/ a supported hang to warm up the joint because it is painful with a cold start. The purpose of this activity is primarily focused on re-shaping your acromion (or re-flatten it) to create space in your shoulder capsule per your original design. What happened over time is that your bone (acromion) literally got bent out of shape, so you have to straighten it out. 

Shoulder Capsule Mobility – to really understand this, you’ll have to purchase the ultimate guide to resolving pain, preventing injury, and optimizing athletic performance and look up how to specifically do this. I’m a fan of the band assisted approach (not the Kettlebell). Basically, this protocol entails pushing the ball joint of your humerus way back into the shoulder capsule to it’s designed position. I do this after I brachiate – open up the physical joint and then shove the joint back, deep where it belongs. You have to do this for over 2-minutes to get the best results. 

Strength Training – finally, do exercise elements to build up your upper back and anterior deltoids. If you buy the references I outlined in these two blogs, then you have all you need to know. An additional exercise I do that is not prescribed is elevated feet ring rows w/ knuckles up. You can do ring rows w/out elevating your feet – but you won’t juice up your back to the same extent. So where is my Prescribed Shoulder Mobility Recovery WOD (one day I’ll post a video blog on this if there is demand): 

Pre-game:
1. Warm-Up – Mobility – look up mobility WOD activities for your thoracic region of your back, lats, pecks, etc. You want to prep the muscles on your chest, back, sides that limit the full mobility of the shoulder joint. This takes about 10-mins to do properly. 

2. Warm-Up – literally Warm UP – do forward and backward small shoulder circles w/ arms fully extended to the side, palms up. I like to try to make my arms rotate behind my frontal plan. I do these in both directions until my shoulders are burning. Then do larger circles both direction until you feel your arms are ready to fall off. This is like 4-5 mins of work. Now your shoulder joint is properly juiced up for some good physical therapy. 

3. Shoulder Mobility Recovery WOD: 3 x Rounds for effort of:
Brachiate (max duration)
Shoulder Capsule Mobility (both Arms) – 2mins each arm
Strength Training Elements 

I recommend doing this a minimum of 4x a week. To date, I keep experience gradual improvements and went from not being able to do near anything upper body to now being able to row, deadlift (full effort), front squat (full effort), power cleans (lighter weights), OH Squat (lighter weights), etc. and continue to improve. I make a point of taking fish oil to help w/ the inflammation, but my shoulder continues to get healthy.  Once I’m 100% healthly – I’ll outline a detailed post on a very specific approach.  I feel comfortable that I’m on azimuth – we’ll see how it goes and I hope it helps any other weenie in pain.  Even if you aren’t in pain, assess your shoulders and make sure you have full mobility – otherwise, if you strength train, you are an injury waiting to happen.

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Neck/shoulder is feeling awesome

I've only had two treatments for my neck/shoulder, and I have to say it's feeling a whole lot better.  I haven't cracked my neck at all after the last treatment.  To be honest I don't know if I could crack my neck if I tried, the joint feels that much more stable.  I still find myself releasing all kinds of knots in my neck, so it's not 100%, but I don't feel that itch to crack my neck like I used to.  I also think my neck muscles are  tightening up because they are responding to another, different muscle that is tight and I just can't get that one source muscle to release, if that makes any sense. So hopefully when I see Bobby he can release that one muscle and boom I'm set. ...I can not stress how much of a role massage therapy has played in my recovery, I think it has really accelerated the process with prolotherapy.

I'll give you one guess as to
when I took this picture.

One of the biggest things is I can now wear my watch.  A couple years ago I bought myself a Breitling Super Avenger, which weighs a hefty 153.30g, and that's without the bracelet!  I love this watch, but I couldn't wear it because after a while the weight would pull on my neck and shoulder and make it worse, especially when I was dealing with the tendonitis in the shoulder. 


Now, I can wear the watch and it doesn't seem to set off my neck/shoulder.  I find myself wearing it all the time now, and it makes me happy.  So thank you Prolotherapy!

A really hard decision made today.

Exhausted, today's workout thankfully didn't have anything approximating squats. This is what was on the board:

800 m run
30 clean and press (95 lbs)
30 chin ups
800 m run
25 clean and press
25 chin ups
800 m run
20 clean and press
20 chin ups

This is what I ended up doing:

800 m
30 clean and press (20 lb dumbells)
30 chin ups
800 m
25 cleans (95 lbs)
12 chin ups
800 m
20 cleans
10 chin ups

I did it in 49:50

I really really really hate the fact that I had to stop the press element in the clean and press, but on three different reps I felt/herd my shoulder "click", which means there's still an impingement in my shoulder. Because of the muscle tear, when I move my arm above my head there's still a danger of something catching, thus the clicking. I know that it might not hurt at that moment, but I will feel it later. So I had to stop, and that took all of my will power.

Chin ups were also really, really hard. The last set I could only do them one or two at a time. Good news is I got my form back, I felt like my kip is really getting good. Bad news is that my forearms are my weak link. Like I did one or two straight pull-ups, so my lats (which are still sore) were strong enough, I just couldn't hold onto the bar. Thankfully, that will improve, and soon I'll be pounding out the chin-ups. Strangely, I'm looking forward to Friday, wonder what Jerry will have in store!

The hopefully short road to recovery

Well, it was on my fifth day of crossfit where I injured myself. We were working on strict press, specifically doing max reps on 80% of our max weight. I was on rep 15, and my shoulders were starting to feel the fatigue. "I know," I thought, "I'll widen my grip, that'll help," and as soon as the idea came to me I did exactly that, I widened my grip. Now, crossfit is my first experience with Olympic lifts, so I will chalk this up to a rookie mistake, but I adjusted the weight the instant the idea came to me, which was when my elbows were locked and directly over my head.

As you can imagine, when I did this pain shot through my left shoulder. It didn't make me drop the weight or anything, but I definitely felt pain. However, the pain subsided almost instantly, and so I did about five more reps and proceeded to do the WOD. that night when I went to bed my shoulder was a little sore, but when I woke up the next morning it was really, really painful.

Long story short, I went to the doc, who did an ultrasound and said I have a partial thickness tear of my supraspinatus, one of the muscles that are called rotator cuff muscles. This floored me, I had read that these injuries can take up to six months to recover from, so I was relieved when I learned I should only be out for 3 weeks. Thankfully, it's a slight injury.

I'm two weeks into therapy now and the pain is less and less by the day. It's been frustrating not being able to work out like I want to, but there's nothing I can do about it now but continue my therapy and get better, healthier, and eventually back into what I fondly refer to as the "blue room of death." So my current mantra is "I will recover, I will get back to my old strength, and then I will get even stronger."

Let's just hope that it won't take too long.....