11 days out from my fifth Prolotherapy treatment

It's not yet two weeks out from the fifth treatment, but I'm really feeling better. I think a lot of the discomfort I was experiencing was stemming from the damage to my rib cage.  It's also pretty amazing how much my shoulder has changed after just one treatment to the shoulder capsule.

I don't know why, but Dr. Fullerton kind of ignored the shoulder capsule this time, even though I was pretty certain I could use another treatment.  He asked of I could hold a plank now, and I said something like, "Maybe??"  I didn't really know how to respond because I haven't tried doing a plank/push up since the last treatment.  ...I now realize that I should've simply said that, but for some reason I felt nervous and just didn't know what to say.

I'm still pretty impressed with how much more I can decompress my left ear now.  It's pretty much identical to the right ear.  Also I haven't felt as near as much need now to try to crack my neck, so that is obviously a good thing.

I still feel the need to try to roll out some areas in my upper back, like where the upper trap attaches to the shoulder blade, I think?   One of the hardest things about this whole process is that because it's my back, I can't easily point to it.  Like I can only approximate the location.  I think next time I will have to roll out and then turn around and show him where my skin is red.

I've really been tempted to go early this January and get a treatment just for my hips, but I think I will probably just wait it out for the next time.  ...if my shoulder/back is still giving my trouble I will book two sessions a week apart, and go from there.  So I guess I'm betting that I will need a sixth treatment on my back.  ...That's kind of sad, but I keep getting so much better after each session.

We will see;  we will see.

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:

Two weeks out from Fourth Prolotherapy Session.

Concerning the shoulder/back, I'm still pretty weak/sore in the shoulder. Like grabbing and holding onto a soup can doesn't feel good.  It's weird how much it's affecting me. Like I rolled over onto this shoulder in my sleep and the pain woke me up.

I'm halfway there to re-starting weight lifting. Going to do rehab (phase 1) until it doesn't hurt anymore, then doing phase 2 until I feel good with that, then on to sprinting and lots of Pilates Barre method classes. I know I know, a dude doing pilates and barre. But they seem like a really good solution to working my core in the correct manner, and will help me get proper mechanics down.

Once symptom of the laberal tear is my shoulder gets reall tired with constant pressure. Like if I try to hold a plank or a downward dog it really wears out quickly.  So I'm really looking forward to see if I improve in that area.

I'm really interested in seeing how this past session changes things. I think he really got the remaining muscles that were bothering me, especially my serratus.  I'm really looking forward to trying out deadlifting again. I've never done deadlifts without hurting my back, so if this works it will be pretty damn amazing.

I just really hope that my back is done, that I can move on. I accept that the pit in my shoulder capsule may need a few more treatments, but as far as the muscles go I really hope everything is set.  I just wish the Doc had started treating the tear in my labrum, the pit in my capsule, sooner.  It still makes me pretty mad that he hadn't addressed it until now. Hopefully I can get some pity points and he'll do it for free while he works on my hip. 

Speaking of my hip, I'm definitely feeling different. Although it's hard to tell if it is the PRP because four days after seeing Dr. Fullerton I had a varicose vein removed in the same leg.  Well, not removed, but burned shut with a laser that was placed inside the vein.  While my body reabsorbs the burned up vein, I'm experiencing a lot of pain in my groin, not unlike what I was feeling before I started up dry needling.

I do find though that bringing my knee up doesn't hurt like it used to. I am now realizing how much I used to brace myself for pain while bringing my knee up, say to cross my right leg over my left.  It will be interesting to see how squatting will feel.   Can't wait really.

So I'm only two weeks away from being able to try out my new body, albeit I will have to approach things conservatively.  Still, there is a possibility that I won't need another treatment. The pit in the capsule could be completely healed, and it could be that the tissue in my hip Dr. Fullerton addressed is really all I needed. If that turns out the be the case, I will be overjoyed. Of course, if I need a fifth treatment I really won't be mad because I have been experiencing such progress over these past nine months.

As I read what I just wrote I see so much hope and excitement for what's to come. I can't help but think about how I've been excited for what's to come for years now. Heck back in '09 I was pumped because I just needed to figure out the pain in my shoulder and hip and I was good to go.  I wonder if this is normal, or if I am just really, really strange.  I guess I have to be constantly optimistic, otherwise I would just get beat down and wouldn't be able to keep going forward. Yes it's been a long journey, and yes I always think that I'm just one step away from being completely healed, but I figure as long as I keep getting better then I'm doing something right.

And I am getting better all the time. Every step I've taken has made me feel better. I guess my body only allows me to feel as certain level of pain, and as I fix one thing or another I realize how much pain I was actually in.  I am still surprised that I had so much wrong going on with my back and I was still able to crossfit.  Or even walk, for that matter.

For the first time, when I left Dr. Fullerton's office two weeks ago my neck/ear felt completely normal.  This is obviously a good sign. I just hope I don't need a second treatment for the shoulder capsule.

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.

Rehab from Torn Labrum in Shoulder: First Day.

Excited because today I get to do resistance work!!!
Going to start out conservative, going to work on scapular stability.  I should point out that I'm not just working on recovering from a torn labrum, but I'm also working with damaged rotator cuff and various back muscles.

On a related note, I've realized what I'm doing is broader than just treating a torn laburm. Through this process I've found out that I have an injured rotator cuff as well. There are a lot of people out there that might benefit from avoiding surgery to repair their rotator cuff, so I'm going to make it easier for them to find some of these videos.  A torn labrum and damaged rotator cuff go hand in hand, actually. This might be one reason why surgery repairing a labrum only might be ineffective in relieving pain, it might be only a partial repair. Plus, if you have poor mechanics you're just going to tear it again.

Anyway back to my protocol for scapular stabilization.  My rehab will go through three different phases. First is endurance, second is range of motion/strength, and the third is speed strength.  Endurance will get those stabilizers back to strength, so I will develop proper mechanics. Then I can work on strength, like bench press. And after that has been worked some then I can work on explosiveness, like in Olympic lifts and sprinting.

Here is the document describing the exercises I'm doing for phase one. I'm planning on doing only 2 sets for the first two times, and after that bump it up to three. Also, I'm doing these every other day, adding weight bit by bit. Hopefully I can move on to phase two in two to three weeks, depending on how I'm feeling.

Post Prolo: First Day of Exercise

So it’s been two weeks since I saw Dr. Fullerton and I’m now able to do really low-impact stuff. For example, I can now walk on a treadmill for 10 minutes!!!!!! Sad as that is, I’m happy to be out doing something. …I’m also a little surprised how winded I get walking on a 3% grade incline.  As I understand it, if I feel good from today’s work then I can do 15 minutes 

We will see how it goes.  In another two weeks I will be able to do some type of resistance training. I’m already trying to plan out some stuff and when I have it all figured out I’ll post the protocol here for all to enjoy.  I’ve reached out to my friend/trainer/pt guy in IL who programmed my rehab for my hip in the hopes that he’ll do it again. If he does this will be amazing because his understanding of the body is amazing.  Here's the latest entry for the Vlog:

Seems to be a Connection between my Right and Left Hip

Interestingly enough, even though Dr. Fullerton addressed my left not-that-painful hip, the pain in my right pectineus has gone away.  I don’t understand the reason why, I mean how could a pit in my left hip capsule affect the front of my right hip?  But my right hip pain really isn’t there anymore. On a scale of 1 to 10 it was down to like .5, but now it’s where I forget that I’m pain free. It’s the kind of pain free where I haven’t thought about it, which is the ultimate goal.

I have to admit, I wonder how much of my struggles have stemmed from the injuries/weaknesses in my back.  I know the back muscles (especially the rhomboids) play a large part in stabilizing the torso with the front squat, and that was definitely where I would fail.  My legs could handle the weight, but I would still dump the bar on the way up because I’d lose my balance.  I’ve been doing dumb bell rows, and I’ve noticed it’s way easier to pull the weight with my right arm than it is with my left. The weakness has never felt like a strength issue, it’s always felt like a “muscle just stops responding” issue. Having a frayed trap/rhomboid/lavator will do that I guess.

…The fraying of the muscles in my lower back could also be a reason why I struggle so mightily with deadlifts. A common reason why people fail a deadlift is a weak upper back. If my lavatory, etc. are frayed and weak this could be the reason why I have so much trouble with the heavy pulls. Also, if my left spinal erectors are the ones doing all of the work, then that could explain why my lower back just kills me after deadlifts.  It’s never been a matter of leg strength. Never has been. I was doing leg presses (don’t judge) of 450# for 10 reps pretty easily right before seeing Dr. Fullerton, yet I’m struggling pulling 300# off the ground and doing anything above 230# with the front squat is killer.

All these things give me hope that once I’m healed I’ll have a much higher ceiling with the front squat, deadlift, pull ups, and rows.

And the Vlog continues:

First Prolo Treatment with Dr. Fullerton

Fist off I have to say that I really like Dr. Fullerton. He's very professional and very thorough.  Heck even my wife likes him and now thinks that prolotherapy is a valid form of treatment.  The plan was to meet him on Thursday afternoon for an examination, and then friday morning for the treatment.  The first meeting went much longer than I expected. First, it took a long time to go over my medical history. It was fairly confusing for both the PA doing my intake and myself since I've seen four different doctors in VA and IL for the hip that I wasn't seeking treatment for, while having seen a PA in NC for the shoulder pain who gave the diagnosis of a torn labrum.  There's a lot of information there that can get jumbled up over the six years I've been seeking treatment.

So after my intake was complete Dr. Fullerton came in.  Like I said, he was very thorough.  He had me do a bunch of different functional tests to see what was wrong.  It was very similar to getting an assessment from a PT.  He then used the ultrasound machine to see what was going on.  He also did palpitations to see if any spot hurt.  Using these methods he pretty much pinpointed the exact areas of pain in my back.  The lavator, the rhomboid, the trap, and the supraspinatus.  He said these muscles all looked "frayed". That's not exactly what one likes to hear, but he said he's seen worse.  This fraying is all in addition to the torn labrum.  He also found some weakness in the spinal errectors on the right said of my back.  If they couldn't do anything, perhaps my left side has to overcompensate, which is why I've always had a tight QL and pain on the left side.  He also examined my left him, the one that now doesn't seem to move as well as my right, and said there was a pit in the capsule.  That doesn't sound good.  He also found out that when doing internal rotation with that him it caused pain on the inside of the hip joint, the part right next to my junk.  I'm not sure what all of the diagnosis were or meant, all I know is that he found a boatload of problems and he had his work cut out for him.

 

Then I saw him the next day for treatment.  He had me do all those tests that I failed again. Then he injected me with lidocaine to numb the relevant body part.  He waited for the numbing agent to take effect, and then injected the body part with dextrose under ultrasound guidance.  After that he then had me do the test again, and I passed!  It was very strange how immediate the effect was.  For example, he twisted my hip into internal rotation and it hurt on the inner part of the joint. He then injected some solution into the outer part of the capsule, did the motion again, and it no longer hurt!  After he went over everything with Dextrose, he then did the injections of the blood.  He had 180ml drawn to be spun out, so I imagine he had a lot of PRP to work with, so I think he injected everything with the PRP as well.

There was almost no pain during the treatment. None.  The lidocaine really worked at making the real injections painless.  The pain that I did experience came from the pressure of having so much solution

Lots of band-aids after the treatment.

injected into my body.  The pain immediately after the treatment got a little intense.  It's not that the pain is really that severe, is that you know you can't get away from it, nothing you can do will alleviate the pain, and that's hard to accept.  They put an ice-pack on my back for 10 minutes (That's the max you want to do, and only the day of since you don't want to reduce any of the acute inflammation it's suppose to cause.) and gave me some Tylenol and I was good to go.

The injection sites feel like hot water balloons underneath the skin.  My hip didn't feel anything for the first two hours, but my back felt it immediately.  I was able to sit in the car while we drove back home from Austin, and then I went out and ran some errands and then went to the museum with some friends. If I had the chance to do it all over again, I would've just stayed at home and slept, but I was able to do everything and anything I wanted to.

I really like that Dr. Fullerton was able to find so many things wrong.  Well, I don't mean to say that I'm happy I have so many things wrong with me, just that I feel that he was so complete that after these treatments I won't have anything unaddressed.  I won't have anything lingering.

I now definitely want him to examine my right hip once he has finished fixing the left hip, if the left hip proves not to be the source of the lingering pain in my right hip.

Given a choice between the two, I would rather go to Dr. Fullerton than Dr. Hauser. Dr. Fullerton's examination is much more complete. Dr. Hauser isn't really for diagnosing, just fixing.  So if there's something missed in the diagnosis, Dr. Hauser isn't going to find and address the problem.

Here's the part of my recordings the day of the treatment:

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.

Dry Needling Update and Shoulder Treatment Decision

Ok so I’ve been trying out dry needling, four times so far, and it seems pretty legit.  The process is a very strange sensation, and not at all comfortable, but it seems to work, so I’m all for it.  Each needle feels different, and the bigger the trigger point, the bigger the response. For example, yesterday when he addressed my sartorius (which makes a lot more sense than what I thought it was: my rectus femoris) it wasn’t really a big deal, didn’t really feel anything.  Then the PT worked on my adductor magnus and wow it was sensitive.  Each needle prick felt different. One time when he put the needle in it felt like I was hit by a Taser in four different places on the back of my hamstring. Another needle and it felt like a hot wire of pain up my leg.  Each one was different, and each one was significant.  Thankfully, the pain/discomfort is very brief.  He also worked on my tensor faciae lata, and that almost felt like nothing.

The Physical therapist really worked me over yesterday, and when I got up off the table I walked with a bit of a limp I was so sore. But I also felt better, strangely.  Now a day out, I feel much, much better. I will also be seeing him on the Fourth, two days from now.  Based on how I feel from that we’ll decide to keep up the twice a week or go down to once a week.  This guy I’ve found though is amazing, like he is hitting exactly where I’m feeling the pain.

Oh yeah, I’m still squatting. Yesterday before seeing the PT I went and front squatted 170 five times for three sets.  My ultimate goal is to front squat 315 without pain.  If that happens, not sure how I’ll celebrate but it will be awesome.

Concerning the tear in the back of my shoulder’s labrum, I’m going to see if I can convince the guy to needle my tricep, and just keep lifting.  I am in some discomfort, but for the past two weeks or so it has been really, really tolerable. I would be tempted to try prolotherapy, but it means I would have to give up pressing for like 2 months at least.  I’m still making some good gains on my lifts, and my neck/shoulder is feeling ok, so I’m going to just wait.  Maybe if I start benching 300 and then stop seeing gains I’ll consider prolotherapy, but right now there’s just not enough upside for me to try it right now.  …Although I do have to say, for the record, that there is a big part of me that wants to treat this injury.  I am so damn close to being whole, to no longer having these lingering issues, that it is tempting to give up pressing for two months just to be no longer injured.  Anyways, I’m going to keep lifting.

[UPDATE: I've started prolotherapy for the torn labrum, and am now doing PRP injections as well as continuing to see a PT for dry needling. Here's my Vlog entry:]

Possibly last hip treatment, first shoulder injection

So I saw Dr. Hauser for hopefully my last hip treatment.  I’m hopeful that it will be my last treatment, but I’ve also been through too many “hooray I’ve fixed my hip” experiences to really celebrate until it is completely done with and I stop experiencing pain in my hip.

My recovery with each session is faster and faster.  However, for this last treatment Dr. Hauser decided to be real nice and inject me with 80cc of Sodium Morrhuate instead of the regular 60cc.  ….That is a lot of solution to get into your hip.  But even with the eighty injections my hip was feeling less locked up then it had the previous time.  It still hurt (the sodium Morrhuate tends to burn), but that’s what the vicodin is for. Day of I was still able to walk and go up and down stairs, albeit with a bit of a limp.  …On a side note I should mention that I try hard not to limp, because last time I limped the muscles in my leg patternized in such a way it caused a lot of discomfort, if not a touch of pain.

I asked about when I can get back to squatting, and the answer wasn’t exactly the best.  After allowing the three weeks for recovery, it looks like I’ll have to ease back into it a bit.  Starting with half squats and stuff like that, gradually getting more and more range of motion back.  I’m guessing I can do power cleans and maybe some other stuff, but I’m excited to get back to really working out.

I also asked him to check out my shoulder, and he disagreed with my self-diagnosis of supraspinatus laxity being the culprit.  Instead, because of the way that I crack my neck to feel relief of pressure, he believes that my issues stem from laxity in my neck.  Specifically, the ligaments/tendons that are connected to my C6 and C7.

He actually seemed hesitant to try prolo for this, suggesting I try the more conservative treatment of wearing a neck brace when I sleep.  Just by not cracking my neck, things should slowly go back to where they should be.  However, I’ve got money in my flex spending account that I need to spend and I’m all for healing the fastest way possible.  So I’m now doing a combination of prolo for the neck and sleeping with a neck brace on.  I feel a little silly wearing the thing, but I’ve worn it and I think it helps.

The hardest thing is that I can’t crack my neck.  It wants to go so badly, but it’s been two days and I’ve refrained so far.  Each time I want to I just foam roll the knots in my neck and the want lessens.  This is a tough one, but I want this to be over asap and that means no cracking.

Thankfully I can do pretty much everything with the neck injections.  As long as I keep good form, I can do pretty much anything, so once I’m back with the hip working at 100%, this won’t stop me.

Again, I really cannot believe that I should be done with hip treatments, and am on my way to healing my neck/shoulder.  Yet here I am, on the cusp of fixing both.  This year has been turning out to be a damn good year.

FAI/labrum tear does not have to equal surgery!

So I just got a question from a follower from Denmark asking how I'm coping post surgery.  Maybe there's a bit of a language barrier, but maybe not and I haven't been that clear.

So let me clarify the record.

Two years ago I was diagnosed with FAI (cam and pincer type) and was told I may have a small tear in my labrum as well.

Incidentally I learned I had tight hip capsules.

I started seeing a massage therapist while doing exercises to treat the hip on a regular basis to release the hip muscles, and it starts to render me pain free.

Fast forward to August last year and I seemed to make the hip worse in an Olympic lifting competition.

I go get another MRI to see what's going on.  In the report it comments that my femur heads are nice an smooth, nowhere does it mention that there is an impingement.  It seems that my impingement has gone away.

I still have a laberal tear though (which seems to be the root cause of the pain), so I start seeing a Dr Hauser, a prolotherpist, and I seem to be progressing nicely.

Nowhere in there did I get surgery.  For me, surgery is not the answer for a hip impingement.  An impingement is the result of poor mobility, if you fix the impingement it will just come back because you still have the mobility issues.  Moreover, even if the surgery fixes the underlying issues it may not leave you pain free.  I'm willing to bet good money that the large majority of people who have pain and impingement actually have muscular pain and not joint pain.  If you fix the impingement, the muscles are still going to be too tight.  After months or years of learning how to be tight (and painful), the muscle is going to take a lot of attention to make it release and stop hurting.  If you go online and read people's blogs who just have the surgery, it just doesn't seem to work.  Even if you have multiple surgeries (like five of them).  Surgery is at best an incomplete solution.

First fix the mobility issue, the body will take care of the extra bone growth on its own (mine did).  If you already have a tear in the labrum, then try prolotherpy before surgery.  Prolo seems to be largely dependent on the skill of the administrator.  For example, the "expert" in Alexandria said he couldn't help me, but lo and behold I'm getting help from Dr. Hauser and it seems to be working.

My point with all of this is surgery is not the only answer.  Orthopods think it's the only answer because that's all they know.  They don't know anything about massage therapy or PRP treatments or anything else.  They just do surgery, and that's it.  So if you ask an Orthopedic surgeon for help of course all they are going to recommend is surgery.  But there are other ways, I'm a prime example.

[Edit 7/8/13: I am now seeing a PT who does dry needling, and it is doing wonders for the last remaining bits of pain. I highly recommend you find someone who does dry needling early on in your search for pain relief.]

First Prolotherapy session finished

Nervous as hell, I showed up to the doc's office at 8:45, 15 minutes ahead of time.  I had already taken my vicodin and xanax, and I was starting to feel a little woozy.  Still lucid, I filled out some sheets and then was taken to a room.  They had me gown up and applied a topical novacaine ointment to my hip/thigh area.  After waiting a while for the drugs to set in Dr. Hauser showed up.  I was handed two squeeze balls laid on my back, and he got to work.  I could feel some of the pricks of the needle, but just barely.  Then he had me lay on my side and started going at it from there.  I don't think the numbing agent had been applied there because I could definitely feel that more, but I just focus on something else, like those stress balls.

But then it was over.  It probably took like 2 minutes, max.  Apparently he gave me 60 injections, but I could have sworn it was like 15 at most.  My hip definitely felt some swelling, but it was discomfort and not pain.  They put a heat pack on me and let me just lay there for a while.  Eventually I got up and dressed.  I was pretty tired and I think the drugs were making me woozy, so shortly after Kristin started driving me home I passed out.  When we got home I laid down on the bed and then slept for six hours.

My hip definitely feels different, it feels swollen and like I'm stretching my glute or something.  There's not really any pain though, and the pain from the psoas being too tight doesn't seem to exist right now.  I don't know if it from the drugs or the swelling has allowed the muscle to relax.  I don't know.  All I know is that I now have to be very careful with what I do, to make sure I don't make my hip click.  If I do, I'm preventing my labrum from knitting together, and that is the last thing I want to do.  It will be tricky, all those little habits like crossing my legs will be tough to not do, but this is definitely worth it.

If I can beat all of this without surgery, I am going to be a very happy man.  The thing that I like most about this prolotherapy is that although I can't really exercise like squats or Pilates, I can walk around and be independent.  This is not like what I would experience if I had surgery, where I would be on crutches and my body would be recovering from the stress of putting my hip in traction.  Surgery really should be an option of last resort, and if this works I am going to be very, very, happy.

Possibly a light at the end of the tunnel of hip pain

Finding a way to relieve the pain pain in my hip has been been quite the journey, one that almost sounds like an episode of House, MD (although I was never dieing at any point). Because I'm not sure if I've been very clear on my plight for a cure, I've decided to write up a summary of my dealings with this problem:

Part One: Hip feels like it's on fire.

June 27, 2008: Started crossfitting, and soon after my right hip started to feel pain, like it was on fire.

July: Saw Dr. Bruno, an Orthopod, for my hip, and he wasn't sure what was going on but had some physical therapists work with me. This involved stretching and weight exercises as well as TEMS and ultrasound therapy. Nothing was really working though.

August: After researching the crossfit forums, I realize I need to see a DO, and I have the therapist confirm that my pelvis and hip are twisted, causing the illiopsoas to stretch unnaturally resulting in severe inflammation. This inflammation is what is causing the sensation of my hip being on fire. Dr. Craddock also tells me the twisting of the pelvic muscles is why my hip clicks when I raise and lower my knee (a problem I've had since I can remember).

August 26: I meet a DO, Dr. Craddock, for the first time, he resets my hip and the pain goes away almost immediately.

August '08 - June '09: I receive regular treatments from Dr. Craddock, but after two months of no longer experiencing the inflammation of the illiopsoas I notice there is still a lingering, deep throbbing pain. This pain doesn't feel like fire, and is much easier to ignore. I figure it's still the illiopsoas, that it just needs some time to get used to being un stretched. However, this pain doesn't really go away.

February '09: I see a massage therapist and tell her about all of my various ailments, although I find her massage relaxing I do not find it therapeutic.

Part two: Maybe it's a torn labrum?

July '09 part 1: I casually mention to Dr. Craddock that my hip still clicks when I raise and lower my right knee. For a brief moment he seems a little confused by this because all the muscles are in the right place. After a second he then says I may have a torn labrum in my hip, and this might be causing the clicking and the residual pain.

July '09 part 2: I see Dr. Bruno again and he reccomends an MRI, but without contrast. He gets the results and tells me I have a torn laburm, but he's not sure since he deals mostly with old people. He then sends me to another Orthopod, Dr. Johnson, who deals with sports medicine.

July '09 part 3: Dr. Johnson determines I have fermoral acetabular impingement (FAI), but is unsure about the labrum because the MRI does not have contrast. I believe the pain I am experiencing is in my hip joint, as it feels incredibly deep. It's around this time when I come across prolotherapy for torn labrums. Dr. Johnson says that if theses treatments don't work there is arthroscopic surgery for this condition.

August: I meet up with the prolotherapist Dr. Wagner, and he says he needs an MRI with contrast in order to do anything.

September: I see Dr. Wagner again, and after the MRI he tells me that I do not have a torn labrum, only FAI and that he can not do anything for me. So I'm back to square one. Or is it two? I'm confused now with all these doctors and procedures.

Part three: No, it's tight hip capsules.

September: I go back to Dr. Johnson, preparing myself to have surgery. He comments that there probably is a small, small tear in my hip labrum, but it is the FAI that is causing the pain. He suggests trying Euflexxa injections to lubricate the hip joint and render me asymptomatic.

November part 1: The meds finally arrive and I get my first injection of Euflexxa, where they take a needle, pierce the hip capsule, and then inject the viscous solution. During the procedure I find out that I have extremely tight hip capsules, which Dr. Johnson notes may be the cause for my FAI. After the procedure, thanks to the numbing agents I receive during the procedure I do not feel any pain in my hip, and Dr. Johnson takes this, as well as my description of the pain, as a sign that the pain is indeed in the joint and not muscular. However, as the meds wear off the pain returns. ...I have a feeling that this new piece of the puzzle is important.

November part 2: I meet up with the chiropractor Dr. Bills for back and shoulder pain, but then mention the tight hip capsules, he then works on them and they suddenly feel a whole lot better. This indicates it is muscular and not a joint problem. This gives me a lot of hope.

November part 3: second Euflexxa injection. Still have pain in the hip.

November part 4: I talk to Dr. Craddock, and he recommends Rolfing, a deep tissue massage. I find one and book three appointments.

November part 5: I mention this to Andrea and she recommends Olga, her massage therapist. I cancel my appointments with the Rolfer and make one with Olga.

Conclusion: There is hope still

So yesterday I saw Olga, and she worked me over thoroughly, and unlike the previous time I got a massage I felt like this was extremely therapeutic. She worked extensively on my hip/leg muscles, and it was an incredible sensation. I told her to go as hard as she could, and the pain was indescribable. It was like my muscles were bubble wrap, and she was a rolling pin. As she slowly dragged her elbow up and down my muscles, I had this sensation like some combination of popping or sparking in muscles I never even knew existed. She commented that my muscles were extremely tight, but they were releasing quite nicely. She worked both my right and left hip.

While she was able to get my left hip to release, she said she was unable to get my right hip to release. She also commented that because this is a chronic problem it will take a while to fix it. I've scheduled an appointment with her next week, and I really hope that next week will be the week the muscles learn to relax. Unfortunately, she told me not to workout after the massage, so I had to forgo the wod.

Today I saw Dr. Bills again, this time exclusively for the hip. As he worked on them, I asked if he noticed any difference, and he said they felt a LOT better, that he couldn't feel as much "gristle" in them as he did last time.

This makes me very happy. It has been a long, long journey, but it seems like I've finally figure it out: Tight hip capsules twisted my pelvis causing the inflammation of the illiopsoas, but the tight muscles also jam my femur into the hip socket, creating the FAI.

I know I've said this before, but I'm very excited by the thought of no longer being in pain. Hopefully there will be no more curveballs, and this will finally kill the throbbing ache that I experience everyday. I write this so that others out there who may have hip pain or any other type of ailment may have hope and learn from my experiences. If I help at least one person out there, then I am a happy man.

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Weighted Chin ups, and an MRI/Arthogram of the hip

So today I had my second MRI of my hip, this time with contrast. This time before the MRI they injected liquid into my hip joint. First they shot me up with lidocaine to numb out the area, then they took this very large and faint-inducing syringe and injected it into my hip, guided by fluoroscopy. There was some pain, but it was very brief and the whole process took less then five minutes.

I'm meeting the newest doc, Dr. Wagner, on Wednesday to go over this, and we'll be able to finally have a definite diagnosis and form a game plan. Hopefully it will only take a few treatments of prolotherapy to get me right, I don't want to have to deal with surgery.

I'm also excited about the idea that Dr. Wagner will also be able to help me with my shoulder. However, right now my shoulder is feeling no pain, and every time I push it it responds well. I will continue to be conservative in returning to working out, but I can now add weighted chins to the mix. And with that, today's WOD:

Weighted Chins: 1, 1, 1, 1, 1, 1, 1

I only got up to 58#, I can't find it but I think my max is 63#, but given that I'm just starting to get the shoulder back in the game I'll take it.

It was a good thing that we did chins today, as the doc told me I can't do any hip-related workout like running for 2-3 days. Right now my joint is filled with fluid, and is thus unstable. After I was done with the chins I did some push ups and light hang cleans. Andrea helped me with my push up form. Apparently I let my back bend, and this arch causes all kinds of problems. I think this arch is related to problems I have with my posture, as well as push press. My shoulder is doing so well, I'm going to start re-instituting my grease the groove, and will try to do at least 5 sets of 10 push ups throughout the day.

Gameplan for the hip and Deadlift 3 rep max

On Wednesday I got to see the surgeon, Dr. Johnson. According Dr. Johnson, Dr. Bruno was a little uncertain if I have a torn labrum because in his notes for Dr. Johnson he wrote, "torn labrum?". Anyway, after looking at some x-rays and the MRI, he determined that I definitely have femoro-acetabular impingement, as indicated by a cyst in my femur. Whether or not the labrum is torn was a little harder to tell, given that the MRI was done without contrast (even though I suggested to Dr. Bruno that it be done with contrast, thank you online med sites). However, the cyst is from the femur hitting something in the hip improperly, so even though the images were not exactly clear, if the hammer shows damage, most likely the anvil has damage as well.

He said that if I were to have surgery I wouldn't be able to get back to crossfit for around six weeks.

Six weeks? Is that all? I could do that no problem.

However, first I will try conservative treatment to see if addresses the pain, and if not then we'll do surgury. Here's the Hierarchy of treatment, starting from the most conservative to the least, being surgery.

1. Physical Therapy
2. Prolotherapy
3. injection of the hip joint of a numbing agent
4. Arthoscopic surgery

The third option would also be prep for the surgery. Contrast in MRI's are just liquid, so Dr. Johnson recommends adding a numbing agent so we can hit two birds with one stone. First, we'll have contrast for another MRI. Second, if the numbing agent takes care of the pain then we'll know the pain is not from anything muscular.

Regardless, I'm very excited about prolotherapy and am not afraid of surgery anymore. I'm also very, very happy to have a game plan. I think the mental anguish of not knowing what to do was worse than anything else. Now that I have a plan, nothing looks that bad.

I think the mental boost was very helpful for Wednesday, because we had another heavy lifting day, and tried to find our 3 rep deadlift max. Last time we did this (6/23/09) my 3 rep deadlift max was 265. Today it was... 305. A full 40 pounds more. I also managed to do 2 reps of 315, which is 20 pounds more than my previous two rep max.

I'm very happy with how I approached this workout. I caught myself mentally giving up, looking at the 305 bar and doubting my ability. Thankfully, because I caught it I reminded myself that this is my chance to prove my strength, that I have to make this moment count because this exact moment won't come around again. This motivated me to address the bar, take a deep breath and pull. At first nothing happened, and I almost gave up, but then I dug a little deeper and the bar started to move, and then I was standing. I could feel my back bend under the weight, but I kept the core tight and nothing hurt. This was great because I found a way to keep focus and push though, and most importantly, I didn't hurt myself.

It seems that I'm addicted to making large gains, it's like I've been going through withdrawal and Wednesday I got my fix, and it was quite a high.