MTHFR gene and heart health

So I got my regular TRT bloodwork done, and I asked my TRT doc to check out my LP(a) and the other stuff. Since my Homocystine was high, he decided I should get my MTHFR gene checked out as well.

Good news: the inflammation seems to have gone away, my CRP score and Homocysteine were both within range, so they have gone down considerably since last time they were checked.  This is probably from me taking high dose of L-Mthyl folate and vitamin C.

Bad news: Regarding the MTHFR gene, I am a homozygous mutant with the C677T SNP (also written as T677T).  From what I understand so far, this mutation severely hampers my body's ability to convert folic acid into folate. It affects my body's ability to create folate to about 30% of what a normal person can do. This, in turn, can cause other issues, such as high homocysteine (something I already have!). An important note to make is that people with the MTHFR gene are at higher risk for heart issues, like stroke and heart attack, etc.  So yay, one more thing that puts me at risk.

Going down the whole MTHFR rabbit hole has lead me to learn about Methylation. If you want to learn about it just read this article, but the TLDR version is that it's the metabolic process of switching genes on and off as well as repairing DNA.  

I'm a little confused now because it seems Niacin is good for lowering Lp(a), but it will hinder my ability to methylnate, which is a bad thing ("Avoid taking high doses of niacin (vitamin B3), which can hinder methylation."). So my TRT Dr has be taking 5mg of folate to lower my homocysteine and help my body methylate, while my cardiologist has me taking large doses of niacin to try to lower my LP(a).  Perhaps they are just canceling each other out? What to do concerning this will probably be my biggest question for my Cardiologist.

Shifting focus to more about Hearth health.

Ok so it's been like forever since my last post. 1) who really blogs anymore, amirite? 2) there really hasn't been nothing earthshattering to report. I was broken, I'm now less broken, and yet I'm still in pain because I'm still broken 3) I've kind of moved on with my life.

I'd like to focus on that last part for now.  As I stand here typing this out. I'm experiencing discomfort/pain in my lower back on the right side, and I feel some neck pain also on the left side.  I still feel lower back pain when I squat/deadlfit, but this pain has been moving around. Currently it's now feeling more like my QL/Oblique on my RIGHT side.  Typically in the past the pain has been on my left side. So there's change, which is good. Change means progress is being made. What you don't want is to get a treatment (whatever treatment that may be) and then go right back to feeling the same way.

And yet, with these pains, they are pains that don't really bug me like they used to. These pains are easier to ignore, easier to just accept and move on.  And while I am planning to see Dr. Fullerton at least one more time, I'm also starting to listen to my wife who thinks I just need to accept that I will always be in pain and just move on with life.

I guess what I'm trying to say is that I used to really identify myself by these pains and the overcoming of these pains. I'm starting to move away from that, PRP and these injuries are not as central to my self-identity as they once were.

But I always seem to have an interest in something health-related, and now it is heart related.  ...I guess this should come as too much of a surprise given that I'm now approaching 40.

Because I'm on testosterone replacement therapy, I get regular bloodwork done.  Well, for some random reason my TRT doc decided to not only get the typical cholesterol blood panel, but ordered that my Lp(a) get tested as well.

The Lp(a) is a sub-fraction of a cholesterol particle, I won't go into much detail about it because there's already articles written up about it, like this one: http://www.lipoproteinafoundation.org/?page=UnderstandLpa.

The TLDR version is that LP(a) is super inflamatory, and some people have super high levels despite nutrition and exercise. One famous example is Bob Parker of "The Biggest Loser" who had a heart attack despite taking such good care of himself. Genetically he was predispositioned to have hight Lp(a) levels

From what I can tell, you want Lp(a) to be under 14 mg/dL. borderline is 14-30,  high risk is 31-50, and very high risk is over 50.

The test showed my levels at 80

Seeing this I feel like I am lucky to be alive right now.

So yeah, it seems that I am one of those with the genetic predisposition for high levels.  Since getting these results I've started taking niacin, as it seems to be the only thing that can affect Lp(a) levels.

The test also showed that I had undesirable levels of Apo-b, another kind of protein. My level was 110 with a range being lower than 80.

When I asked my TRT doc about it he seemed unconcerned about it, but this isn't his specialty so I'm going to have to find someone else to ask about this stuff.

I later had more bloodwork done, and while it didn't test the Lp(a) or Apo-b, it showed more inflammation in my blood.

C-reactive protein (CRP) is a substance produced by the liver in response to inflammation. My levels was about three times the range at 20.5 with a range of less than 8

I also had super high Homocysteine levels, which could indicate a deficiency of folate or B12. Doc wants me on 5mg of B12 a day, which I'm currently doing. Again though, this was serious as my levels were 33.2 with a range of under 11.4

All these put me in super high risk of a heart attack, stroke, etc.  I need to figure this stuff out quick before it kills me.  I'm adding in B12 to help with the liver/homocysteine levels, Niacin for the Lp(a) levesl, and Vitamin C to lower the CRP. I'm also trying to remove sugar from my diet, as well as processed grains. Hopefully this will be all that I need, but I may need to try to book an appointment with a specialist in the near future.

Thankfully, my trygicerides are low, my HDL is high, and my blood pressure seems to be pretty good ~120/80.

Man, I am worried though. Really hits home that I could up and leave this earth at any time.  

TLDR: My bloodwork shows that I have tons of inflammation in my blood and am super risk of coronary heart disease (CHD), cardiovascular disease (CVD), atherosclerosis, thrombosis, and stroke.  I have super high Lp(a), Apo-B, C reactive protien, and homocycteine.  I'm changing up my diet, adding in vitamins Niacin, B12, and C to my daily routine. Doing this for a month and then getting re-tested. If that shows problems then I'm calling in a specialist. Pray for me.

Blog po

PRP treatment for the back and hip: Lat, Serratus Anterior, Iliacus, and Rectus Femoris

Alright well I'm feeling pretty good about what just got treated over at proloaustin.  Dr. Fullerton had me flex my back, noticed some atrophy on the left (painful) side, injected some suspected points of injury with numbing agent, and had me flex again.  The difference was pretty substantial, as shown in the pictures.  The pain went away and I felt the muscles in my upper back relax.  Nerve blocking, as I believe it's called, is quite the diagnostic technique.

So he addressed the serratus and perhaps some of the rhomboid or lower trap. What he treated was very substantial, and it felt like this is what is is causing the remaining discomfort I'm feeling.  I don't know if I'll need a second treatment of this area, but this area definitely needed to be treated, so I feel good about that.

With the hip, I showed Dr. Fullerton the exercise that I performed that caused all the damage to my hip.  That proved to be really helpful, and so he wanted to check out my hip flexors.  The psoas actually seemed to be in good shape, but the iliacus was a different story. He also found some lingering damage with the rectus femoris.  I think the iliacus was the last piece of the puzzle as well.

I feel really good, feel really hopeful right now.

Update for PRP treatment of iliacus, serratus anterior, and rectus femoris

So just checking in on how I'm recovering from getting my serratus and iliacus treated with PRP injections

First, I'd like to say that I'm changing up the format of my vlog here. I started out recording this as like the "torn labrum" chronicles, but as I've progressed I've found that the torn labrum in my shoulder was just one, kind of small, piece of the pain puzzle.  So now I'm focusing more on just how a PRP treatment affects me in one specific area.

For example, I've come to realize that Dr. Fullerton works best when he knows what action causes pain. If I tell him "It hurts when I do X" it is much, much, more helpful than saying "It hurts here all the time"

Realizing this, I went in to the last treatment saying it hurts when I do overhand lat pull downs, especially wide grip.  This led to him having me flex, where he saw some asymmetries.  Here's a pic of me flexing.  Then he numbed out the serratus in certain areas with injections of lidocaine and had me flex again. Here's a pic of that.  There was a pretty big difference in appearance, and the pain went away when he administered the numbing agent. This technique is called nerve blocking, I believe.

So with this info he did the PRP injections in my back in those places.  Low and behold, when I went got back into the gym and tried overhand lat pull downs, they no longer hurt. I'm also noticing improvement with my overhead press being more symmetrical.  I also just feel better in general. Like I'm in less pain.

My point with all of this is that the treatment was a success in treating the issue that I presented to Dr. Fullerton. However, it seems like there are still some more underlying issues, as I'm still in pain some all the time, just less so.  The motion that really sets me off is pulling my scapula down, which is what I'm going to present to Dr. Fullerton for next time.

After getting a PRP treatment my body is usually really tight, the muscles respond to the trauma by forming these big knots/adhesions. These are painful, so I try to get them treated with soft tissue work. I've tried dry needling, which has proven pretty helpful, but I'm still left a bit unsatisfied with my PT. So I try other modalities. Like I have seen a chiropractor, and that was really helpful once because they found a rib out of joint and when they put that back in there was substantial pain relief.

The latest modality I'm trying is rolfing. She came recommended by my sprinting coach, so I figured she was legit. She was definitely legit.  She just looked at me and with a glance was like "ok your serratus needs to be worked on". She knew all the problems with my upper body were on my left side. And boy did she find things. Apparently my neck is "special" and she tried very hard to get my sternocleidomastoid to release but wasn't able to get it to release completely. So she recommended that I see an acupuncturist, as the mastoid/neck muscles tend to respond really well to that kind of treatment.

So I went and had that done, and the acupuncturist also did some cupping, and when he placed the cup on my mastoid it provided the most relief I have felt in some time. The day of and the day following I was completely pain free, it was amazing.  Sadly some of the pain has come back, but not completely. So progress is being made, and I'm happy with that.

So with regards to the upper back/neck, I feel like there still might be something going on in the front, something that may be causing my sternocleidomastoid muscle to tighten up. Dr. Fullerton has found damage in the first and second rib as well as the sternoclavicular joint, so perhaps something is still lingering there. The rolfer found some issues with my pec minor and with the levator muscles on my front side.  Maybe this is all in response to the issue that I have in my back, but perhaps not. This is the frustrating thing,  I can't be sure what's the cause and what's the effect. But I will document my symptoms here.

With regards to the hip, I definitely feel better in some regards, my feet now line up symmetrically, and I no longer have that pain in my hip when I go to raise my leg in walking (which was the pain I described to Dr. Fullerton).  So I think the iliacus was the culprit with some of the pain in my hip.

However, I tried doing windshield wipers the other day and the rotation sent a huge, HUGE, shock of pain through my side. So whatever muscles are used with that motion, there's something really wrong with that. Perhaps my obliques? I don't know, I'll take it up with Dr. Fullerton when I see him next.  

So there we have it. Dr. Fullerton successfully treated all the symptoms that I told him was going on. It just turns out that there are other things/motions that caused pain as well.

So I feel like I'm near the end of my pain/prp journey. I know I've felt this way for, like, years now, but I really do feel that I'm nearing the end.  ...In the beginning, after a treatment it felt like I had a new body, it was behaving so differently that I had to spend a lot of time figuring out how to use it.  Now, it's starting to feel like I'm just no longer in pain in that particular area. 

For example, after Dr. Fullerton addressed my glute med, I now squat with a symmetrical stance. It used to be my feet were always staggered a little, now my feet are both underneath me. But that's it. It doesn't feel like things are working completely differently, when I resumed squatting it didn't feel like all kinds of muscles were being used differently. I didn't get random DOMS in odd muscles. Now things just work better and I'm in less pain. 

Pretty much the same story with my shoulder. I can now keep my scapula retracted while pressing, and I'm in less pain, but it's not like my tricep or pec minor is suddenly working differently.

If Dr. Fullerton were to retire and I couldn't see him again, I would be disappointed but I wouldn't feel doomed. The pain that I have in my shoulder is very manageable, though the pain in my hip does flare up from time to time.

For my hip, the location seems to point to the psoas. When I read the symptoms of an injured psoas, my symptoms check off pretty much the entire list. I have some nebulous groin pain, I have pain in my lower back, it takes some effort to stand upright, and the knee on the opposite side doesn't feel like it's working right.

For my shoulder, things are less clear. My upper trap and posterior scalene are tight a lot of the times, as well as my infraspinatus. But if I were a betting man I would say they are responding to issues lower down my back.  Like the intercostals or my lat or both.  Whenever the chiro works those muscles I feel like it's addressing the cause of everything. We will see when I see Dr. Fullerton again.

Now that I have normal testosterone levels, I'm really seeing gains in the gym. I've lost about 20 pounds over the past two months, and all my track times are going down (as you would expect with being lighter) and my strength seems to still be going up. So things are really awesome right now. I don't want to mess with this by taking a month off again, but this nagging hip/psoas pain is starting to get to the point where I think it will be worth it.  I think once pool/track season is at an end I'll get my (hopefully) last treatment from Dr. Fullerton. Feel like a broken record saying that.

So that's where I stand: I'm in a good place, but I feel like I'm *this* close to being 100%, and that excites and scares me a bit.

Seventh PRP treatment for the neck/shoulder

Alright well went had had my trap treated.  Like every other time I've had a treatment, I hope this is the last one.  ...I imagine it really could be because a 40% trap tear HAS to be the main source of my pain/discomfort.  I should also say that Dr. Fullerton treated my first and second rib, and that has helped with the discomfort I have in my neck.  Here's the vid of me actually getting the treatment, very nice of Dr. Fullerton to let me record it.

It's a Traps!!!!

So I just got back from seeing Dr. Fullerton. I saw him simply for diagnostic purposes, because I felt like he was a bit rushed in diagnosing and treating whatever he found, all in one session.  So I thought to see him to just figure out what is wrong, and come up with a game plan from there.  He checked out my shoulder, especially my upper back, and he found that I have torn my trap muscle, in the mid-back area.  This is probably the main source of the pain I’m currently experiencing.  He also checked out the shoulder capsule and the infraspinatus (a muscle that gets needled regularly). If he found anything he didn’t comment on it, but he was mostly excited about finding the tear in the trap. I think he was excited because he found it using techniques with the ultrasound that he had learned about earlier this year.  Secondly, I think he was impressed at the extent of the damage. The tear wasn’t just in the tendon/ligament, it was in the actual muscle belly as well.

He also checked out my hip. While it is so much better than prior his treatments, it still bothers me to raise my right leg to my knee.  He found some damage to the tendon that the adductor magnus attaches to, as well as some damage to where that particular tendon continues on up to the abdominal rectus.  Hopefully the next treatment I get will be my last for that.  …Story of my life right?

I’m not as hopeful that the next treatment for my shoulder/trap will be my last, mostly because I fear there is something going on in the front of the AC joint as well.  Dr. Fullerton is only really able to address one thing at a time, so I understand his focus on the back.  I just worry that I will need yet another treatment after this.

Because of the timing of things, I don’t expect to see him again until around January.  I need to get some other things in order before I go see him again.  But I have hope still; I think I can actually beat this.

Possibly the last treatment for my right hip????

Well, hopefully these next few months will be my last series of posts dealing with hip pain.  I think I’ve finally resolved the last piece of the puzzle, at least concerning my right hip.  I saw Dr. Fullerton this past Friday, and having been tired of him addressing my shoulder and then running out of time to address my hip, I decided to make this appointment all about the hip.  He went through the notes from past visits, and asked to see my side lunge.  

The side lunge is a stretch that I can do very easily with my left hip, but not so easily with my right side.  I can’t do it on the right side because my groin is too tight, nor is it easy to balance. So after seeing the imbalance with the stretching, he then did some injections around my inguinal crease (some of the damage was underneath my femoral artery/nerve) and then had me try it again.  This time I could do it a lot better because my groin wasn’t tight, but I still couldn’t balance like I could on my left side.  He then performed some injections on the more outer part of my hip, and then this time when I tried it I could stretch my right leg just like my left leg. 

It was ridiculous how easy it was to perform that stretch on my right side.  I remember showing the asymetry to a PT and he was like “well maybe over the years your hip has adapted to various pathologies and now, that’s just how it works.” He made it sound like it was permanent and couldn’t be fixed.  Well, it can be fixed, and Dr. Fullerton fixed it.  It’s been a few days since seeing Dr. Fullerton, and my hip has clicked a couple of times with very slight movement, like shifting weight in bed.  Of course I worry that I’m doing something to make the hip out of socket, but perhaps it’s always been out of whack that and now for the first time it’s starting to behave properly.  I am also noticing some muscles surrounding my LEFT knee are spasming.  I’ve noticed that when I get one muscle treated, if it’s been affecting another muscle, that other muscle will start spasming as it releases.  So perhaps my right hip has been affecting my left knee. Pretty cool stuff.

Once I’m allowed back into resistance training, I’m planning on doing some pilates and yoga to work on these muscles.  I imagine with a healed hip the movements will be much easier to perform.  They say to help deal with injuries you need to work on core strength, but what happens when it’s your core that is injured? Anyways, I am looking forward to testing it out and will report back on how it handles.  I’m not posting a video about this because my vlog is more about my shoulder recovery than dealing with my hips.

In a couple of days I will see Dr. Fullerton yet again for him to treat my shoulder, so I'll report back with that.

Six weeks out from fifth prolotherapy treatment

So it’s been about two weeks of resistance training after my fifth prolotherapy treatment.  As I predicted, at the two week mark I started to get all of my old pains back. And, as I predicted, after that I started to get back to feeling better.  As of right now, there are days where I don’t even notice any pain in my back area, and there are some days where I feel the need to try to roll out some knots. 

I also think I’m starting to realize that the discomfort I’m feeling is stemming from the issues in the front of my shoulder.  I realize that most of the discomfort I’m feeling is from tight neck muscles in the front of my shoulder, like the scalene and the sternocleidomastoid. So for the next session I hope for him to check that out and make sure everything is fine.  I remember one session where he poked the front of my shoulder and it hurt a lot, and it made him go “Hmmm” but he didn’t do anything about it because he decided to address the damage to the back first.  Perhaps it is time for him to try that again and see what happens. Wouldn’t surprise me if there was something wrong with the front of my shoulder too. Sigh.

Did a little bit of the phase one stuff, and nothing felt… rusty. Every movement came pretty easily.  I still did real light weight and in slow, controlled movements.  After all of that I then did a little bit of Indian clubs.  I worked with the two pounders and  there was one motion that stretched my shoulder and it felt… significant. It kind of hurt, but it was the pain that I’ve associated with adhesions tearing, and not injury pain.  As soon as I stopped clubbing I felt fine.

It still doesn’t feel quite right in my left side when I try to pull down my shoulder blade, but perhaps that’s because it’s playing tug of war with my shoulder, it’s hard to tell.

I saw my PT that does dry needling, and he found a huge knot in my pec, probably from the trauma of the prp injection. 

I really haven’t been able to push myself with heavy weights yet because I was in an accident and right now my car is in a shop. I can’t get to a gym so I’ve been using the apartment’s fitness center but they don’t even have a barbell so I’m kind of stuck.  I’m hoping to get a temporary gym membership down the street but we will see.

I am able to do thinks like Dumbbell squats, and I have to say my core feels a lot more stable now on the left side.  I used to feel kind of… wobbly.  I also feel like I have more control over my shoulder blade, even if I keep finding myself with a forward-oriented shoulder.

…It’s been over a year now of seeing Dr. Fullerton, and I thought after a year I would just stop and give up.  But because I keep feeling better each time, I keep seeing improvement, I don’t want to stop.  Instead, I’m excited to see how much better I will feel after the next treatment. I’m sure I’m coming off a little strangely with this, but I’ve always been one to take care of things: My car, my chief knives, my butcher’s block, etc.  But the most basic thing to take care of is my body, and it seems that I didn't do a good job of that earlier in life.  Now that I'm a little wiser, I want to be pain free.  I want my body to work the way it was intended to work.

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.

Day after Fourth Prolotherapy Treatment

I have to say I had no idea so much was wrong with me. Everything that Dr. Fullerton treats is getting way better, it's just there so much stuff that he can't treat it all at once. Each session takes like four hours of him probing around with the ultrasound wand, figuring out precisely what to address. Every time I see him and he's working on me he comments that he should use the ultrasounds he's taking for an upcoming presentation. Yesterday I finally asked him why he always says that. He replied that because of my musculature, the damage is really easy to see on the monitor. So that was a nice stroke of the ego. This time he looked at my back again, but for the first time he looked at and addressed my right hip.

What was found

Where do I begin? There was some damage going on with the lateral part of the QL, and there was also some damage to where the serratus meets up with the lat. That part seemed to be really the last part of my back that hasn't been addressed. I also talked to him about how holding a plank or downward dog

The (hopefully) final
few areas that were addressed

hurts my shoulder, and how maybe that was due to the labrum tear? He looked at the shoulder again, and despite the fact that he didn't find anything the first time this time he found some debris and a pit in the capsule. So it looks like I'm actually going to get that tear in my labrum repaired as well.

He took a look at my right hip and found some damage up in the high quad/pectineus area.

When he administered the injections to pretty much every area, that body part responded by twitching like I was going into a gand mal seizure. Concering prolo, the twitch seems to signify that there was damage in that area. The more the twitch, the more that muscle/ligiment/tendon whatever needed help. So it seems that all these new spots that we addressed today were really needing help. So I'm hoping to continue to see great improvements over these next few months.

Pain/ability

The pain right now isn't that great. I feel like I have some pressure in my back, like a hot water bottle is lodged underneath my shoulder blade. Uncomfortable, but not painful. I am really limiting the use of my right arm though. I find myself lowering my head to meet my hand when I shampoo my hair. I was walking the dog and pulled the lease with my left hand and I felt a sharp pain somewhere in my back. It kind of felt like an adhesion breaking up but I found it to be really unsettling so I am trying to use my left arm as little as possible right now.
My leg feels pretty good right now, the day of I was walking with a limp but now I think I can walk alright, even take on stairs without too much of an issue. 

Mental fortitude

I'm 9 months into this treatment and I have to admit that taking this upcoming month off is going to be frustrating. I was just starting to get some real strength back and I was also making some important strides with my technique in sprinting (get it?). I hope I won't lose too much strength/muscle memory when I get back into the mix, but I don't like being on the sidelines.
Hope this is the last time he will treat my back, but if it isn't I'm not going to be mad because I am making so much progress. Now that my body is becoming hale again, I think I'm going to look into some kind of soft tissue treatment. Like I might go back to a DO that does manipulation, or find a massage therapist. I'm not really too convinced that the rolfer I saw is the answer, because he treatments were so temporary. Of course, perhaps things will be different now. Who knows.

Excited for treatment of my hips.

Something I haven’t really talked about on this blog is my left hip. My right hip is the one that has gotten all the attention. It’s the one that had the torn labrum, it’s the one that seems to have some ligament damage. It’s the one that got PRP from Dr. Hauser. But it was my left hip that kept failing the ober’s test while passing the Thomas test, indicating the femur was hanging out in the front part of the hip socket (not a good thing).

Dr. Fullerton discovered a pit in the left hip capsule. He said it was in a very strange spot, in the front, right where the rectus femoris inserts into the capsule.  A hole right there would make sense. That would give the femur space to move out into the front of the socket.  As Dr. Fullerton has treated the pit, I’ve noticed a couple of things.  First, when I do lunges my left hamstring and glute feel much more… stretched and involved.  It definitely feels like the femur is sitting farther back in the hip.  Secondly, and this is exciting to me, when I squat I no longer have knee pain while doing it.  When I front squat I would always feel a little bit of pain in my knees when I hit depth. Now I no longer feel any pain in my left knee!!! It’s pretty amazing.

I would hazard a guess as to the source of knee pain in my right knee. I think because of the ligament damage in the hip my adductors are pretty tight, including the adductor, longus, magnus, and gracilis.  I can see these muscles pulling my kneecap in a little bit, altering the mechanics just enough that it puts some time of unpleasant force on my knee.  I’m willing to bet that once the ligament damage is fixed, the knee pain will go away as well.

The thought is very exciting, and to be honest I can’t wait for the end of August to arrive!

Why I couldn't deadlift much weight.

About three years ago my Oly coach noticed the musculature of my back and commented that it was indicative of using the middle of my back as the fulcrum, not the hips.  This is one reason why I can’t seem to deadlift more than 225 without my back hurting for the rest of the day.  I’ve tried, desperately, over the years to fix this. I’ve been working on core strength, making sure I keep a rigid spine when I lift, and yet things fall apart when the deadlifting starts to get heavy, no matter what.

As I’m getting my back fixed, it’s starting to become apparent as to why that’s the case.  Dr. Fullerton addressed my left QL, and now that it is starting to work properly it is taxing my spinal erectors even more, and they are not happy about it.  I think perhaps they are tight and painful because they are damaged, just like pretty much every other muscle in my back.  I am amazed at how many layers of damage my body has.  One muscle gets fixed, and that makes the others act up.

It’s also an interesting sensation because the pain is becoming more accurate.  As opposed to this blob of pain in my lower and upper back, I now feel my infraspinatus being tight and painful, as well as my spinal erectors.  I mean, I can’t even do more than 30# kettlebell straight-legged deadlifts without setting off my back right now, so deadlifting is out of the question.

Fortunately, I’m sprinting and that (if done properly) will work the hammies and glutes.  I’m also front squatting to work on my quads more and give my posterior chain a bit of a break from the sprinting. Speaking of squats, I can feel my QL/erectors wanting to give out on me when I near depth on the squat. I always could feel my core trying to unravel at that point, but now I have a more direct sensation as to what’s going on.  It’s like I’m seeing my body with a finer resolution.  Hopefully this will all go away with another treatment, and I’m praying that my infraspinatus is just damaged and it’s not the labrum tear that’s causing the infraspinatus to act up. Almost one more month until I can find out. Yay?

Six Weeks out After Third Prolo Treatment

Well it's been six weeks since my third prolo treatment.  I have again been seeing a lot of results/improvements.  When I try to decompress my ears, it actually works on both sides! This has been a huge annoyance and I'm really happy this is no longer the case.

When I used to overhead press, I would feel one of my muscles snap over the other. It was super uncomfortable, and it told me that they were really tight and there wasn't anything I could do about it. No matter how much I foam rolled I couldn't get the knots to release.  Now there aren't as near as many knots.

I also used to crack my neck all the time, and really only on one side. It was the only thing I could do to get some relief (I've been told cracking will sometimes cause loss of muscle tone, which makes sense since that was the only way I could get the muscles to relax a little).

I also no longer have pain in my back/side, the lateral part of my QL. And I still feel muscles in my back working in ways they are not used to. They are starting to work correctly, I can tell because it's getting easier to keep my abs/core tight when I run, stand, lift, whatever.

So a week after that second dry needling session I went back (I mean, a visit is only $25 with my insurance plan) and told him how it tightened back up only after like six hours of relief. I also informed him about some pain in my mid-lower back, like right underneath the rib cage next to my spine.  I chalk this up as the result of becoming more active.  Concerning the infraspinatus, he tried addressing not just the muscle, but the nerves that control the muscle.  This was done by sticking needles in both the muscle and around my spine (c5 joint).  He left them in there, and then had some electrical pulses go through them. the idea is to address and calm down the nerves telling the muscle to fire.  Afterwards I felt.... different, and in a good way. It was much more subtle than when he addresses adhesions. But in this case it doesn't seem like I have adhesions, here I have a muscle that is too tight all around.

While he left the needles in my neck/shoulder, he then addressed the adhesions in my lower back. Dear Lord those were sensitive, and when he was done I felt so much better, I hadn't even realized how much discomfort they were causing.

I decided to do some Pilates that day, and that may have been a mistake. Afterwards my lower back started tightening up. My shoulder didn't feel worse, but I think I pushed it too hard with my back.

Fast forward another week and I'm at the fourth visit for dry needling.  I get the same thing done to my shoulder/neck, and then he addresses my lower back.  Holy hell did that hurt!!!!  Once when he poked me he "Gah!" type sound in surprise as my spinal erectors freaked out.  It was probably the most intense session I've had yet, and that is including the times they kept bending the needle in my groin because the muscles were so tight.

So yeah, here I am today. I've definitely made some gains in healing, but now as some muscles start working again it's revealing that other muscles are not healthy either.  It kind of feels like whack-a-mole: every time you nail one thing two others pop up.

So all kinds of muscles in my back/shoulder are feeling better, but right now my infraspinatus and some spinal erectors are clearly not right.  I imagine the spinal erectors will be an easy fix for Dr. Fullerton when I see him in a little over a month.  However, I'm concerned about the infraspinatus.  I think Dr. Fullerton has already addressed this muscle. And if it proves to be sound underneath the ultrasound then this might portend further damage that needs to be addressed.  My fear is that the instability in my shoulder joint caused by the tear in the labrum is causing my infraspinatus and tricep to tighten up in order to protect the joint.

If this is the case I'm going to be pissed.  Like, really mad.  The torn labrum is the whole reason why I started going to Dr. Fullerton, and he decided that my issue is not really the labrum but all the damage to the muscles around the shoulder.  If I do have to have the labrum treated this means I will have to pay for maybe three more sessions. Not only that, it means I will have to continue this cycle of two months on, one month off for perhaps six months, even more.

I just pray to God that the problem stems from the muscle being damaged, not the labrum.

Concerning the whole one month off, two months on thing, I think this time I was a little too aggressive in coming back.  I only did like three days of rehab before coming back to sprinting, and I don't think my body was ready for it.  I think I'll wait at least a week of doing phase 2 type stuff until I go back to sprinting.  So that means I'll only get like 7 weeks of sprinting every three months, and that makes me sad. But again if this is what I have to do then I'll do it.

Honestly, I'm not sure what I'm going to do with myself once I'm pain free.  I've made this journey such a part of my life, such a part of my self-identity, that I'm not sure what'll I'll turn to next after this whole mess is cleaned up.  I realize I might be worrying about nothing, that I'll always be dealing with this, but I wonder what I'll do when I will suddenly have so much more free time and money to spend.  Also, I'm really interested in what it will be to exercise with a body that is working correctly. How will it feel to deadlift with my spinal erectors working correctly? How will it feel to overhead press without pain in my shoulder/back?  How will it feel to be able to raise my right knee without discomfort?  I'm excited to find out.

So Freaking Close

So after this third treatment of my back muscles things are feeling really good.  A couple of days after the treatment I got my back dry needled to address the adhesions that happen in response to the prolo injections.  That really helped but I still felt something not right, so a week later I scheduled another dry needling appointment and told the PT that I still felt knots in my back, right on the inside of the shoulder blade.  He checked it out and found out that the knots were in my rhomboids. ...I thought this is wasn't news, that I always thought my rhomboid needed to be addressed.  Apparently this was new to the PT because the rhomboid is almost never the culprit for knots in that area.  Doctors will often see that the pain is in that area and say "oh hey, strained rhomboid", when in fact is the upper trap almost all the time.

So yet again my issues are more unique/rare. And this is yet another example of don't just take what the expert gives you. You need to stand up and say "No, I don't think the problem has been solved" and still advocate for yourself.  If I hadn't spoken up I would still have knots in my rhomboid.

So having the rhomboid released, when I walked away from PT office I was feeling amazing, I had no pain in my back at all.  When I swallowed, my left ear decompressed like the right one.  It was so satisfying. It was like an itch had finally been scratched.

But later that night, I felt another muscle spaz and freak out.  It was a muscles that came down diagonally from my shoulder to my spine.  The next morning I was feeling almost the same.  I still could decompress my left ear like my right, but when I tried rolling around on the lacrosse ball I found some knots that would not release no matter what I did.

So one week later I saw the PT again, and when I gestured which muscle I felt tighten up he said that was pretty much exactly where the infraspinatus is and he checked that out in addition to all the other muscles around there.  When he stabbed the infraspinatus omg it was soooo tight.  Getting up off the table I had a real hard time using my arm at all, it was that affected.  Again though, it felt amazing in that my back was no longer in pain.

Now, as I write this, it's been one day since that session and my infraspinatus has already tightened back up.  The only other time I've had a muscle tighten back up this quickly was my psoas when I had the tear in my labrum.  I've been told I have a tear in my shoulder's labrum, so if this is the case I'm going to be pissed.

Why would I be pissed? I'd be pissed because a torn labrum is the whole reason I went to see Dr. Fullerton in the first place.  When I asked him about it he said it didn't seem to be an issue, that all the fraying in the muscles in my back seemed to be the issue.  Well, the infraspinatus proves to be structurally sound then I'm going to give him hell for not addressing it earlier.  I know I was giving myself by the end of this year to be patient with the treatment, but damnit I'm tired of taking these months off of my training.

Speaking of training, I get to go back to resistance training/sprinting in two days, and I'm super excited.  I will be doing like 3 days of the rehab and then it's back to squatting and benching with some sprinting mixed in.

Pictures of Progress

So after every treatment with Dr. Fullerton I take a picture of my back with all the band-aids on it.  I do this for fun, but after looking at the three I see that each treatment has, in fact, addressed a different part of my back.  I am sure there are a few places that the band-aids missed, but I do think it's interesting to document the peeling back the layers of dysfunction that is my back.

January, April, and June

On another note the acute inflammation has died down a bit, so I suddenly feel like I've regressed in healing.  I know this happens every single time, but I really do seem to psych myself out when those old twinges come back, even if it's the slightest bit.  Just have to ride out this "prolocoaster" and in another three weeks I'll be back to exercising like I want to.

Day after Third Prolo treatment for Back/Shoulder

So this is the third treatment of my shoulder/back muscles by Dr. Fullerton. It seems that normally people’s issues are fixed after only just the first treatment so the fact that I’ve had three treatments makes me a bit of a rarity (something I already knew).  I can see why it usually takes two treatments max because everything that he has addressed is so much better than it was before.  The thing is, I have so much wrong with me that he can’t get it all in one session.  I don’t think this is lack of ability on Doc’s part, it’s just we are peeling back layers of issues and I happen to have a Goddamn lot of layers.

Each band-aid covers at
least two needle marks.

He addressed a lot of my QL, the one that made me think I had a kidney infection.  At one point when he was injecting me the area started spasming/twitching.  This is, it seems, is a sign that whatever he’s working on is really needing it.  So hopefully all of the issues with my lower back have been addressed.

He also felt around my upper back and worked on the rhomboids and upper trap area, to name a few places.  I believe some of the injections were directed to the inferior part, beneath the shoulder blade.  As with the lower back, I really hope that he’s done with the upper back as well.

Because most people don’t need a third treatment, they didn’t set out a huge block of time with me.  I told them that might be a mistake when we were scheduling it but they said don’t worry.  Well I’m a little peeved because I was really hoping they could address my hip as well.  Even though Dr. Fullerton was not able to address my right hip, I asked him to at least check it out with the ultrasound and come up with a diagnosis.  That, he obliged me with (and I thank him for that, this was at 7:30pm the day before he was travelling to Greece for vacay).

He checked it out, and pretty quickly came up with a diagnosis: I had some damage to a ligament or tendon right next to my femoral artery and femoral nerve in the inguinal crease.  He looked a little perplexed when he was checking it out, but that could be the face he normally makes when he’s checking something out for the first time (every other time I’ve been face down on the table so I’ve never seen this.)  Right now I really can’t remember the name of the tissue that is damaged. Right now I’m going with the iliolumbar ligament, though when the office responds for my request for info I’ll edit this post accordingly.

He asked me if I was having problems raising my leg, and I told him there was this drill in sprinting class where we have to lift our leg back and forth over a hurdle, and while I was solid as a rock on my left leg my right leg is super wobbly.  He said that’s probably the problem then.

While it’s nice that I now know what the issue is, I’m kind of wondering what to do about it now. Ideally, I would have had the injections performed and I would be back to working out in a month.  But now I have two choices. I can either wait three months from now and get it done and then take another month off, or I can try to get the hip treated ASAP and then end up taking like seven weeks off (his next available is like three weeks from now).

I’m think of holding off. To be honest my hip doesn’t really bother that much anymore now that I have the dry needling, and I am just starting to make friends at my sprinting group. I want to be active in that group, and the idea of me taking two months off really chaps my hide.  So it looks like I will probably have to wait a little bit longer to become 100%. I’ve waited so long, what’s a couple more months right?

11 weeks out from second prolotherapy treatment.

It’s now less than one week from getting my third treatment, so it's been 11 weeks since my second treatment, and I thought to report in. As expected, things are getting better, things that used to work one way (incorrectly) are now working another way (correctly).  For example, when I do over head press now, I don’t feel my back muscles snapping over each other.

But the more things get treated the more stuff I find wrong with me. My lower back (seemingly QL) is really off and I'm coming to realize it's a factor

In what has been going on in my hips. Having a tight QL tightens up my piraformis, and that in turn tightens everything else up.  This may explain why when I’m sitting at the bottom of a squat my left hip is higher than my right hip: the muscles are tight in response to the tight/damaged QL.  I’m really hoping that this session will fix/treat everything.

I started squatting recently, and I wasn’t too excited because usually my knees hurt some.  It’s nothing I can’t handle but I always wondered if it was normal or if it was indication that something was wrong.  Well I think it was an indication that something was wrong because this time around my left knee didn't hurt at all, it felt... natural.  Hopefully I can get this going on with both knees.

This desire has led me to have Dr. Fullerton look at my right hip as well. I thought addressing my left hip would fix the right hip, but that doesn't seem

to be the case.  I'm hoping when the doc looks at my right hip he will see an intact capsule but some frayed muscles around it, since

I spent a lot of time and money fixing the capsule with Dr Hauser up in Chicago.

However, who knows what will happen.  These are the various scenarios I envision:

Everything is fine, tight muscles are responding to other tight muscles, don’t need treatment

Capsule is fine, but there some fraying going on

I have a sports hernia

The capsule is damaged some

The capsule is damaged some and I have fraying in the surrounding muscles.

Going back to the issues with my shoulder/back. although I'm getting better and I feel like my upper back is like one treatment away from being completely fixed, I don't want to go back to being inactive. I've found a sprinting group and I really like that, and I've found a weightlifting partner and am enjoying getting back into the swing of things.  In fact, because of my weightlifting background I have been asked to teach a class on cleans/snatches for the sprinting group.  Looks like they will have to wait about a month, but I think that will be a great time for me to plan and prepare for the class.

So I’ve made all this progress, I’ve made all these friends, just to take another month off.

But if this is what it takes to get better, so be it.

However,  I really don't want to keep having these setbacks. My wife has noticed me leaning out since I've started sprinting, and I want to keep

Going, keep getting faster, stronger, and leaner.

Having said all that,  I know that if I keep going as is, I will just hurt myself further.  Prolotherapy is, for me, the path to becoming 100%.  Just need to keep focus.  My next post will probably be the day after I see Dr. Fullerton, so until next week!