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.

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.

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:

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.

Another Labral tear????

Well, I finally saw someone to figure out what is wrong with my shoulder.  …I don’t know why, but I feel like I’ve seen many, many Dr.’s about my shoulder. But as I sit here and think about it, I am not so sure.  So I saw a PA today and we did all kinds of tests.  After passing quite a few, he then gave me one where I had to resist pressure with both arms.  My right arm resisted, and my left arm went straight down. Like, I couldn’t muster any strength at all.  “Now we’re getting somewhere.” He tried a couple more tests, all of which I failed.

He told me these all point to having some damage to the labrum in the shoulder.

Really?  Really? Another laberal tear???

We are going to confirm with an MRI with arthogram.  It was funny, having the PA explain to me what the labrum is as well as an arthogram. …Sometimes I wish I wasn’t so familiar with this stuff.

I have no idea if this comes from my time with crossfit and its dangerous kipping pull ups, or it could have come from wrestling or whatever. This kind of damage can happen slowly over time, and I think that is what happened to me. Whatever the case, I am looking forward to getting the MRI and following that a real diagnosis.

Interestingly enough, I might decide to go back to Dr. Hauser for more prolo, this time on the shoulder. I’m pretty darn sure the situation isn’t dire enough to warrant surgery, at least not surgery without trying prolotherapy first. We’ll see how this works out.

I just want to know what is going on, so I can start fixing it.

Danger of doing kipping pull ups without sufficient strength

(UPDATE: if you've hurt your shoulder I've found something that can really help out.  It's simple and cheap, and it's hanging from a bar multiple times a day. Won't heal the labrum, but it can help out with a lot of other shoulder ailments.)

If you peruse the injury threads on the crossfit.com board you'll find a lot of shoulder injuries, specifically SLAP tears (tears in the labrum). A lot of them seem to come from kipping pull ups, and I've come across a possible explanation. There is an article explaining what a SLAP tear is and how it comes about, most notably:

In theory, SLAP lesions most likely occur in overhead athletes from a combination of these 2 previously described forces. The eccentric biceps activity during deceleration may serve to weaken the biceps-labrum complex, while the torsional peel back force may result in the posterosuperior detachment of the labral anchor.

As some one else pointed out, when you look at the kipping pull up with this knowledge you'll see:

Eccentric bicep loading = the negative part of the pull-up, the arms straightening at the bottom

Arm deceleration = the swing into the kip

Abduction and external rotation = the position of the arms at the apex/reversal point of the kip

Just imagine the "peel-back" force in the shoulders when they are forcefully wrenched back at the apex/reversal point of the kip. If you really think about it, the head of the humerus is trying to push out the front of the glenohumeral (shoulder) joint, the kipper is trying to RELAX their muscles at the bottom to get the most out of their kip, leaving all the strain on the LABRUM (think of it as a suction cup on the scapula that holds the humerus on the body, with the greatest forces on the top/superior and the front/anterior parts), and the resultant forces--over time (repetition)--TEAR the TOP part of the labrum from the FRONT to the BACK...this is therefore a SUPERIOR LABRUM ANTERIOR-POSTERIOR injury mechanism, almost perfectly designed (as evidenced by the orthopedic doctors making a ton of money off of people who do them).

Steven Low, writer of an awesome exercise blog, has chimed in on this subject matter as well. I have much respect for the man. Not only do I have a link to his blog in the margins, but his posts have really helped me in the past with my injuries (led me to find a DO for my hip, helped realize massage would fix the tendonitis, etc.). Concerning SLAP tears, he says:

The reason why you don't seen the top CF athletes getting slap lesions is because their shoulder mobility sucks. If your shoulder mobility sucks when you relax your shoulder muscles at the bottom of the pullup you have your muscles contracting against opening the shoulder all the way thus mitigating any forces on the biceps long head tendon. In addition, the muscles do help bar forces from the shoulder.

However, when you get people who are weak (e.g. women in general, or those with good shoulder mobility) they're the ones getting the primary forces distributed through the muscles into the other soft tissues such as the long head of the biceps. This is especially the case with learning the kipping pullups where there's going to be a lot of jerking down into the motion while learning it.

I would never ever ever ever recommending learning kipping before you at least have 3+ deadhang pullups. It's not just not a good idea putting trauma on the shoulder especially when it's easy to not do it right and jerking down into the movement which is much more dangerous than a smooth movement.

Jerking down from toes to bar can do the same thing for reference.

There's also another article here by Whole 9 that basically sends the same message of do dead hangs before working on the kip. Crossfit Virtuosity also recently mentions how important it is to have strict pull ups before you start kipping (and provides a great program to get strict pull ups).

This kind of concerns me because my shoulder mobility is pretty darn good, however I have a very smooth swing, without a jerk. I also wonder if butterfly exposes the shoulder in the same way (don't think so). But from now I will definitely make sure I'm keeping my shoulders engaged at the bottom of a kip, I already have a tear in my hip labrum, and I really don't want to add a shoulder one to the mix.

...I should also point out that, as far as I know, no one at CFOT has suffered a SLAP tear. This is further testament to the training and programming that Jerry lays out for us. The man knows his stuff.

(UPDATE #2: Turns out I have a tear in the back of my shoulder's labrum, not a slap tear, but a tear nontheless. I've decided to forego surgery and try prolotherapy to repair the damage naturally. For more about prolotherapy check out these two videos here and here.  I've started a vlog where I document what recovering from prolo is like:



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