"Yep, right there. You see that spot right there? That's a tear," said Dr. Fullerton. "So, when you move your arm out, when you rotate it, the motion tugs on that tear and that's probably why it hurts."
Dr. Fullerton had spent over an hour imaging my right shoulder with an ultrasound machine. That was after he had examined my shoulder and ended up scratching his head. The exam didn't fit the typical pattern of a rotator cuff tear.
The tear is near the end of the supraspinatus tendon close to the bone. It's small. Not big enough for surgery.
"So, what's your suggestion about this?" I asked.
"Well, you can keep doing what you're doing since you're getting better. We could also inject the area with a mixture of dextrose and lidocaine to stimulate it. There's no rush here. So, if you want to wait a couple of months and keep working on it, you can," replied Dr. Fullerton. "But, I would like you to get an x-ray of the shoulder just to make sure you don't have a big spur or something there. I doubt that you do but it would be good to know."
So, with that information, I had to make the call to Christine to let her know that her suspicions were right. She was gracious as always and refrained from saying "I told you so."
I've been in rehab for my shoulder injury since the end of December 2009 and have made great progress. The reasons I went to see Dr. Fullerton were 1.) Christine told me to and 2.) I was still having trouble with a throwing motion. Knowing that I have a small tear and where the tear is explains why it still hurts with certain motions.
What to do? Well, I'll get the x-ray and likely opt for prolotherapy in addition to the ongoing rehab. I'm curious about prolo so part of the reason is to satisfy my own sense of wonder about what it feels like, how it works, and to see how quickly I can heal the tear. Prolotherapy is not widely accepted within the medical community although it is less controversial than platelet rich plasma injections (PRP). Basically, what prolo does is irritate the tissue and stimulate it to heal. This is a similar process to what we use in an exercise based, tendon remodeling program so the combination should work well.
I've said before that accepting reality is one of the first things you have to do to start healing. For each of us, that process takes a different path and a different time frame and some of us get stuck in anger. We're angry at our pain, our injury, for what it has done to our lives. We can't do what we want to do and, well, it pisses us off. It doesn't help. You have to make peace with your self, your pain, your injury, then you can move forward. Until you do, you'll stay right where you are. It took me less time to make peace with my injury this time around than it did when I ruptured a disc in my back in 2008. I'm learning.
I'm looking forward to the next few months as I help my shoulder heal, learn some new things, and get better - in more ways than one. I'll let you know how it plays out.