When I realized that my shoulder was in too much trouble to heal itself, I had to decide who to ask for help. I was still in the typical male mindset of “rub some dirt on it.” I just wanted someone who knew where to put it and what kind of dirt to use. From my work with jaw muscle issues in my dental practice I recognized the pain that I was having as muscular in origin. This pain can be exquisite and refer from the site of the injured part to distant locations in patterns that have been extensively studied. This muscle pathology has many causes. The most common cause, the one that I deal with in my practice, is chronic muscle tension or what we know as “overuse”. The muscle fibers get fatigued from constant contraction and build up chemistry that disrupts their normal function. This leads to breakdown of the normal anatomy and the formation of distinct abnormal structures we call trigger points. It sounds positively medieval, but one of the best ways to treat these trigger points is to physically disrupt them by poking them with a needle. The technique is called dry needling. Most of us are familiar with acupuncture. Dry needling is the process where an acupuncture needle is inserted through the skin and into the trigger point. This process is not anymore than uncomfortable and in my case remarkably effective. I am getting ahead of my story.
I knew a Physical Therapist that had treated my patients with trigger points in their jaw muscles. I consulted Matthew and he agreed to see me for evaluation. His evaluation was a frozen shoulder and that I had trigger points in just about all of the muscles in my shoulder that he thought he could help with dry needling, massage, and an exercise regiment. He would not commit to healing my shoulder, but that he would see what degree of benefit that PT could provide. Over the next month we had, I would guess, 8 sessions of PT and dry needling, and my pain was reduced significantly. My sleeping was back to normal and my outside the office activity was pretty normal as long as I was gentile and careful.
My range of motion, however did not improve and during this time. I had some significant pain and weakness in some of the arm motions that I use in my practice. There was one specific patient that needed some difficult fillings on the lower right molars. There are times in daily practice when it is necessary to use your hands for multiple functions in addition to actually doing the procedure. This was one of those situations where I had to hold cotton rolls in place on both sides of the teeth retracting both the tongue and the cheek to keep the area open and dry. My shoulder was screaming! How I managed to get the job done I will never know. Right then I realized that beyond any doubt I needed to go see a real doc and have a full work-up done. I will not go into details. but after two work-ups, X-rays, MRI, and a steroid injection. I was given my diagnosis … complete a total rotator cuff tear with biceps tendonopathy. I was basically given three choices: Live with it as long as I could; have a reverse total shoulder arthroplasty (thats a Real Doctor name for creating a new joint from titanium parts); or to attempt to reconstruct the shoulder with original factory installed parts. My decision was easy, I had to do something and the thought of using hardware to fix the shoulder if I did not absolutely have to was not attractive so I opted to have reconstructive arthroscopic surgery. This was done on January 28, 2016 on an outpatient basis.
My next post will cover the procedure itself and the initial recovery.