I was diagnosed via MRI in August with SLAP Tear and Biceps Tendonosis by one of the nation's "best" shoulder surgerons... My right shoulder has hurt as long as I can remember, even as far back as 20 years in high school when I was a baseball pitcher. Pain has increased over the years, like a sharp burning pain right beneath/between my coracoid process and acromion. After my diagnosis was revealed, I spent a couple months investigating my options, particularly options beyond surgery... this well-known doctor was a little too excited to get me into surgery "ASAP", and something did not feel right about everything. I initially had the insurance precertify the surgery, verify benefits and set everything up, just to be sure the process was seamless as it sounded just in case I had to go the surgery route. It was, and it would have been easy enough to get into surgery that same week. But, no wanted to go that route yet, I searched more.

I immedietely sought a second opinion, and jumped into physical therapy and chiropractic care to address some things that were contributing to my shoulder pain in the first place. The second Ortho doc I went to said, "Yeah, you have a SLAP tear, but your strength and range of motion are very good... so what would we really be correcting? If the pain if from weak and tight tendons and muscles surrounding the joint, then let's first try a few weeks of PT and a steroid injection to calm the pain down, and go from there." I liked his open, honest approach... more conservative, more "let's see where things go if you aren't keen on the surgery route."

I arrived at the opinion that a SLAP Repair and SAD procedure would take me away from work for too long which I could not really afford financially, and the long recovery would be too much on my family, work and fitness life for up to a year. Shiort-Term Disability would have only paid me 60-80% of my salary, which is not enough to get by on right now. My occupation in the medical field is very physically demanding, so if I tried to suck it up and go back to work too early, I would have been a liability to myself, my co-workers and my patients. I figured it would only help my personal recovery journey to get my thoughts down "on paper" as to the route I chose, and will come back here periodically to update as time goes on. More to come shortly.

OK, so I went through 3 weeks of 2-3x/week Chiro and PT sessions, enough time to re-align some things, do some therapeutic ultrasound and re-learn the ol' Shoulder/RC strengthening routine. I do feel my pain decreased as my flexibility and strength increased, and it was during my first chiro visit that I found I had "Scapular Winging," which kind of means that scapular part of my shoulder was very weak and not compensating at all and not really aiding my shoulder at all in a bunch of movements. So I was given some more exercises to start getting my scapular muscles to fire when they need to. As time went on, my pain was less and less, but it was hard to tell whether it was the DepoMedrol or the PT and chiro helping me.

I still had that crepitus "crunching" feeling in my shoulder along with a deep dull pain that seems to hang aound, so since I had been investigating Prolotherapy/PRP for awhile, I decided to give Prolotherapy a try, to see if it could help stabilize some of the unstable tendons and ligaments in my shoulder capsule. I live in Cincinnati, and oddly enough there is really no "Numero Uno" Prolo doc here (it is a very surgery-focused city), so I expanded my search outwards, focusing on 3-4 docs within a 6 hour drive. Out of respect for the docs, I won't name names publically (drop me a line if you looking into this for yourself and want specific guidance), but can say I scheduled myself for 3 different places on the same date 3 weeks out, giving me enough time to sort out which appointment to keep. It was one of those "let your gut make the decision" situations. I ended up deciding on a D.O. (Osteopathic Sports Medicine Physiatrist) doctor 6 hours away from me, and I chose him based on his Prolo experience, value (what he charges) and personality/personal feedback (his willingness to communicate with me directly via phone/email prior to my first appointment). I scheduled for October 19, 2011.

On October 19, I left the house around 5:30am, hit just about zero traffic all the way there and was at my destination before 12 Noon... nearly 2 hours early for my 1:30pm appointment time. This doctor actually offered to make an exception due to my distance driven, and see me on his only "administraive" day of the week, so I wasn't about to waltz in early and see if he could see me earlier than planned. I drove around the city for a bit, stopped at Starbucks and read a bit until it was time to head to the Doc's office.

Upon my arrival, the doctor's office was extremely clean and professional, and the staff was very friendly and very sensitive to the fact that I drove 6 hours to see them. I was quickly taken back, weighed and had all of my vital signs checked. The Nurse reviewed with me exactly what I was there for, discussed all of the procedure's risks, follow-up care, etc. and I signed the necessary consent forms.

The doc came in as the nurse was finishing up with me, and he was very cordial and friendly. We discussed expectations, the procedure and he described exactly what was going to happen before we started. He took me through the whole gamut of tests that typical "SLAP" patients go through. He did a lot of palpating for sore areas, and marked them all off accordingly with a marker. He then used Ultrasound to visualize and verify all of the landmarks, and also used the ultrasound to guide his injections to make sure we were addressing all the right spots.

He then turned my shoulder, back and upper chest into a "sterile field" and gave me 4-5 shots of Lidocaine to numb the areas. These shots were given with a pretty small needle, and did not hurt at all. He allowed the meds a few minutes to take affect, and we made small talk and whatnot until he felt we were ready to proceed.

The first injection was what he described as the most "intense", and was delivered with a 3" needle to the back of my shoulder into the AC (I think) joint. I did not feel any pain, just pressure of the large needle advancing forward. He drew the needle back several times while redirected and injecting the 20-25% Dextrose solution into various areas. That was the worst of it, really, as all the rest were given qo the scalene area and the front and sides of the shoulder. All in all, I was given 30+ injections, and barely felt any of them besides the first one. I was cleaned and "patched up", and then after discussing my old ACL reconstruction, he agree to use the remainder ogf his solution to inject my right knee at no extra charge. Super nice guy, great staff, and I am sure I will be back to see him in ~4 weeks, as injuries such as mine can take 3-6 sessions to realize a full benefit. I'll update later on today, since i am now technically 3 days out from this visit.

So fast-forward to today (Post-Prolo Day 3), I have a tiny bit of tenderness near where the trapezius was injected and a couple little bruises here and there. A little tender to the touch on the areas that are bruised. Honestly, I would be surprised and almost disappointed if i didn't have SOME pain from 30 injections... haha. As for the shoulder itself, I do still have some pain where I had pain pre-Prolo, but I don't have any of the crepitus "crunching and cracking" I had pre-Prolo. I know it will likely take a few sessions to slowly build up the connective tissues, so I am cool with being patient and not expecting too much too fast. The way I look at it, if this were Post-SLAP repair Day 3, I'd be in a much different, er, mood so to speak. lol.

There is definitely less soreness and acute burning-pain flares during my range of motion and stretching exercises now - it's definitely not the Lidocaine hanging around, b/c that kind of drug has a very short "life" in the body. I am not really "lifting" again yet... gonna play it safe and let the healing continue to happen a while longer. I am hitting cardio hard every day for 30-60 minutes, and did some very light band exercises with the shoulder today, but only enough to keep the blood flowing, not pushing the shoulder to fatigue or pain or anything like that. Hoping to go back to the doc again in late November for some more Prolo to my shoulder and knee. Oh yeah, no crunching or cracking in my knee anymore, either... and that's ALL it wanted to do pre-Prolo. I will report every day or so as to my progress and observations leading up to my next visit in late November... hoping my reports may educate people a little, or at least give people a different look at an option to try before going under the knife. Prolo has minimal risks, and is essentially quick, painless and reputedly works on a TON of conditions... maybe worth a try. I know I still may go under the knife before it's all said and done, but I sure am gonna fight it.

OK, so I haven't been updating this thread at all b/c it didn't appear as though anybody has been responding to it or even reading it. lol. But that's OK, it helps me to get my thoughts on screen anyway, so here goes. I am scheduled for Session 2 of Prolo on November 21. Since the initial visit, I feel things have improved quite a bit. Certain motions that I would start and then criunge and stop, no longer hurt and burn where it once did. I no longer feel myself "cheating" to use my shoulder by bending and whatnot. Simple things like reaching up to put something on top of the fridge, raising my hand like a kid in a classrooom, reaching accross my body... these thing were very challenging to do, but not nearly as much so now. I still do have some pain in the spot that we are treating, and I still have to "think" about what I am going to do before I do it to avoid overloading it and stunting the healing process. I'm still doing a ton of cardio and light band exercises - I stop when I feel pain, something I didn't used to do. Silly, I know. I will come back on to report my next experience soon... if anything as a diary for myself to read. haha.

Prolotherapy is a pretty hot topic with a lot of interest. When I check the stats for your posts I see that over 150 people have read the thread and most spend a lot of time here, so I'm thinking they are reading the whole thing! Not to mention, what you post here will be read years from now, so please don't feel like you are posting into a vacuum.

It sounds to me like prolo is a really good option to try first along with physical therapy. Minimally invasive and limited risk, it seems like a good option.

I hope you keep recovering well from it!

Andy