• Matt Nguyen

Markelle Fultz and The Shoulder Conundrum: A Theory

USA Today

On Tuesday morning, The Athletic’s David Aldridge reported that the Philadelphia 76ers’ Markelle Fultz would be seeing a shoulder specialist early next week. Until further examination, Fultz will not be practicing or participating in games. This marks another chapter in what has been a dizzying and confusing journey for what was once the consensus number one overall pick in the 2017 NBA draft.

The History

Last year, Fultz’s agent revealed that his poor shooting form was a result of a sore shoulder. Initial reports were confusing, as his agent reported that he had fluid drained from his shoulder. He later amended the statement, saying that Fultz had a cortisone shot. The Sixers then held Fultz out due to shoulder soreness and dyskinesia. Long story short, Fultz ended up playing just 14 games in his inaugural season.

After the news of a second shoulder check-up in as many seasons, let’s dive into what may be causing Fultz to look like a 2K glitch.

First things first, let’s take a look at the shoulder.

The scapula, or shoulder blade, is a triangular shaped bone that sits on top of the backside of the rib cage and creates the scapulothoracic joint. There are many muscles in and around the scapula that perform in harmony to lead to good shoulder movement.

Scapular dyskinesia is an alteration in normal position or movement of the scapula. Most cases of scapular dyskinesia are a result of the loss of muscle coordination. That would explain why Fultz had to essentially relearn how to shoot following extensive physical therapy and rehab. With dyskinesia, there could also be further injury to the rotator cuff, labrum, and the shoulder capsule.

In the gif, the right scapula is in perfect control as the arm is lowered to his side. Notice the left scapula though. The muscles are in such imbalance that it shoots towards the middle right as he tries to lower his arm.

That leads to this upcoming visit to the shoulder specialist. Something is still going on with Fultz and that shoulder. I have a theory that Fultz may be dealing with residual effects from the previous shoulder and a disruption in the brain-body loop.

The Theory

In acute pain, the pain pathways to the brain fire due to input from the peripheral tissue, or the tissue that is damaged. That signal is then sent to the brain whenever that tissue is used. Higher functioning parts of the brain then send signals back to stop the pain and start a healing process. Once enough anti-inflammatory responses are sent and the tissue is repaired, use of said tissue is then returned to normal.

Fultz has been dealing with pain for quite some time. His is classified as chronic pain. In chronic pain, the inflammatory response begins in the same manner as the acute pain. However, with chronic pain, there are several factors that expand the pain map in the brain. This means that there is a constant firing and release of inflammatory products into the tissue, overwhelming the anti-inflammatory response. This creates a loop between the body and brain that the tissue is in a constant state of pain while preventing proper healing.

I’m can’t say whether or not Fultz still has tissue damage in his shoulder or if his scapula is still out of whack. What I’m saying is that the pain loop has registered something in his brain and it has definitely affected his shot. It’s possible that whatever results from next week’s visit can solve the issue. However, I feel like most of what’s going on is still all in his head.

I’m still hoping that Fultz returns back to form and shows the league why he was drafted number one overall.

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