Shoulder Calcific Tendonitis

When Noise Masks the Problem

By Kevin Meyer Updated on August 3rd, 2018

Shoulder Calcific Tendonitis

Last week I was reading Mark Graban’s latest book, Measures of Success, which does a great job of discussing how to use data to effectively lead and manage an organization.  With new technologies it has become so easy to capture data that we often go overboard – and really never understand why we are grabbing data and what it actually means.

One concept in the book is learning to discern true signals from noise, and then doing something about them.  This made me ponder when signals might be lost (or improperly conjured?) among noise in qualitative situations.  Actually, a more correct analogy is the classic lean concept of draining water – waste – to expose rocks – problems. It hit me that I had just experienced such a situation with a medical condition I hope I’m recovering from when you read this.

The day before this post is scheduled, I’m having surgery for a painful shoulder condition – calcific tendonitis.  As a result of an injury to a tendon, the body sometimes screws up and starts replacing tendon tissue with calcium.  Usually it soon realizes the mistake and reabsorbs the calcium and replaces it with tissue, but in some situations, like mine, it doesn’t.  So I now have a 2 centimeter hard calcium spike shredding my right supraspinatis tendon.  Through the wonders of arthroscopic surgery the calcium will be removed and the tendon repaired.  It’s not a fun recovery – four weeks in a sling and sleeping upright followed by three months of physical therapy – but it has a very high rate of success. [Update: surgery went well, but he also found and repaired a bone spur and torn rotator cuff.]

I began noticing the problem a few years ago after I injured my shoulder yanking a bag out of the overhead compartment of a plane.  Work outs, particularly movements that put pressure or strain on the shoulder (pull ups, push ups, burpees, sled push, even a downward dog!) have become increasingly painful.  However until recently it has been easy to modify and still get a decent work out so I just chalked it up to aging and moved on.  During regular daily activities I usually don’t notice any pain, and I’ve always been able to sleep well.

Those daily activities covered the real problem, which I realized when I did the silent retreat I told you about last June.  Surrounded by silence and tranquility, I soon realized I was really, and unexpectedly, in constant pain.  I also realized that I was modifying my normal activities to compensate far more than I realized, from eating to how I hold a book while reading, to even how I grip the steering wheel in a car.

That was the signal that something needed to be done.  An MRI and visit to the doctor confirmed the diagnosis and that the problem was only going to get worse.  Surgery was recommended.

Where else may you be experiencing a qualitative problem that is being hidden?  Is the overall great outward performance of a team member masking an underlying issue where she or he is actually unhappy or has untapped potential?  Perhaps that overgrown section of garden is hiding the gopher hole of a varmint that is silently destroying your yard?  Does your team need to go offsite for a day, without cell phones and email, to properly focus on and discuss issues?

The analogy is admittedly not perfect, but the point is that sometimes problems, and their scope, do not become apparent until extraneous information is removed.  If you see a potential issue, isolate it and focus on it, and see if it is something larger.  Then do something meaningful to correct it.

  1. Tony Heath

    August 5, 2018 - 7:35 am

    Kevin. Nice essay with a good point. I hope your recovery goes easily.

  2. Mark Graban

    August 5, 2018 - 8:17 pm

    Kevin – Thanks for the mention of my book and for the kind words.

    I hope your recovery is going well and that you didn’t experience too many issues during your time in the healthcare “gemba.”

    That’s an interesting question about qualitative issues.

    Let’s say you have one co-worker who always just grunts and nods when they see you first thing, while another is cheerful, smiley, and greets you with a “good morning sunshine!”

    They might each have some “routine variation” in their daily mood. If the latter colleague didn’t say anything one morning, but was still smiling and had a bounce in their step, you might not overreact to that change. Perhaps, unless that was the ONE and only time in the last five years they didn’t SAY “good morning sunshine!”

    That might be a signal, a rare event, a sign that something has changed in the system? That might be something worth investigating?

    Likewise, if the daily grump suddenly smiled and beamed “good morning sunshine!” you might do a separate root cause analysis about that?

    Get well soon.

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