Disclaimer: The following piece is based entirely on fact-based information. I was incredibly disappointed in the media’s blatant misinterpretation of Fultz’s current situation and wanted to tell the truth. The source material will be provided at the bottom.

Everyone in the basketball world knows something about Markelle Fultz. Whether you’ve followed the story step by step over the past two years or watched Amari Cooper of the Dallas Cowboys mock Fultz on Thanksgiving, you know the young NBA star is struggling. This piece is not going to be a retelling of the Fultz mystery from the beginning, rather an explanation of the events that lead us to today. If you stick with me, you will finally get some answers about the former top draft selection in 2017.

Expectations

Fultz was drafted number one overall in the NBA Draft and was the clear consensus top combo-guard in the 2017 draft. The 76ers moved up to get Fultz, who was hailed as the “final piece” of the process. The expectations were through the roof, and Philadelphia has a reputation of, well, blind passion. Fultz was the perfect scheme fit to pair with Simmons, as his shooting prowess was well documented in his lone year of college ball at Washington.

Philadelphia fans finally had high hopes after all the years of tanking. I remember listening to sports talk radio in the summer of 2017, the day the news broke that the 76ers had traded up to number one again. Fans were elated. There was a palpable sense of excitement throughout the entire city.

That was the highest point of public approval for Fultz in Philadelphia. The top draft pick would soon fall from grace, leaving fans confused, disappointed, and angry.

Misdirection

Over the past two years, there have been some massive ups and downs, in what has to be the biggest sports mystery in the last decade. The most recent change in direction was Fultz suddenly being removed from the lineup to get his shoulder looked at by specialists, yet again.

During his absence, a report from The Athletic claimed that Fultz would, “Prefer a fresh start,” and wanted to be traded away from Philadelphia.

Sources on @TheAthleticNBA: 76ers' Markelle Fultz will have an apparent wrist issue ailing his shooting examined Monday in New York, could prefer change in scenery. More reporting from @JaredWeissNBA, @DerekBodnerNBA, @sam_amick and @davidaldridgedc:https://t.co/NyR2FKT8bk — Shams Charania (@ShamsCharania) November 21, 2018

After all, it kind of made sense that Fultz would want a fresh start, and preferably in a place where the fans are less intense. This was later confirmed to be completely false. However, the damage was done. Most Philadelphia fans who were still supporting Fultz considered this the last straw.

Over the past few weeks, it became apparent Philadelphia has given up on waiting for Fultz, over an untrue story. Many fans who were being patient suddenly ran out of it, when thinking Fultz would rather leave. Fans who had his back all this time felt betrayed, and this was all caused by a false claim.

More than anything else, fans and maybe even Markelle Fultz, just want to know what is wrong.

The answer may have been found.

The Diagnosis

The recent diagnosis of Markelle Fultz’s shoulder is a significant one. It is also a complex and rare medical issue. Most importantly, this is a diagnosis that starts to explain everything when you really look at it.

After discussing Fultz’s diagnosis at length with knowledgeable people in the athletic training field, I started to put the pieces together that begin to unravel the Fultz mystery. This story took some digging, a LOT of digging actually. As I said, the issue is complex, but I will do my best to explain it in layman’s terms.

Fultz, after seeing multiple specialists in December of 2018, has been diagnosed with Thoracic Outlet Syndrome (TOS). This a physical ailment, and one that affects the range of motion in his right shoulder.

TOS can come in three forms, Venous, Arterial, and Neurogenic. Fultz has been diagnosed with Neurogenic Thoracic Outlet Syndrome specifically.

Thoracic Outlet Syndrome, in Fultz’s case, is caused by the compression of the brachial plexus. Your brachial plexus is a network of nerves that connect your spine, neck, and arms. In the simplest way to put it, Fultz’s nerves between his neck and arm have been compressed, and are malfunctioning as a result.

These nerves control muscle movement and sensation in your shoulder, arm, and hand. Symptoms include loss in the range of motion, numbness or tingling in the arm and hand, and pain in your shoulder.

One could question how it took many specialists and team doctors so long to figure this out, especially with how obvious it sounds once you look into it. Turns out there is a pretty good reason.

“Symptoms associated with thoracic outlet syndrome can be caused by a number of other conditions, which makes it difficult for doctors to diagnose the condition. Many people experience thoracic outlet syndrome symptoms for years before they are diagnosed with the condition, which can cause stress and frustration,” per the Mayo Clinic.

Fultz has been struggling with a physical issue throughout this entire process, and I cannot imagine how frustrating it has been to hear how his issue must be in his head.

For Markelle Fultz and the 76ers, this diagnosis is good news. The reason why is because it is treatable with physical therapy, and there is no reason to suggest Fultz has suffered any permanent nerve damage.

–The odd part is, that sports media publications believe it is bad news. The only publication I found that wrote about this diagnosis as a good thing, was Inverse, a media company that has very little ties to professional sports. It is known for its scientific publications, and I have to give them credit, for getting this thing right.

As Fultz’s story became more bewildering, it began to interest the medical community around the world. Dr. Karl Illig is the Director of the Regional Medical Center Thoracic Outlet Center, who specializes in treating TOS. Yasmin Tayag, a writer for Inverse, featured Dr. Illig in her piece on Fultz to speak on his recent diagnosis.

Dr. Illig believes this diagnosis is a blessing for Fultz.

“Because no longer is it just: ‘We can’t figure out what’s wrong with this kid, it’s all in his head, he’s crazy.’ All of a sudden, now it becomes a real, honest-to-goodness diagnosis,” Dr. Illig said.

Most importantly, the issue was identified and it is completely treatable with physical therapy or surgery. As of now, Fultz will be treated with physical therapy.

According to Dr. Illig, patients with TOS often are seen by six previous doctors, before getting the proper advice to seek a TOS specialist.

With how much of this aligns with Fultz’s situation, there is a reason to believe Fultz is feeling a major sense of relief right now. After all, according to Dr. Illig, “[TOS] is a major psychological burden for the patient.” That burden becomes much lighter knowing it is a physical ailment and not something in his head.

Fultz, whose health has been speculated on national media for the past two years, faces an even larger burden than those of people who live private lives.“When you tell them they actually have a real diagnosis, they actually sometimes start crying, they’re so grateful,” per Dr. Illig.

While doctors struggled to identify Fultz’s ailment, fans and major media created their own diagnosis: “Markelle Fultz is a headcase, his problem is all in his head.” Stephen A. Smith had a lot to say about Fultz on First Take on December 5.

Smith believes that Fultz is undoubtedly the “biggest bust in NBA history.” Among many claims, Smith added, “I can assure you, this is not just about his shoulders.” Smith is implying that even if Fultz has a shoulder problem, which he does, Fultz is still struggling mentally.

To Smith’s claim that he is certain that Fultz has suffered mentally from this ongoing problem, I would say that he is blatantly pointing out the obvious. How could Fultz not be struggling mentally right now?

Fultz’s injury is physical, but the results of that injury, have absolutely caused some mental issues. To those who call Fultz a headcase, I want you to imagine this:

You are Markelle Fultz, you grow up without a father in your early life. You overcome the odds and become the first overall pick in the 2017 NBA Draft.

You are drafted to Philadelphia, arguably the most intense fan base in professional sports. All of the sudden, something is wrong with your shoulder. Your range of motion is decreasing inexplicably, and doctors have no answers. Your coaches, teammates, friends, family, and fans want to know what is going on, but even you do not know.

Everything you have been working so hard to achieve, is suddenly being ripped away, and at this point, even you begin to think “Is it all in my head?”

I can only imagine how Fultz is feeling now, knowing it was not in his head, and can finally start healing. Fultz can begin to repair his physical being and his mental fortitude.

How It All Connects

Now that we know the cause of all this, we can start to make sense of all the weird things we have seen from Fultz over the past two years.

The first thing this explains is all the weird stuff we’ve seen at the free throw line this season.

This was the first clue that really got me thinking. Fultz knows every single time that he goes to the free throw line, it will be replayed over and over again on national TV. Fultz knows every single thing he does on the basketball court will be over-analyzed and interpreted to fit a narrative.

Watching Fultz perform such a bizarre motion before releasing the shot linked above, I thought, “That looks like he is trying to trick his shoulder to act a certain way.” Fultz would not have attempted something so bizarre if he did not believe that it was a way to get the correct result. The 20-year-old was trying everything he could.

Speaking of doing everything he could, Fultz spent last summer with Drew Hanlen trying to get his shot back. Hanlen is a proclaimed “shot doctor,” who believed Fultz’s jumper could be fixed by repetition and coaching. Unfortunately, a major cause of TO is overuse of overhead movements, such as shooting a basketball. Hanlen over the summer announced that Fultz had taken 150,000 shots while working with him. Knowing what we do now, it is no wonder things got worse for Fultz as the 2018-2019 season began.

A previous shoulder injury that Fultz suffered in his rookie year, also has connections to TOS. Remember when Fultz was diagnosed with Scapular Muscular Imbalance? It was back in October of 2017. Does anyone want to take a guess what one of the causes of Scapular Muscular Imbalance is? You guessed it, Thoracic Outlet Syndrome. In fact, there have been academic papers published by doctors who believe the scapula has an even bigger impact on the treatment of TOS than originally thought.

What Happens Next

This syndrome affects very few people, roughly one percent of the population. As a result, there has not been much medical discovery in recent years about TOS. What we do know is, it is a more common baseball injury than anything else. This could explain why basketball doctors were unable to identify this issue initially.

Keith Meister, the Head Team Physician for the Texas Rangers, has published works on the rehabilitation process for TOS. Meister has published a detailed outline for a rehabilitation protocol to treat TOS in professional athletes, for The Texas Metroplex Institute for Sports Medicine and Orthopedics.

Meister’s outline highlights a three to six week recovery time frame for this injury, however, that does not mean Fultz will return to the 76ers lineup in the next six weeks. A more realistic timetable for Fultz to be fully healthy and ready to shoot basketballs in high repetitions, is six to twelve weeks, according to Meister’s rehabilitation protocol.

Regardless of the timetable for Fultz’s return, this will be a fascinating rehab process to follow.

My Thoughts on All of This

Whether you want Fultz to succeed in Philadelphia, or get traded, this is good news for Fultz and Philadelphia. This presents a chance for Fultz to FINALLY have his “I’m good” moment. His problem has finally been identified, and hopefully, has the right professionals around him to get right.

The best part is that the expected recovery time for TOS is three to six weeks. Prior to his diagnosis, the outlook was incredibly grim. The fact that his ailment was identified, and that there is a good chance that he will make a full recovery physically, is fantastic news.

The not so good news is that it’s going to take a lot longer for Fultz to get back to playing basketball. Theoretically, if the rehabilitation process goes to plan, Fultz would be fully healthy in six weeks. That does not mean the 76ers will want him immediately back in the lineup. After all, a lot of this injury was caused by overuse.

Maybe it is a good thing that the word on the street is that Fultz is a bust, so he can finally get out of the spotlight and get his body and mind right. It is disappointing how many times I have had to explain to others that writing off a 20-year-old is silly. Mocking Fultz and celebrating another person’s physical ailment is lame. There is finally some clarity for Markelle and the rest of the basketball world.

Whether Fultz eventually gets back to “normal” or not, don’t listen to emotionally driven narratives that call Fultz a headcase. Not only is his problem stemming from a real physical issue, but it explains almost every head-scratching moment of confusion over the past few years. It explains his silence and the initial mishandling by doctors.

Hold on wait a minute… Y’all thought Fultz was finished?

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Source Material:

mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/diagnosis-treatment/drc-20353994

tmisportsmed.com/pdf/tmi-tos-rehab.pdf

inverse.com/article/51537-markelle-fultz-thoracic-outlet-syndrome

nyulangone.org/conditions/thoracic-outlet-syndrome-in-adults/types

muscleimbalancesyndromes.com/2012/04/23/can-the-scapula-play-a-role-in-thoracic-outlet-syndrome-rehabilitation/