Daily Mobility Exercises by Dr. Kelly Starrett Forums General Scapula problems – last chance help needed (probably solved now)

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    • #70471
      AvatarAndrew Woodruff
      Participant

      Edit/Solution 2014-03-26:

      Allright I have finally found something that seems to work. I can’t tell
      if the underlying problem is solved but I have been pain free for over a
      week now. I started doing two things at the same time so I’m not sure
      if it’s only one or the other or both together.

      1. One PT I saw
      said that my shoulders were too low. Contrary to what I was told to
      believe before, a long distance from your ear to your shoulder is not a
      good thing. The clavicle is supposed to be at a fairly steep angle where
      the outer portion is significantly higher than the inner one. If you’r
      clavicle is horizontal or only has a small upward angle, you are not in a
      good position.

      So he told me to do this: stop all exercises that
      lower the shoulder girdle. That includes pulldowns, bench press etc.
      Alsto stop stretching the upper trapz. And do lots of shrugs, with the
      arms straight overhead.

      2. I’ve begun to incorporate a
      neck/thoracic spine mobilization as part of my normal posture. it’s
      basically this: pull your chin/head back, and imagine pushing your torso
      forward in the opposite direction. I really like this one as it feels
      like my neck is better anchored to my thoracic spine.

      While I
      don’t want to be too optimistic, this seems to be a solution. I can’t
      remember when I last was pain free over a week in a row.

      So if you have a smiliar problem you might want to check the height of your shoulders and the angle of your clavicle.

      ========================================================================================================

      Mwod is working great for me, improving flexibility, reducing pain etc. But there’s one thing I just can’t fix no matter how much time I spend on it- my right shoulder blade. It hurts like hell, almost all the time, trigger points that start burning just from walking around (not even using arms) etc. Between the scapula and neck there is a deep and very intense dull pain. If I try to stretch the are it feels like the entire thing is going to tear. Definately bad pain. I’ve been to various PT:s but I’ve not had any diagnosis. What they’ve told me is “more rotator cuff”, “don’t train so heavy” etc.The usual non-weight lifting PT stuff.

      I took some pictures of my back in various positions, as you can see the scapula seems to be organized in some positions but when I stand with arms hanging and just flex my entire back the right side looks really ugly. What’s going on here? One PT also told me my right side is definately less muscularly developed than the left, but it doesn’t show so good in these pics.

      I train both sides equally, INCLUDING rotator cuff work, serratus work, facepulls etc. Makes no difference. Also, on one picture you can see that when I raise my shoulders to my ears, my left side goes a bit higher than the right. Feeling a little clonk and small pain in the left side when I do that but otherwise that side is fine.

      If anyone has any suggestions to what I must do to get rid of the pain and get normal shoulder function on the right side, please enlighten me. Thank you so much.





    • #72761
      Avatar[email protected]
      Participant

      It’s hard to tell for certain without seeing in person, but it looks like your Right scapula is much closer to the spine than the Left is. Rhomboids and lower Trapezius would be responsible for pulling it close, and Serratus would likely be responsible for pulling the left further away. Also hard to tell is the line of the medial scapular border, which makes a difference in terms of upper or lower rhomboids being responsible for pulling in. And most difficult to tell from the back, is whether your head is forward of your shoulders. It seems to be, and if that’s the case, it’s putting a lot of strain on the Levator Scapulae which attaches to your neck to the upper/inside corner of the Scapula and is very often responsible for the burning sensation you describe.

    • #72762

      Good to hear that MWOD has worked so well for you overall. 

      I would say that this may be one of those cases where if it sounds sketchy, it may be sketchy. What I mean by that is anytime you have muscle loss(atrophy) you need to rule out possible nerve related causes. It sounds like you have seen PTs before but even PTs can miss underlying nerve problems. The area that you are having most of your symptoms and weakness is commonly associated with C5-6 nerve root compressions that can occur in the neck. I would recommend seeing your physician and having them check for a possible nerve compression first. 
      It’s always better to be on the safe side with things like this.
      Good luck,
      Danny
      MWOD Team Member
    • #72764
      AvatarAndrew Woodruff
      Participant

      Thanks guys. I have an appointment and I will mention this nerv root thing.
      I’ve been to several PT:s in the past for various issues and basically they always describe the same thing: Ice, stretch, rest, don’t lift so heavy…

    • #72765
      AvatarAndrew Woodruff
      Participant

      One thing I just thought of that I wonder if it means something:
      Whenever I get this burning trigger point sensation on the upper corner of my scapula, raising my arm above my head actually alleviates it. So it feels like the scapula is in a better position when I raise the arm above my head than when it hangs down on my side. To get relief I usually raise my elbow to the ceiling and put my hand on my neck. Any conclusion to draw from that? I always though OH position was ‘worse’ for the shoulders.

    • #72768

      You basically just described a test we use when evaluating the neck called the shoulder abduction relief test. You’re doing the right thing going to your physician. Make sure you tell him/her all of this information, it’s very useful for their subjective exam.

      Take care,
      Danny
      MWOD Team Member
    • #72794
      AvatarAndrew Woodruff
      Participant

      The PT did a very thourough examination. But found nothing wrong. She complimented on everything. Everything was moving so great. I told her everything I wrote here. I even showed her the picture. She agreed upon the picture that it looked bad (winged scapula). But when she herself examined me she said she couldn’t find what she saw in the picture. I told her it seems the scapula moves OK when I’m moving my arms relaxed, but if I flex my back as hard as I can things go bad.

      But in the end, unfortunately, she found absolutely nothing wrong and she couldn’t offer me any solution.

    • #72805
      AvatarAnonymous
      Guest

      It may be that you have no restrictions which is good.
      Is there any nerve compression or nerve damage?
      You may need to retrain the muscles if you had an injury.
      It may be establishing and maintaining a stable position that needs attention.
      In a static position you may be able to set the position, but what happens when movement is introduced?
      Category 2/3 movements vs category 1 movement.
      It could be understanding what is needed to create the stable position.
      It could be a motor learning situation.
      The front of your shoulder may be tight so when you flex your back your body has to find slack within the system to allow you to flex your back. What you are seeing is how your body is compensating to complete the task.
      This compensation can create other issues up/down stream.

    • #72807
      AvatarBilly Carbonneau
      Participant

      Also having some winging any help with this would be appreciated. 

    • #72808
      AvatarAnonymous
      Guest
    • #72811
      AvatarAndrew Woodruff
      Participant

      kaitlin, thanks for your suggestions.
      I have already smashed my scapula free, but as you say I think I have stuff in the front thats tight.
      It seems im extremely tight above and below the clavicle on the problem side compared to my normal side so I’m going to free it up and see what happens.

    • #72812
      AvatarAnonymous
      Guest
    • #72901
      AvatarAndrew Woodruff
      Participant

      Well, finally. I think I am now on the road to becoming better.
      I saw another person today, and I got a really really good impression.
      He did a lot of weird tests and at the same time jammed his fingers right into my pec minor, neck, posteriour shoulder and other stuff. I got a good impression because the areas that he looked at and what he said resonates well with what I’ve learned here on mwod.

      Key points:

      * My platysma muscle appearantly is insanely tight
      * So is my pec minor
      * And my posterior shoulder

      He said that I am evenly strong on both sides, HOWEVER, on the right side the muscles are not working as they are supposed to do, meaning some muscles have been compensating for the lack of function of others.

      So he jammed his fingers and knuckles right into my business, punched me a little here and there and mobilized my neck and ribs and other stuff. I’m due for another appointment next week and he said he believes I will notice improvement in my symptoms within a month.

      Edit: Now, one curious thing is he asked me if I had ever been involved in gymnastics. I haven’t, and I didn’t ask why he wondered, but now I’m curious.

    • #73004
      AvatarNeemah Esmaeilpour
      Participant

      drekavac,

      I have been having the SAME issues as you and the have been going on for the past 3 YEARS! I am currently trying Prolotherapy which hasn’t helped yet. What type of doctor did you see this last time?
      Thanks,
      Chelsea
    • #73005
      AvatarAndrew Woodruff
      Participant

      cmucker0

      This time I went to a chiro. I did this because private care can often see you same day.
      Public health care has a waiting list 1-2 weeks most of the time.
      But the chiro didn’t help me so I’m due to see another PT next week.

      To be honest, there are some great PTs out there but unfortunately there are also many who are of absolutely no help. It’s all about finding one of those good ones… I had a nigthmare experience with one who didn’t even perform any test, he didn’t ask any questions either. He just slapped on a TENS stimulator and left me in the room alone for 20 min. He repeated this all three times I saw him, even though I said it didn’t help. So I didn’t go back. How the heck do guys like that even have a license?

    • #73007
      AvatarNeemah Esmaeilpour
      Participant

      I keep wondering the same thing. I have seen so many doctors/chiros/PTs it is unreal… hopefully the Prolotherapy will help. I will definitely let you know if it does!

    • #73027
      AvatarAndrew Woodruff
      Participant

      Went to a phenomenal PT today. Now I have stuff to work with.

      I have scoliosis. And my upper trapz are hyperactive while lower and middle are completely off. I have trained my lower trapz for a long time but she, if I understood her correctly, says that it’s a motor-fault. I have to work really hard on relaxing upper trapz and activating lower trapz in all exercises.

      Also, she thinks my trigger points and especially that point that goes painful by itself is a result of the scoliosis. I still wonder if maybe it could be the other way around, that trigger points cause the scoliosis.

      Atleast now I have concrete stuff to work with. Feels great!

    • #73361
      AvatarAndrew Woodruff
      Participant

      Hey guys it seems I solved the problem.
      Difficult to say for sure exactly what did the magic because i’ve been busy working everything from ankles up to neck.
      However, one day I started working a lot on my scalenes, upper trapz and first rib, and since that day I have not had any pain. I’m fairly convinced a certain variation of the scalene stretch was what did the magic, so for anyone with similar problems I recommend looking into that area.

    • #73368
      AvatarAnonymous
      Guest

      Great to hear you are getting this figured out.

    • #74281
      AvatarCasey Atkins
      Participant

      I have scoliosis too and have the same thing happening with my scapula, but I haven’t been able to improve it. I’m noticing my platysma muscle is really tight and noticeable, so I was thinking I needed Botox and was just getting old (I’m 30) . I’m going to look into doing the scalene stretch and maybe that can help me too. Thanks

    • #74314
      AvatarAndrew Woodruff
      Participant

      I’m sorry to say I was wrong, the problem is not better at all, altough the scalene stretch helps to alleviate the worst pain.

      My PT is out of ideas as well. 🙁

      I’ve started to look into something called depressed scapula syndrome, remains to see if it helps.

    • #74392
      AvatarAndrew Woodruff
      Participant

      Allright I have finally found something that seems to work. I can’t tell if the underlying problem is solved but I have been pain free for over a week now. I started doing two things at the same time so I’m not sure if it’s only one or the other or both together.

      1. One PT I saw said that my shoulders were too low. Contrary to what I was told to believe before, a long distance from your ear to your shoulder is not a good thing. The clavicle is supposed to be at a fairly steep angle where the outer portion is significantly higher than the inner one. If you’r clavicle is horizontal or only has a small upward angle, you are not in a good position.

      So he told me to do this: stop all exercises that lower the shoulder girdle. That includes pulldowns, bench press etc. Alsto stop stretching the upper trapz. And do lots of shrugs, with the arms straight overhead.

      2. I’ve begun to incorporate a neck/thoracic spine mobilization as part of my normal posture. it’s basically this: pull your chin/head back, and imagine pushing your torso forward in the opposite direction. I really like this one as it feels like my neck is better anchored to my thoracic spine.

      While I don’t want to be too optimistic, this seems to be a solution. I can’t remember when I last was pain free over a week in a row.

    • #74453
      AvatarHagop Giragossian
      Participant

      Hey I’ve been through more or less the same with you, I posted on here a while ago, I had pain also when hanging from a bar, so its been a long time since i have done a single pull up. What really seems to help me and it seems to be my biggest problem is shoulder extension especially on my right side, even more when coupled with internal rotation which is lost with a lot of this bad t spine movement. Now if you as I have really worked on the T spine movement, you will see that you will hit a plateau, that is when you should hit the shoulder extension, I use a rogue green band, loop it and pass it around my shoulder, take a few steps forward, and then slowly start moving my arm behind my back, and then with that extending it and lowering my position so that there is more of a vertical pull on my shoulder. Couple that with a little rotation of the neck away and you may find some new areas to free.

      Good luck!
    • #76734
      AvatarJulie Daugherty
      Participant

      Now it’s been almost 3 years – how are your symptoms?

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