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- This topic has 12 replies, 3 voices, and was last updated 4 years, 3 months ago by Tom Matchinsky.
04/10/2017 at 1:57 pm #71771Julie DaughertyParticipant
Hey,I’m wondering if some of the muscles connected to the neck could be so tight that they tug down on the cervical spine and create nerve problems. For example, if you have 1 (or 2) very tight and spasm’d levators could they feasibly be so tight that they can pull down on the C-Spine and pinch discs or nerves?
04/11/2017 at 3:32 am #76876Patrick ThomasParticipant
Could be possible
I recommend getting this situation checked out by a doctor or practitioner.
The levator scapulae is a long muscle of the shoulder girdle. It originates at the transverse processes of the
atlas and axis as well as the posterior tubercles of the 3rd-4th
Nerves involved cervical nerve (C3, C4) and dorsal scapular nerve (C5).
04/12/2017 at 5:50 pm #76880Julie DaughertyParticipant
Thanks Kaitlin. I’ve had this looked at by probably 10-15 PT’s, Chiros, LMT’s, Rolfers and Docs at this point. I’m seeing a chiropractor right now who is having me build core strength and stability as he says the brachial plexus is being impinged somewhere in the neck; I think he is hoping that by strengthening the core it will take the pressure off of my neck so it can all heal up. We’re almost 5 weeks in and I’m not much different than I was when I first started with him (going 2x per week for 5 weeks.. it’s adding up).I saw an osteopath/physiatrist two weeks ago and he brought up the dorsal scapular nerve and said he thinks it’s possible the muscle is choking the nerve or the nerve is flaming up the muscle. He said it’s a chicken/egg scenario so we’re doing needling and an EMG next Friday. I never got a chance to ask him, though, if a really tight muscle can pull that hard on the cervical spine to trap nerves like that. I was always under the assumption that nerves get pinched by bones and nerves cause muscles to spasm but can’t find really anything online that talks about nerves being pinched by tight muscles – as in you release the muscle and the nerve will heal.I’d LOVE to see KStar talk about this but I can’t find anything on it. He discusses levator in one episode and the symptoms he talks about in the episode are consistent with mine for the most part but it isn’t as in-depth as I would have hoped (not his fault, obviously).Main symptoms:– Very ropy levator on both sides (you can feel a rope of muscle as you run your fingers over the part of my upper back)– Side of neck pain with any activity of arms in front of me or over my head– Shoulderblades look hunched and elevated, especially when doing crossover symmetry type stuff– Rhomboids feel completely shut off (could be low trap or mid trap but rhomboids are my guess)
04/13/2017 at 3:01 am #76882Patrick ThomasParticipant
Have you let your chiropractor know you aren’t seeing improvements?
The scalenes are 3 pairs of muscles in the lateral neck.
They are innervated (by the fourth, fifth, and sixth cervical spinal nerves (C4-C6). nerves)
The brachial plexus and subclavian artery pass between the anterior and middle scalenes. The middle scalenes descend along the side of the vetebral column to insert by a broad attachment into the upper surface of the first rib, between the tubercle and the subclavian groove. The brachial plexus passes anterior to the middle scalenes.
The dorsal scapular nerve arises from the brachial plexus usually from the plexus root of the cervical nerve C5. Once the nerve leaves C5 it commonly pierces the middle scalene muscle, and continues deep to levator scapulae and the rhomboids (minor superior to major). It provides motor innervation to the rhomboid muscles which pull the scapula towards the spine and levator scapulae muscle which elevates the scapula.
Has anyone looked at your scapula placement when standing at attention?
When the dorsal scapular nerve is injured the scapula on the injured side is located farther from the midline than the uninjured scapula. When this happens the person is unable to pull their shoulder back.
Injury to this nerve may cause the scapula winging. The scap may become laterally displaced with upward rotation.
04/14/2017 at 2:37 pm #76884Julie DaughertyParticipant
I saw a PT a couple of months ago who did a couple of passthroughs on my subscapularis via ART and I got some good feedback and my ROM opened up pretty good for a day or so.If a muscle has been gummed up and in spasm for months is it likely to take several sessions to see drastic improvement (like a sticky subscap) or would I likely see full improvement and lasting relief on one session?
04/14/2017 at 3:21 pm #76887Patrick ThomasParticipant
The brachial plexus lays on top of the subscapularis muscle.
This is not a new situation and didn’t get to this place in a day so it can take time to resolve this situation.
You could have a rib or 2 out of place.
Did you do the mobilizations in the above episodes?
First you need to identify and address the cause of the situation. Until the cause is resolved you’ll chase symptoms.
There may be movement patterns or technique of skills which need attention.
Pretty safe to say it will require more than one session.
It took some time to get to this place.
There are things you can do daily to help keep things in check.
Consistency is key 15:00 minutes a day.
Then it will move to maintenance and checking in with it once things are in a better place.
04/19/2017 at 2:22 pm #76889Julie DaughertyParticipant
I totally get that. Is it weird that when I go after the subscap and lat I will loosen up for a few hours and then when I wake up in the morning I feel stiffer than I did before I started releasing – the tissue actually feels completely dried out. Would that tell you to keep working on it or that I’m in the wrong place?
04/21/2017 at 1:12 pm #76891Julie DaughertyParticipant
Hey Kaitlin,Okay – I have a diagnosis. Brachial plexus is trapped at the scalenes; the confusing part is my first rib does not seem elevated to the chiropractor and osteopath. I am going in for needling today. I know that I can do posterior shoulder, back and core work to help prevent the issue from happening again but first I need those nerves to get unstuck and muscles firing again.With the first rib not elevated is it possible for the scalenes to “lock long”? It would seem that this could be even a bigger issue than short and tight and an elevated first rib because I don’t know what kind of mobility I can do to get the scalenes to go back to normal resting length.Any ideas?
04/21/2017 at 9:25 pm #76892Patrick ThomasParticipant
No it is not weird.
It didn’t get this way in a day and it won’t resolve in a day.
Have you addressed your sleeping position?
This could be a contributing factor.
Sounds like you need to address hydration. This is an impacting factor with muscle, tissue, tendon health.
04/21/2017 at 10:31 pm #76893Patrick ThomasParticipant
What next steps did the practitioner talk with you about?
Were you given a PT referral or plan to address this situation?
Brachial plaxus trapped is a pretty general diagnosis.
A neurapraxia is when the nerve has been gently stretched or compressed but is still attached (not torn) and has excellent prognosis for rapid recovery.
That is one of the situations I listed above.
The first rib may not always have out of place for the brachial plexus to be tacked down.
Do you know anyone who does IASTM work?
HawkGrips or the Leopard Claw can be used to start addressing this area to re establish sliding surfaces then move to the next layer of the situation. Addressing up and down stream of area as well.
The nerve is tacked down between pec minor and sub scap.
04/22/2017 at 7:29 pm #76894Julie DaughertyParticipant
Hey Kaitlin,I had an EMG yesterday and am not sure where to go from here but it does give me some better answers. We examined lots of muscles and innvervations and MOST are in good shape:Testing good: Trap, biceps, triceps, fingers, serratus, lat, levator, rhomboid minorTesting bad: Rhomboid majorHe tested it 3 times because of how odd it is that the dorsal scapular nerve innervates the levator, rhom minor and rhom major and yet the major is the only one with an issue here. It makes me wonder if it is tacked down in the muscle tissue at the major or in between the minor and major. Have you heard of this before? Suggestions?
04/28/2017 at 2:28 am #76902Patrick ThomasParticipant
Did the doctor or practitioner who you saw give you recommendations for treatment or create a treatment plan?
Have you done any work to address this?
Do you have pain in the rhomboid?
Do you have scapula winging?
The injury to the nerve could be below the places the dorsal scapula nerve innervates the levator, rhombois minor.
05/27/2017 at 3:10 am #76928Tom MatchinskyParticipant
I would start doing some overhead carries, half TGU’s and arm bars. You can certainly continue to do soft tissue work that seems to be helping and opening ROM but if you don’t actually actively use the ROM consistently and focus hard on creating a good mind muscle connection after you have done some mobility work will leave you frustrated. These exercises are easily found on you tube. You could also do some ring rows and ring push ups and supports.Travis JewettMWOD Staff
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