winged scapula and a host of other problems
 

Hi everyone,

I'm posting this in the TOS thread because it seems like a lot of the winged scapula threads are here (I've searched them and read through them), even tho I don't have TOS (although I've had symptoms that were very similar to TOS).

I'm 21 and have been injured for over 2 years now. My 'injury' wasn't really an injury per se; I was an elite olympic-style weightlifter and woke up one morning in 2009 after a really great meet and realized my right upper back (between the medial border of my scapula), rotator cuff, lower neck (like C6 and C7) as well as my bicep and tricep were in complete spasms. Looking back at a photo of me taken a few weeks after the 'morning after' my scapula were noticeably medially winging (not dramatic, but noticeable) when they had lied flat before the injury.

2 years later, the scapula are still like that (no amount of serratus or lower trap work has changed it), and my pain and discomfort is unbearable, with spasming on BOTH sides now (the worst spasming is still in between the medial border and the spine, as well as the superior angle of the scapula and in the insertion point of levator on the skull, and the greater tubercle area on the posterior side of my shoulder (although everywhere from about T12 up through my neck experiences various degrees of spasm and pain).

I have no life anymore, can't do household chores, let alone be an athlete, and am at the end of my rope. I've seen and done about every kind of therapy that exists, and still no change (minor change with a chiropractor who adjusted my first rib and occiput, and that alleviated some of my TOS symptoms). I was wondering if anyone could shed any light on this? I heard about long thoracic nerve palsy and am curious, but don't feel like my winging looks to be at the level of most patients who have LTN palsy.

Here is a picture of my back for reference, as well as more detailed symptoms below (for those of you who make it that far). Thanks in advance.

Current symptoms
• Body is twisted (per current physical therapist) ie rotated pelvis, shoulders etc
• Pain at C1 on L and R
• Scapular winging (hasn’t improved even with enormous amount of strengthening exercises)
• Terrible trigger point superior angle of scapula
• Knots in upper back and in between shoulder blades (been present since injury in 2009)
• Trigger points in rotator cuff muscles, and shoulder girdle muscles in general
• First rib pain
• Pain on R side of spinous processes of cervical spine and thoracic
• Can’t raise arm laterally or else feels like my fingers are going to rip (this is rectified when serratus is ‘adjusted’) => mostly just right
• Pain/tenderness at base of skull (posterior)
• TMJ
• Constant need to crack my shoulder blades (do this by violently retracting one shoulder blade); both sides
• Subscapularis pain/tightness on right side
• Grinding/clicking of collarbone when I move my arm behind me along sagittal plane (right side)
• Grinding at T1
• Weakness in right hand and lack of strength in arm (used to do planks, arm would fatigue and shake)
• Trigger point on one of ribs (serratus? Intercostals?)
• Tightness/cramping/tenderness in right forearm (slightly on left)
• Extreme lack of mobility – cannot extend my fingers when arms are abducted
• The things that always aggravates this condition are 1) sitting in a slouched position (in a chair – I always have to sit either straight up or put a pillow that aligns my head); any kind of lifting or overhead movement of arms (even putting dishes away)
• Other things that aggravate: carrying a backpack on my shoulders (even one that has nothing in it), overhead movements, any weight bearing activities on my arm;
• RELATION TO PELVIS/HIP ISSUE????????? FEET????!!!! (arch on left foot = awful)

winging scapular
 

Did you ever give the nerve involved a chance to rest and heal before launching what sounds like a vigorous rehab program centered on strengthening the muscles in proximity to the shoulder blade?

Sorta at the beginning, but not really. I'm trying to remember. I had no idea what was wrong, so I blindly did everything my doctor told me. Which was pointless. He then told me I could keep exercising and lifting.

So in short, I guess not, because I was told that nothing was wrong. I've used my arm extensively throughout the 2 years because no one told me not to. So now I'm really confused.

your back looks like a more muscular version of mine, i can relate to most of what youre saying. i dont get spasms anymroe but its because i avoid doing ANYTHING. i can't sit and watch tv.

i have this too. my right shoulder is way more winged and i hear my collar bone go thud, ribs thud, shoulders i don't even move but if i do it cracks like crazy.

i agree it sounds like your muscles and nervous system hate your guts. do you have any strength in your lower body? my hips are very hypermobile, my ribs are twisted and i know it aggravates things, my thoracic spine is completely HYPOmobile. i would work on getting rid of the trigger points and focus on breathing, strengthening your lower body/core muscles if they are weak and thoracic mobility. don't try to fight it, don't reach for things, i used to try to and it really messes you up.


i'm only now doing the most basic strengthening, isometric type exercises and i've been in pt since march!

my lower body used to be very strong, I was a competitive weightlifter before this happened. my hips are crooked, but are much better now (I don't get low back pain that much anymore after seeing a postural specialist).

Do they have any idea what has caused this for you? I can't live the rest of my life like this.

i never really got a clear diagnosis. my pt said RSD which i completely disagree with!!

http://en.wikipedia.org/wiki/Ehlers%...anlos_syndrome
i do have this, you probably don't

it led to me hurting my brachial plexus in minor incidents (walking dogs, playing a wii etc) so many times i lost count coupled with improper stretching of my neck and a SEVERE magnesium deficiency which i am still recovering from.

is your thoracic spine relatively mobile? mine is very very tight.

i have hope though, there was a girl i befriended on the internet who did stabilize her shoulders with physical therapy, hers were way worse than mine. otherwise i mightve given up. the pt she used was vojta (sp) therapy.

You mentioned that now the opposite side is involved. That's to be expected: above all, the body wants balance. So, hypertension on one side of the body will eventually create hypertension on the opposite side. I take it that you are seeing a massage therapist as well as a physical therapist?

Hard to make a diagnosis from a photo. But to me it appears likely that your subscapularis contains very active trigger points. Not only will they refer pain to seemingly unrelated areas of the back, but the chronic contraction at the lateral border is pulling the scapula forward, creating hypertonicity in the rhomboids and probably in the posterior superior serratus. Regardless of the etiology, it's a virtual certainty that you now have active trigger points all over your back...in supraspinatus, subscapularis, teres minor, posterior serratus superior and inferior, anterior serratus, infraspinatus, the rhomboids, the traps, and in the TOS group (i.e., all three scalenes, pec minor and perhaps even in the coracobrachialis).

Richard D may have surmised the original source of your problem. Exalted by your great performance in the meet, you went to bed still excited, tense, and slept very soundly. Do you perhaps sleep predominantly on the problem side, perhaps with that arm extended forward? If so you could have unintentionally limited blood flow to the area when it needed it most. Then when you awakened, tight and experiencing the burning pain that sometimes results from neuromuscular compression during deep sleep, you logically performed your stretching routine, and inadvertently made it worse.

If you aren't seeing a massage therapist certified in neuromuscular therapy and myofascial release, my advice is to do so ASAP.

Hi,

So sorry you're having these problems.

You describe it all too well.

Sometime etiology may not be as important as a fix or workaround.

for my winged scapulas, I've had many, many hours of therapy, myofascial release, aqua therapy, stretches, yoga, 2 lbs bumbells, Kinesio taping (trememdous helper for winged scapulas) , stallette ganglion injections into my scalenes, trying to stabilize scalenes to help everything - didn't do the trick - also had botox to scalenes - helped just don't last.

Lidoderm 5% patches.

BackMagic spine alignment board.

Miracle Ball Set. and oversized tennis balls, mostly for lower back and thoracic spine, but will put in between scapulas.

I also used a Theracane for my scapulas and related muscle spasms.

e-stim during PT sessions. Moist heat.

Stretches after a shower. Lying on my back with a rolled towel longways up and down my spine. I would stretch my arms out and SLOWLY raise them to center and SLOWLY lower them.

I have also used LED and infra red light therapy pads to my scapulas. They helped tremendously.

Of late, I have found that keeping my arms, shoulders, scalenes and scapulas fleece warm cuts down on my pain tremendously.

Don't know if any of these might help, but just some things to share that have helped me.

Oh, also a hairdryer on a stand is a must.

Would be glad to explain or share any details you may need to understand what I've written here.

I hope you find some peace with your situation.

great tips! i forgot about k-tape i need to do that again

Any progress?
 

Hey rizzo02481 - did you ever solve the mystery injury? I'm currently suffering from a similar issue:

- winging scapula
- Constant trap pain and swelling

etc
etc

Dan