Dr Ben Kibler in Lexington, KY
 

Hi guys. I'm new to the forum. I found it in a Google search for scapular dyskinesis. I had a car wreck and tore the lower trapezius and rhomboid. This has caused quite a bit of pain, an impingement in my shoulder, and various other symptoms. I visited Dr Ben Kibler in Lexington, KY ans he recommended a surgery to reattach these muscles. Is anyone familiar with this surgeon or procedure? Thanks for any input. I'm just trying to make sure this is the right thing to do. Google search "the scapula & the dts by Ben Kibler" and watch the video of one of his lectures regarding this. Around 16:30 mark you can see what my scapula is doing.

Just saw the video and your winged scapula. (Try googling "winged scapula" or "scapular winging" for additional info.) As your doctor points out, a winged scapula occurs because of dysfunction w/ the serratus anterior muscle. While I suppose a torn/detached serratus muscle might cause this problem (do you have proof of this?) ... a winged scapula can also be caused by compression/injury of the Long Thoracic Nerve (LTN) which innervates the serratus anterior muscle. Seek a second opinion w/ a peripheral neurosurgeon to have your LTN evaluated. It's possible that a nerve decompression surgery might be a more appropriate path....

http://nerve.wustl.edu/nd_transfers_scapula.php

I should also note that sometimes people just have muscle imbalance and a weak serratus, in which case physical therapy to strengthen the muscle is usually the first treatment path. (See exercises like the "push-up plus.") But, since this happened after a car accident, seems doubtful that this is just a random muscle imbalance issue.

Def get another opinion...and good luck!

Cyclist, can you help with my question below.

I seem to have injured my LTN in a fall from a bike several years back and have been working on reactivating my right serratus. I can feel a muscle contracting beneath my armpit even if i move my right arm up. Does that mean I can rehab the muscle? Any idea of teh time I'd take and the specific exercises and other muscles to focus on along with it?Also what wre your symptoms. Mine are bilateral TOS, right is (i think) due to serratus issue.
The Levator and Rhomboid are overdominant on the right side because of the serratus issue and I have nerve pain and compression in my right arm and hand.

Left is due to injured longus colli which is not stabilizing my cervical spine. I have constant pain in my right shoulder/neck area, I think overstressed levator and upper trap and also a supraspinatus injury probably.

So if the Serratus is contracting each time I raise my hand, is that a good sign (that its weak) and not that the nerve is overfiring (as it doesn't mostly pain/contract otherwise) and I can rehab it? Any idea of exercises and time it'd take?

I had this surgery with Dr. Kibler. Supposedly my rhomboids were detached and part of my lower trap was reattached. I say supposedly because this cannot be confirmed on MRI due to the location of your rhomboids being so deep and attaching underneat the scapula. Dr. Kibler looks at the movement of your scapula to make this diagnosis. Mine was fanning out to the side when I elevated my arm.

While it corrected the movement of my scapula unfortunately this was just a symptom or damage from an underlying problem that has still not been resolved. It did not help the pain I was having at all.

With that said I do believe this surgery has a good chance to help you if you can tie the detachment to an event like the car accident you mentioned. I would do everything you can to be as sure of the diagnosis as possible. The surgery is not easy as he drills holes in your scapula and threads the muscles back to it. However TOS surgery was more painful (yes I had both).

Dr. Kibler is highly regarded and considered the guru for scapula problems. His physical therapy team is very good as well.

Feel free to send me private message if you want to know more.

Romans 8, your post mentioning Kibler was how I found this site. I don't have the ability to private message for some reason. I guess because I'm new. But I was hoping you would see this post. Thanks for taking the time to reply. I would like to know sooo much more about your experience. I'm looking to have the surgery after the New Year. Mine isn't nearly as bad as the video but it's been that way since the accident for sure. I can't lift my arm up high or throw a ball without pain. I'm hoping this will fix that? Also do you know the chances of reinjury? What was your recovery time and how did you feel? As many details as possible would be great. I know what the doctor told me, but I want to hear it from someone that's been through it. So glad you replied and btw I love the screen name. I live 4 hours away from Lexington on the other side of the state so I'm not sure if he will send me to the Orthopedic Institute here locally or require me to come back there. I'm sorry, but knowing you've had the surgery and only having this way to communicate without the ability to PM, I'm stuck posting messages this way for now I guess.

Can someone please tell me how to send a PM? I'm new here.

A few more posts and the PM as well as other features of the site will be available to new members.

Do posts on this thread count? Or is it only counted in new threads?

Hello
Yes, all your approved posts are counted in your status.
We do not discuss how many as that defeats the object of preventing spam PMs

Sorry I took so long to respond as I do not visit this site as frequently as I once did.

The recovery is not as bad as one would think when you understand the surgery. From a pain perspective the TOS first rib resection was more painful. Rehab is really the same exercises he has you do when trying to treat this problem conservatively. It's my understanding most people fully recover in 3 - 4 months.

I would think this has a great chance to help you if the detached muscles are indeed the source of your problem. The problem is there is no way to tell if that is the source because MRI cannot see the muscle structure underneath the scapula. The detached muscle diagnosis is much like TOS in that it is made more from symptoms and not from some medical test. However TOS usually comes on more gradually while the detached muscle is usually linked back to some traumatic event. This was not the case for me as my rhomboids became detached when I continued to play tennis with TOS or some nerve related problem that was not yet diagnosed.

I hope this helps.