One thing that may have led to this episode: A recent shoulder surgery.

I've been battling a left shoulder injury for about 15 months. Doing lots of left side rehab. LOTS. There's been a lot of stress around the left shoulder and anterior chest/neck area for a while now. I finally threw in the towel five weeks ago and had it done.

I was immobile and packed with ice for some time. Then had limited shoulder mobility. It's gradually gotten better to the point where five weeks later I'm getting somewhat back to normal. That said, I wonder if the restricted mobility contributed here.

What do you do for abs? Seems everything I try engages neck muscles.

(I also do zero upper body since it results in immediate onset of symptoms)

Has anyone self massaged their scalenes with any success?

I have an appt. with a massage therapist Monday. That's an eternity from now in my mind.

I've been looking at Youtube videos and attempting self massage myself. Combining the massage with the usual scalene stretches seems to work for short term relief. Of course, once you stop the pain returns. It would seem you really have to beat these muscles up repeatedly to actually "lengthen" them.

KY

Re: abs, I have the same problem that most ab exercises engage the neck. But while researching health and fitness, I read an interesting tidbit somewhere about how the innermost layer of abdominals aren't actually activated in sit ups or crunches, and they are considered important for bracing the internal organs and preventing hernias. It clicked with me because sometimes you'll hear about ripped guys like The Rock getting hernias and you wonder why their 8-pack isn't preventing that.

IIRC I read about this in the "Posture: Get It Straight" book and possibly also in Julie Bookspan's book on pain.

The exercise I do for these transverse abdominals is to stand up and forcefully exhale while sucking in my stomach both inward and slightly upward, similar to what you do when squeezing into a tight pair of pants. I find my hips tuck forward when I do this and sometimes I'll squeeze the glutes as well. I do about 5 - 10 reps.

I often hold at the end of a rep, both to increase the difficulty but also to avoid hyperventilating.

Unlike most ab exercises, there is no deliberate raising or hold up of the head. You could of course engage your scalenes during intense breathing, so you want to be mindful of keeping your neck relaxed.

This is all from the books. I have not hit the link above to see what the interwebs has to say in detail. Though I did look at the search results listing and saw pages like "The abs you're forgetting in your workout - Transverse abdominis"

Oh man, I wish I got an immediate onset. I get a delayed onset by days or weeks as the muscles gains size and tension. Bleck.

Quick update on sleep.

I hate that I'm doing this but I pulled out some neurontin I still have from three years ago when I had this on my right side.

I know take 2 pills right before bed and then I'll take 2 when I (usually) wake up in the middle of the night. It's doing the trick. Symptoms decrease just enough so I can get sleep.

I just hate the side effects. When I wake up I just have that drugged out feeling among other. I'm staying away during waking hours unless this gets worse.

KY

Stott Pilate's has an ab prep exercise that teaches how to engage abs without straining neck...they have a website...I have their back care series

Curious if people here have worse symptoms in the morning vs. the afternoon?

I wake up every morning and the major malfunction is tilting my head back ever so slightly past neutral. As the day goes on and I continue to stretch my scalenes I can tilt my head back further with less referred pain down to my forearm.

Does this make sense?

Is it possible that my scalenes tighten up over night and maybe my first rib rises as well? And that this slowly loosens throughout the day?

As an aside, it's mind boggling to me that tilting my head back just a little causes such a problem. I mean, my scalenes are that tight?

KY

Thanks for your abs tips! Perhaps of interest: http://www.nytimes.com/2009/06/21/ma...-physed-t.html

I agree with the article in the sense that I would not add the "sucking in" maneuver with other exercises.

I disagree in the sense that I've read that abs crunches (and the other two exercises) would not hit the transverse abdominals afaik.

I also agree that multiple exercises are ideal, though I have trouble with irritating my TOS doing bird dogs in the class manner with the arm fully extended. That is very similar to reaching overhead which creates traction through my arm, shoulder and brachial plexus (which is fine if you don't have TOS). I've been thinking about doing a modified version where I keep the arm bent in some fashion.

I'd have to experiment with side planks to see if they were problematic.

I'm still a fan of the exercise I described and then leaving out that approach when doing other exercises.

Do you know why on the crunches they go with one leg bent? And then do you switch at some point?

I don't know why. Perhaps it takes pressure off the lower back? Unfortunately I'm unable to do any planking, "bird dog," or anything that puts weight on the shoulders or involves arms extended (b/c of TOS). But I'll definitely do the ab exercise you suggested.