I'm not a good person to ask about surgery of LTN as in Melbourne Australia when I injured the LTN 20yrs ago-there wasn't the expertise here to even get any advice it's so rare. My understanding is surgery would only help for impingement/ obstruction.

My focus has been on functional restoration through clinical pilates, neurophysio /bobath technique, occupational therapy etc. Still pain remains a major issue for me and poor use of arm in raised position. However, I have hardly any winging after all my hard work and it makes a big difference to function at waist level. Don't be disheartened, my anatomy made me susceptible to developing bilateral TOS over time so your situation may have a much more optimistic outlook. booklover

Okay good!!

What about your anatomy made you susceptible? Do you have that rib? Im glad to hear that you are improving your situation. Do you feel that its possible in your future to retun to 100% normal function?

This is upsetting. So you just learned to live with it? Do you feel like it limits what you do day to day? Has anyone on earth actually had TOS/shoulder impingbment type stuff and been cured? If this thing is for life I wont be able to handle it as I get older

Apparently I had an extra cervical disc (a long Neck) and developed fibrous bands on either side to support it which squashed my arteries and nerves. No I have a lot of permanent damage done before the decompression, which is one of the risks of long term compression of sensitive structures. That is, they don't fully recover once you release the pressure. Besides, I had the traction damage as well. The most recovery usually occurs in the first year or so following surgery...I can't really comment further on alternative to surgical options as an active strategy as i only put it off because of risk to right arm as I only had partial use of left...booklover

Hi Booklover, 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. 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.

That's wild! It's kind of nice, but also a real bummer to hear from someone else who developed this madness through chronic dislocation. Despite what I've read in medical literature, talking to doctor's you would think it's about as common as people being bitten by werewolves.

I'm glad you got the labrum work done. MRI with contract (arthogram) was something I was going to suggest to test for an overlooked labrum injury, which is a not uncommon cause of this kind of pain and dysfunction.
Did the issues develop while healing from the surgery? Laymens guess from a fellow bum arm, however you were holding your arm pre-surgery plus while weakened after surgery could have put a lot of strain on your neck, levator scapulae, etc, pinching/irritating the nerves.

I know my winging scapula started to develop from the dislocation stretching and pulling on my long thoracic nerve, coupled with holding my arm up protectively and using my neck muscles to lift it instead of my back.
(It popped out multiple times a day for almost 2 years and got so bad I would dislocate it trying to get dressed or scrubbing myself in the shower.
It got Gross! One PT dry heaved when trying to do the maneuver to pop it back in and my arm just fell in to place and popped out the back with no resistance. Sounded like putting a truck in to gear, Hahaha!)
When I finally got surgery, capsular plication, to cinch that sucker back in there my nerve problems got WORSE because my neck was again forced to do all the work, and my arm was pulled forward by the sling. 2 year of holding it up with my neck and I couldn't let it go slack in the brace.
The doc even anchored my shoulder capsule to my scapula to stop the winging.. but the body finds a way and the shark fin is back.

If you can find someone to do it, it may be worth trying to get the EMG again. Did they just test your arm, or did they put the needles in your ribs and upper back as well? It took a literal yelling argument with one of my Dr's to even get them to test the long thoracic nerve, which is a hard one to accurately test. Even if they do, most EMG's seem to just test for "ON" or "OFF" and not measure any level of dysfunction in between. Which, as you seem to be experiencing, leaves a lot of room for issues. There's a lot of people on here who mention multiple failed EMG's, only to have them re-done years later and show major issues that were missed and Could have been fixed if only someone looked a littler harder.

Keep an eye on that shoulder dent. Especially if you PT mentioned it could be from a weak upper trap. That would be a major contributing factor you the pain in between your shoulder blades, meaning your rhomboids are working double due to the weakness of your upper trap. I'm fighting this same battle in PT now. It's hard to get the balance back if your nerves aren't sending a strong signal to the muscles in that area, and hard for the PT to tell when you're compensating with rhomboids or using your trap.
And that dull, tennis ball like ache in the arm pit my PT says is my serratus anterior muscle basically endlessly spasming. If you still see you PT, maybe they can help focus on that muscle to get you some relief.

I hope you keep pushing to get someone to take this jazz seriously! It helps a lot to go in to the Dr's ready to guide them in a new direction, rather than letting them guess and send you through another round of unhelpful PT.

Here's a few more articles for your perusal:
[Edit- ugh, it won't let me submit links yet]


Also, getting TMJ treatment with a special TENS unit (delivered some other kind of shock than the usual) from my desist has helped A LOT, although the relief if temporary, it calmed my cramping shoulder down.

Snapple, would you have an idea about my question above?

Yeah I havent met anyone who has developed this from shoulder instability so I feel pretty unique. I would rather dislpcate my shoulder every day for the rest of my life than have 10 more minutes of nerve stuff though.

And YES how did you know? Half way through shoulder recovery all of these symptoms started popping up.

About my EMG my experience was ********. Pardon my language. The 80 year old neurologist just could not take me seriously. At the time I was 18 and running track, she looked me up and down and saw a healthy teenager who was whining about nothing. She did the tests on two of my fingers on each side then sent me on my way. When I brought up the long thoracic nerve/scapular winging she said thats a disorder that only occurs in older women with hunched posture. So yeah Id like to go back but how? Every doctor says its already been done theres no point in doing it again. And the wait for the first appointment with a neurologist was around 8 months.. Im done waiting for months-years for appts and having people tell me im 20 and should stop complaining.

i want so bad for this to just be serratus anterior weakness so I can strengthen it and start rock climbing again. Also because the outcomes for surgery are so poor that there is no point in even getting one in my opinion.

Whats ypur activity level like? How do you stay in shape? How do you sleep? Do you think its possible for you to reach 100% recovery? What exercises are you currently doing to ward off symptoms?

I basically jut run about 80 miles a week and do core every other day to stay in good enough shape. I find the days where I work out and do core I feel the best and I get the worse symptoms when I hang out on campus and study all day.

Thanks so much for the message. I really appreciate talking to anybody who even remotely understands what its like.

Im curious about this too. If my LTN is compressed or injured could I just get the muscle firing and heal it that way?