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?

Im responding to everyone by pressing reply on each post but it isn't posting? Am I doing this wrong?

Welcome to NeuroTalk!

You're doing just fine!
Sometimes there can be a short delay.

Okay good!!

Hey! Welcome to the crappy club that apparently doesn't exist.
Your dull ache, desire to lop off your ow arm for escape, and neck pulling sounds Real familiar to me. And forgetting what it was like to be human once.
I hope you find help soon, but just steel up to do a lot of self advocating, and convincing doctors that it actually Does friggin hurt. There are surprisingly few docs that are familiar with winged scapula outside of text books.

I have a very similar issue, a totally debilitating TOS that began after dislocating my arm and developing a really intense winged scaupla. I could hold oranges under the damn thing if I could control the muscles around it. It looked like a shark fin. It could have also been my unguided weight training, extensive backpacking, carrying kayaks on my shoulder, working as a jeweler, or stage tech where I would hold about 100 lbs over my head for a few hours. Hard to tell, and it's taken me 2 years of no longer being able to do daily care to begin convincing doctors it's real. SICK scapula diagnoses, chronic dislocation, TOS, and it spread to my left arm about a year in my desperate pleas for help. I just had capsular plication surgery to make my shoulder stop popping out and winging, but the PT to regain my range of motion further irritated my nerve issues, and now it's Winging again! AH!

Did any direct trauma or dislocation precede this?
What sort of shoulder MRI did you get? (No contrast or arthogram?)
What was tested on your EMG?
Where is/what do you mean by scapular depression?(The depression sounds worrisome as possible wasting. As crappy as that is, it Will give doc a definite thing to trace back to the source of the issue)
What sort of doctors have you seen thus far?
Do you have pain and cramping under your arm? Around your scapula? Between both scapulas?

Now.. It's totally possible that the winged scapula itself is contributing to the issue, especially if it's winging medial and turning upward, your shoulder rolling forward. This could your clavicle to narrow and compress your brachial plexus on your first rib (that's my deal). It does kind of put things in this crappy cycle where you can't control the muscles to pull back your shoulder, so it rolls forward compressing the space and aggrevating you scalenes, which irritates the nerves that allow you to pull back your shoulder.
However, it may not be the root of your issue. If it's been going on so long you may have developed other compressions or muscle hypertrophy in your neck. For me, all the the PTs I saw to try and get my scap to sit down made the issues with scalenes WAY worse.

My research material on this subject has become quite extensive in my years of trying to find some answers, but I'll dig up some of the most relevant ones for you soon.
Try to stick to scholarly articles if you can (google scholar is a gem) and check out Long Thoracic Nerve Injury and Quadrilateral Space Syndrome. Look in to your impingment theory as well (although it would likely be the impingment, which caused the winging, which made the symptoms more severe)

I have a few posts floating around on here about my battle with winged scapula hell, and Please feel free to hit me up with any questions or if you want to vent.

Hi!!!

Yes I did have an injury that sent me into this situation. I dislocated my shoulder multiple (like 20) times over the 6 years that I played linebacker when I was younger. I never had problems until I decided to finally go for the surgery and have my labrum repaired. After that surgery my good arm developed the dull ache of death and I haven't been able to shake it for 3 years. Like what the hell?

My shouder MRI was no contrast. I'm pretty sure that all of the issues in my shoulder that were found by my MRI are what cause the eternal dull ache.

My EMG tests were done to test "nerve conduction and velocity"

The scapular depression was something a random physiotherapist mentioned months ago. He said that my upper trap was likely extremely weak and strengthening it should alleviate my symptoms. I did, and still do upward shrugs to isolate my upper traps and they have helped a lot. Not even close to fixing the problem, but helped.

I have seen 3 massage therapists, 2 chiropractors, 3 general physicians, 4 physiotherapists, 2 ortho surgeons, and a neurologist.

Overall my pain is a consistent 3/10, I have not had less than a 3/10 since I was 17 years old. Sometimes the dull ache can decide to go nuts and get to a 5 or 6/10. I get sharp pains between my shoulder blades sometimes and my shoulders, neck, and scapulas all crack and pop and clunk. I hope its my winged scapula causing all this, that would mean that there is still a chance to have a normal fun life, I mean Jesus can't a guy just go lift weights with his friends? Also yes, the dull ache sometimes sits in my armpit and just drives me insane. I would say of all the different forms of discomfort that come with this injury, the dull ache is the king.

Thanks so much for contributing your experience to the thread. We will figure this out and hopefully one day have no need to even be on these forums.

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?

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

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.