Hi guys,

I'm new here, never started a thread before, but I'm looking for some guidance. Okay here goes, so 3 years ago after starting university I developed this horrible ache in my shoulder, I had a single strap bag that I would carry all my books in and would constantly sit at my desk hunched over to study. I also was doing a rigorous weight training program with no real guidance (I was 18 and didn't know it was possible to be hurt). The combination of these things are what I believe pushed me into this situation. Over the last three years I have had highs and lows ranging from absolutely crippled to just a slight itch/pain in my left shoulder.

My symptoms are (both arms but way worse in left):

-dull aching pain in my left shoulder that has made me strongly consider cutting off my arm
-pins and needles only while sleeping in some positions
-terrible pulling feeling from my neck, through my shoulders, under my bicep, and into my fingers whenever I hold my arm out at my sides (adduction)
-Scapular winging or S.I.C.K scapula which can be determined by its resting position or prominence of the inside edge of the scapula sticking out both at rest and with movement. (As diagnosed by PT and orthopedic surgeon)
- severe scapular depression
- popping clunking and crunching from my shoulders, neck, and scapula

As far as tests go I have had
-neck MRI (normal)
-nerve conduction study at rest (normal)
- shoulder MRI of only the left side (tendonosis of the supraspinatus, mild inflammation of the subacromial bursa, and labral cysts associated with a small labral tear. These symptoms are commonly found in those with shoulder impingement syndrome)


Okay so my question is this:

Could my scapular winginging be the cause of all this? Or is it a symptom of a problem in my neck or something (i question this because my neck MRI was normal). Has anybody else had similar discomfort coupled with scapular winging? How about shoulder impingement, could that be caused by winging? If so what are some things I can do to help this? I already do upward rotation shrugs to improve my depressed scaps and wall slides for my serratus To improve scap position. What else can I do? Am I attacking this the right way? If you guys direct me toward articles and other threads I would really appreciate it, I would also love to hear your stories. I sometimes forget what its like to feel completely normal, there are good days and bad days. I appreciate any input you guys, thanks.

I am not a medical professional so I can't give you much specific advice, but I can relate a bit of my story. Sadly, your story and mine have some common threads, but since you are younger you may be in a better position to get well.

I am 29, with a wide array of upper body problems including thoracic outlet syndrome, cubital tunnel syndrome (probably related), pain in my neck and scapula, and intermittent pain in my lower back and right glute. But the problems started when I was 17 and doing a lot of, wait for it, weightlifting without a proper instructor.

Like I said I'm not a professional, so I only feel comfortable giving general advice. How is your flexibility? How is your muscle balance? Posture? Do you breathe correctly (into your diaphragm instead of into your chest)? Have you seen a skilled physical therapist or other professional bodyworker who could assess some of these things? If you haven't, I recommend it. I also recommend sticking with it until you find someone who is highly skilled, analytical, and willing to listen. I had a lot of early diagnoses when I was your age that basically went like this: "You have tendinitis, you're young, it will clear up." It only got worse. Had I seen the right people 8 or 9 years ago, I might be in much better shape now.

Check out our sticky threads too -
at the upper portion on this link- green circle Icons with arrow on them-
http://neurotalk.psychcentral.com/forum24.html

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

It is extremely limiting, but I have not yet "learned" to live with it. That is, I have not given up on getting better. The pain problems have forced me to quit my career and go back to a lower paying job that is less physically stressful. They have also affected relationships and my ability to live where I want.

But complaints about all of that aside, I am still focusing on ways to cure, or at least reduce, my symptoms. I have been on a steep learning curve for the past year, as before that I thought I mostly had elbow problems.

I haven't come across people who are exactly cured, but I have come across people who have gotten their symptoms under control, corrected some of the underlying body problems, and are now living normal lives. Giving up is not going to help.

I'll be obsessed with fixing myself until I'm 100% pre injury level. I don't see myself giving up on getting back to completely normal. i like your attitude. I would definitely call mine managed so long as I stay in my boundaries ie) sleeping on the floor on my back, running as much as possible, no heavy upper body strength building, doing physio exercises every night forever. But in my opinion thats BS, we should be able to find a real solution that solves the problem, not just managing it. I mean christ most of us just had some bad posture for a while, we should be able to get back to normal.

Have you looked into shoulder nerve injuries? I think, for example, the long thoracic nerve supplies the serratus anterior muscle. When this doesn't function properly, it can cause winging of the scapula.

As mentioned above, I'm not a doctor. There are probably lots of conditions that can cause your symptoms (the more I read, the more possibilities!) Have you seen an orthopedic doctor who specializes in the shoulder?

Good advice there. I'd look in to this one more thoroughly. I have similar sx but my nerve conduction/ emg test were normal. Eleven years later neurosurgeon requested they were redone before putting in a spinal cord neurostimulator. Of course, they found long thoracic nerve palsy and chronic dennervation of anterior serratus muscle! Apparently, it's commonly overlooked as they do not test far enough down the nerve tree. Too late for me to look at any remedial surgery, though may have been from the start as likely mechanism was traction.Good luck, booklover

Oh wow. So there is nothing for you to work towards as far as improving symptoms? I wasn't aware that nerve injuries were so permanent. So let's say, in the event that I do have an injury to the long thoracic nerve, would my only option be surgery? I absolutely HATE surgery. everything about it. Electing to have surgery on my shoulder is what put me into this situation in the first place.

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