Expert: Dr. Paul Newhart - 6/10/2009

Question
I was involved in a vehicle accident on 5/09. I injurd my shoulder as well as lower back,hip and leg. It took 9 months for the insurance company to approve shoulder surgery. About 7 months after accident I was having a deep tissue massage at therapists office. When I got off the table I noticed my shoulder had dropped about 3 inches lower than the other. The massage was very painful and they also did a stretching. At that time we were not aware of the damage I had in my shoulder. About 1 month later I noticed my scapula was sticking out and it was painful.  The pain was there before the scapula winging. After my surgery the winging is even worse.  I have had a emg which did not show thoracic nerve damage.  The pain is constant and I am going to a pain management doctor as well as a physical therapist.After the nerve test was negative and the pain in my scapula is keeping me from doing the exercises to get my strength back. The worse the winging gets the more limited the use of my shoulder and arm get. Today I was given a nerve block/steroid injection to see what that would do. I don't think the doctor knows hat to do.  He is a excellent doctor but since the emg was negative I think he's lost as to what to do.  I have been getting triggr point injections in my shoulder since 8/08.  I also had 4 injections of botox shot in trapius nd shoulder blade about 6 weeks ago. The winging got worse after the botox. If there is any advice you could give us on what we could possibly do ext it would greatly be appreciated. My clavicle was also cut during the surgery and keeps having to be put back in place by my therapist.  Could that have anything to do wing the winging getting worse because it was present before my shoulder surgery. Thank you for taking your time to read this.I can't seem to go back to the start of this e-mail but my accident was in 2008 not 2009.      Kathy

Answer
Without an examination it would be difficult to diagnose.  I would suggest you find a chiropractor that specializes in sports injuries, since you have been the medical and PT route.  You may have weakness of the Rhomboids, or even myofascial disorders that need to be addressed, and a good chiropractor should be able to address it, as well as set you up in a good rehab program to turn it around.