Expert: Julie Donnelly, LMT - 1/20/2008

Question
Dear Julie,

About 9 years ago I had a whiplash injury from a surfing incident on a surfing beach. Since then I have had chronic and recurring pain in my neck and shoulder. I have consulted osteopaths, chiropractors, had massage and even acupuncture. Nothing has had any long term effect.

The symptoms are difficulty turning my head, particularly to the right. As I turn my head to the right, I experience pain underneath my right shoulder blade. My symptoms are currently worse due to working out in the gym. I have full mobility in my arm and shoulder and do everything normally, apart from turn my head. I have read so many things on the net about muscle strain, muscle tears, nerve problems and the like, that I really don't know what condition(s) I have but I am sure it is muscle related and not structural (skeletal). I'm afraid that the condition is not helped by my job which involves excessive use of computers and laptops, so the failure for my injury to heal may be partly also caused by repetitative strain injury and bad posture.

Can you offer any advice please? Is it safe to continue working out in the gym or should I rest my arm and shoulder and, if so, for how long? Will my condition improve by taking any form of medication (Ibuprofen?) or muscle enhancing supplement (creatine?)? Is it likely to be something that requires surgery and should I perhaps return to my doctor?

I very much look forward to hearing from you and thank you for your advice...

Jonathan

Answer
Hi Jonathan,

A muscle can be strained, causing a spasm to form, and it can stay that way for 50+ years if the spasm isn't released.  The odds are very high that the muscle you strained is called the scalenes. The scalenes are located along the front of your neck, on either side of the cervical vertebrae.  If you go to http://www.aboutcts.com you can see graphics of the scalenes by going to the section titled "Anatomy Lessons."  

When the scalenes are tight they will press down on the brachial plexus, a bundle of nerves that innervate your entire upper body. The scalenes will refer pain to underneath the shoulder blade and into your arm pit, as well as a lot of other places along your arm and into your hand.  You'll see when you take a look at the website.

The other muscle that is likely to be involved is called sternocleidomastoid (SCM for short). The SCM originates on the front/center of your collarbone and inserts into the base of the bone that is behind your ear.  When the left SCM contracts you turn your head to the right, and when the right SCM contracts you turn your head to the left.  I would suspect that you'll find spasms in your left SCM. Plus, the muscles that are along the back of your neck, from your skull to your upper back (going right along the side of your spine, on both sides) are probably also shortened by a contraction. They need to stretch when you turn your head, and if they don't stretch, you don't turn your head. In this case the left side is probably contracted, preventing you from turning your head to the right.

I've worked with thousands of people who have various neck problems, and I'm happy to say that the odds are really good that you can learn how to self-treat all of these muscles. If you go to http://www.julstro.com you can read about repetitive strain injuries. Pay special attention to the sections titled "Muscles and Pain" and "What's Happening Exactly."  As you learn more about what is happening, you'll have a better understanding of why it's best for you to learn how to self-treat rather than going to a therapist. You can do it to yourself several times a day, instead of just getting the muscles treated on a weekly (or less) basis.

I don't believe in taking medications for the pain because they aren't taking care of the source of the problem, they are just covering up the pain. It's like using Ambesol on a toothache. The pain is gone but the tooth still has a cavity. You need to find and treat the source of your problem, not cover it up.

In any case, I believe you can get relief. It just takes time and some focused attention.  I've seen so many people be successful, I'm certain that you can be successful too.

Wishing you well,
    Julie Donnelly