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Repetitive Strain Injury/scapular pain and spasms in neck


QUESTION: I read your response to to Deanna, where you very accurately described the problem I have had for several years.  At the end you said there is an easy treatment for this and I would really appreciate it if you would let me know what you think would help.  To remind you of what you told her, I will repeat it:  "the scalenes are pressing into the brachial plexus, and they are pulling on the cervical vertebrae, impinging on the nerve that innervates the rhomboids.  The the rhomboids go into spasm.  You can feel the knot (in the scapular area), but the cause of the spasm is in your neck."

I, too, have had this same problem -- in my left shoulder blade the muscles knot up, the shoulder blade wings out, and I get spasms up into my neck all the way to the occipital area.  I have been through rolfing, myotherapy, physical therapy, chiropractic therapy, joint injections, trigger point injections, and, finally, botox injections.  The botox has finally given me more time in a day without pain, but no one has ever given me a specify diagnosis.  I have been to a physiatrist, an ortho surgeon, a pain specialist, and finally a neurologist, who has given me the botox.  MRIs show nothing. My PT thinks the issue starts in the back, but you think something like this could start in the neck.  I would really appreciate your advice on how to correct the problem, which seems to be just like Deanna's.  Thank you!

ANSWER: Hi Sylvia,

After reading your message I believe you do have a repetitive strain injury (RSI) and I agree that your scalenes are involved, but I also think the serratus anterior is a part of the problem since your shoulder blade wings out. It's perfect that you have been to every type of physician and therapist and had all the various tests. Each one that wasn't successful at finding a problem brought you one step closer to knowing that it's all muscles as this is the only thing that doesn't have a test.

I suggest you go to and read about repetitive strain injuries, and also read the sections titled "Muscles and Pain" and "What's Happening Exactly."  I also suggest you go to to see information about the Scalenes and how they interact with the brachial plexus and rhomboids.

I believe you can successfully self-treat each of these muscles. Self-treatment is good because you can do it every day, eventually causing the muscles to stop going into spasm and stay at the proper length for that muscle.  I suggest you treat the scalenes, levator scapulae, serratus anterior, splenius capitis, splenius cervicis, trapezius and rhomboids. The websites mentioned will explain how to learn the self-treatments.

Wishing you well
   Julie Donnelly

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QUESTION: Thank you so much, Julie!  I would like a consultation from you to be able to pinpoint which muscle is causing my problem and causing painful spasms in my neck up to the occiput.  I never have a pain free day. I frankly am at my wit's end.  Do you think an email or phone consultation would be better?  I am in New Mexico and I work, so if a phone consultation wonder what time would be best for you.  I would like to get your thought before I submit.

I wish you were closer to New Mexico -- I would really like a face-to-face consult, but I will start with an email or phone consult.

Hi Sylvia,

I think the email consultation is the best place to begin.  Most of the time we can resolve it this way, and if necessary we can move to a phone/Skype call.  If it turns out that your scalenes are really involved I can show them to you on Skype as I don't think you need the entire System that teaches how to do this one muscle.

Keep positive about it Sylvia, the vast majority of people figure out what is causing the problem and resolve it, I think you will too.

I'll look forward to hearing from you.

Wishing you well,

Repetitive Strain Injury

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Julie Donnelly, LMT


I can accept questions that relate to chronic or acute pain caused by muscle spasms and contractions. Repetitive Strain Injury is actually Cumulative Trauma to muscles. Releasing the spasm &/or contraction will relieve the strain that is felt at the insertion point on the bone. I am the co-developer of the unique safe-stretching program "Focused Flexibility Training," which combines easy instruction for self-treating spasms throughout your body with proven yoga stretches. I have recently authored two new books: "The 15 Minute Back Pain Solution," and "The Secret to Your Best Golf Game EVER!


Since 1989 I have been working with endurance athletes and individuals suffering from chronic pain conditions. I have authored seven self-treatment books and three self-treatment DVDs and I have developed the Julstro System for the treatment of carpal tunnel syndrome, Trigger Finger, and other Hand/Wrist pain. I am a national and international presenter at conventions, seminars, and workshops. Principle topics are "Work Shouldn't Hurt," and "The Pain Free Athlete." In 2005 and 2006 I was the massage therapist for ultracyclists competing in the Race Across America (RAAM) 3000+ mile race from San Diego, CA to Atlantic City, NJ. I've taught the Julstro techniques to physical therapists at the Cleveland Clinic, to massage therapists in areas around the USA, and I've taught Julstro self-treatment clinics to dancers at Juilliard School of Performing Arts (NYC),the sprinting team at NC State, and I am working closely with several Olympic-hopeful. We have successfully eliminated the repetitive strain injuries that could keep them out of the Olympic Games, and the best part is they know how to do the self-treatments so they can stay pain-free and flexible.

Triathlete Magazine, Endurance Magazine, multiple national and international trade journals.

Swedish Institute of Allied Health, NY, NY - Initial education in massage therapy Licensed NYS Massage Therapist since 1989. SUNY Empire State College, Saratoga Springs, NY - B.Sc. degree in Interdisciplinary Health Education I was an Associate Professor helping to develop the massage training program for SUNY Rockland Community College

Past/Present Clients
Privacy prevents me from filling in this section without prior consent from my clients. Life Experience: I have been specializing in the treatment of chronic pain and sports injuries since receiving my NY massage license in 1989. A personal bout with carpal tunnel syndrome was the catalyst to my developing a self-treatment that heals the symptoms of carpal tunnel syndrome quickly and without surgery. My work with endurance athletes was the inspiration to teach people how to self-treat so they could stop pains even during a race or heavy training day. Both of these situations ultimately became the products that are sold on my websites: and I currently treat people in my offices in Sarasota, FL, Cary, NC, or Pearl River, NY

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