Repetitive Strain Injury/Left shoulder

Advertisement


Question
QUESTION: In my left shoulder it feels like I have a bone bruise on my scapula and my scapula feels trapped like a muscle is over it and preventing it from moving. With it being trapped like this I have had a lot of swelling and knots build up in my back and it is causing problems in my neck. This has been going on for about tree years and it has caused an enormous amount of pain. Well about a year ago I started rolling around on a soft ball and it has helped to reduce swelling and take out the knots. Well about two months ago I was rolling on the ball and something popped in my back and within a week I had a dramatic reduction in pain and swelling and I was able to start moving my scapula again. Two days ago I was rolling on the ball trying to get a knot out in my inner back towards the bottom of my scapula. While rolling something popped and it caused an instant pain that went up my back and into my shoulder. Now my scapula is trapped again and the bone bruise feeling is back. Any idea what the problem is and how I get it to pop back so the pain will stop?

ANSWER: Hi Brandon,

Well, this is a challenge, but there is always an answer so it's just a matter of playing detective to figure out which muscle released your scapula, and which one is causing the current problem.  

The muscles that cross over the scapula are your trapezius, and latissimus dorsi.  Your infraspinatus muscle is directly on your scapula and inserts into your shoulder (it's actually one of the rotator cuff muscles).  Your trapezius goes up into your neck, which makes me think this is the muscle that just caused this latest situation.

There are times when I just wish I could see someone who is writing to me, and this is one of those times.  The challenge (not a problem) is there are more muscles impacting the movement of your shoulder, than any joint in the body.

Let's start with what movements you can make.  Even if it's limited (tell me if it is) can you reach across your body to your opposite upper arm?  Can you lift your arm up toward the ceiling, or out in front of you.  Tell me about your range of motion, and at what point it causes pain, and stops you from moving.  Can you bring your arm back to scratch your mid-back?

Are there any movements that you can't make at all?  Are there any that you can make easily, and without pain?  Can you reach up and put your hand behind your head? Do you have burning pain? Where? Or is the pain more similar to the way you feel when you pull your hair?

If you go to http://www.julstro.com you can read about the shoulder muscles and the movements they make. That will help us to start to narrow this down.

I'll look forward to hearing from you again.

Wishing you well,
    Julie Donnelly

This will help me eliminate some of the muscles

---------- FOLLOW-UP ----------

QUESTION: I wouldn't say that I can reach across my body but I can touch my right arm with my left hand. Range of motion is not good. When I try to raise my left arm up it doesn't want to move because my scapula cannot push out from behind and that makes the front of my shoulder hurt when I try to raise it. It pulls hard from my trap at the base of my neck and down my shoulder and over my scapula. Pain is constant, it is a dull nagging with hot burning numbing going down my arm and into my hand. This goes across my neck and into my right trap and then I get almost the same pain on my right shoulder/scapula area and hot burning numbing going down to my right hand. No I cannot put my hand behind my back and yes I can put my hand behind my head. You should also know that I have had previous shoulder surgery and have a lot of arthritis in my shoulder. I also have c2 to c7 bulging in my neck. Now my shoulder doctor says that my arthritis is causing all my shoulder pain and my neck doctor says that the discs are causing the neck pain and the burning numbing pain and I say that this muscle in my back is causing 60% of all my pain but they won't listen to me.

Answer
Hi Brandon,

I totally agree with you that the odds are very high this is a muscle problem, not a problem with arthritis.  When a muscle is in spasm it is putting a great deal of pressure on the joint, causing pain and preventing it from moving. In reading your second message I think there are several muscles involved in this problem.

The C2-C7 situation is very likely coming from your . The levator scapulae originates on C1-C4 and inserts into your shoulder blade, the nickname is "the shrug muscle" because it lifts up your shoulder.  However, when it is tight it is pulling the vertebrae together, putting pressure on the disc between each vertebrae and also impinging on the nerves that come out of the vertebra.  They will easily cause the disc to bulge, plus the pressure is downward, so it can be involved in the lower cervical vertebrae although not as directly.

As for your shoulder, there are many muscles involved but the key ones are the infraspinatus, teres minor, and teres major.  Did you go to http://www.julstro.com/joint_pain?  There is a lot of good information on that page.  Everything I teach about the shoulder came from when I had such a severe case of frozen shoulder that I couldn't move my arm more than 2" to the front, or out to the side, and I couldn't move your arm back enough to bring my thumb past the side-seam of my pants. The shoulder is tricky because there are more muscles inserting into that joint than anywhere in your body, but I can assure you that it can be fixed. It just takes time and determination, but it can be done by using a tennis ball.  

There is too much to be able to describe what to do here in this message, but basically you take the tennis ball and lean against a wall searching for "hot spots."  Each hot spot is a muscle spasm that is preventing your arm from moving.

The interesting thing is muscle spasms frequently will mimic the pain of arthritis because they are pulling on the tendon, which then pulls on the bone at the joint. The pressure can be so severe that when you try to move in the opposite direction you can't, and if you keep trying you'll get an inflammation because of the strain on the bone.  While treating the muscle won't change arthritis, it will eliminate this muscular problem and can make a major difference in the pain level, and range-of-motion, in the joint.

It's worthwhile checking out the muscle, it can't hurt, and it is a really good possibility that it will help.

Wishing you well,
   Julie Donnelly

Repetitive Strain Injury

All Answers


Answers by Expert:


Ask Experts

Volunteer


Julie Donnelly, LMT

Expertise

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!

Experience

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.

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

Education/Credentials
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: http://www.FlexibleAthlete.com and http://www.julstro.com. I currently treat people in my offices in Sarasota, FL, Cary, NC, or Pearl River, NY

©2016 About.com. All rights reserved.