Not at all. Don’t even know what bothers me more now, the constant sore mid/lower trapezius and rhomboids or the pain in my shoulder.
I noticed specifically that shoulder hurts a lot when I do the crossover arm stretch (popular mid deltoid stretch) and also the triceps stretch when you bend the elbow and try to bring your hand down behind your back. Similar to the Apley Test. Resting/not using the shoulder seems to make the pain go away but then if I ever start to use it again, it all comes back.
Been to the chiro for 3 adjustments now. Heats/massages/electrocutes my back for about 15 minutes and then cracks it for 1 minute. Feels nice but same problem the next day.
Did a blood test to see if there’s anything abnormal. The only things are my HDL is high and LDL slightly high and I’m vitamin D deficient… Any tips?
[quote]CottonShoulder wrote:
Not at all. Don’t even know what bothers me more now, the constant sore mid/lower trapezius and rhomboids or the pain in my shoulder.
I noticed specifically that shoulder hurts a lot when I do the crossover arm stretch (popular mid deltoid stretch) and also the triceps stretch when you bend the elbow and try to bring your hand down behind your back. Similar to the Apley Test. Resting/not using the shoulder seems to make the pain go away but then if I ever start to use it again, it all comes back.
Been to the chiro for 3 adjustments now. Heats/massages/electrocutes my back for about 15 minutes and then cracks it for 1 minute. Feels nice but same problem the next day.
Did a blood test to see if there’s anything abnormal. The only things are my HDL is high and LDL slightly high and I’m vitamin D deficient… Any tips?[/quote]
Get an MRI. It will probably show nothing. If I were you, I would get a buttload of muscles relaxers (norgesic works wonders) and have my back massaged at least EOD. It could just be that at one point, you had an injury, the injury has healed but the pain has persisted due to faulty processing by the brain of the signals he receives from the area (this happens usually with all chronic pain, such as yours. )
I’m not into drugs so much… besides I believe my problem is mechanical. I noticed yesterday when I try to really push my shoulders back and down hard, it feels tight in the upper portion of my left pec. After feeling around, it feels like it’s tight and has some knots. After stretching it and massaging all day, I feel like I can bring my shoulders back more and less pain. I’ll keep going to the Chiro at least for the massages and electric treatment. The back cracking seems like a joke. Absolutely no effect noticed. I crack my own back all the time and look where it’s gotten me.
I had similar shoulder and especially scapular pain that was debilitating for about a year and a half, after which it finally went away.
I suspect it was due to a spinal nerve impingement.
Do yourself a favor and take the NSAID at the maximum recommended dose. They can help with the nerve inflammation and reduce the actual cause of the pain. And most important, they can reduce the chances that the pain becomes chronic. Once the pain becomes chronic, it stays and pretty much debilitates you long after its cause is gone. You want to avoid that at all costs.
I was dumb and decided to tough it out without NSAIDs and my pain became chronic to the point where it affected every moment of my day and night for 18 months. So the lesson is don’t try to be a tough guy.
I appreciate the advice. Still hesitant to resort to the NSAIDs ever since I read from the FDA that they have been shown to cause stomach ulcers and potentially cancer of the digestive system…
I’ll definitely research it more though. I’m still in the early stages of actually taking action about this pain, since I’ve been waiting for it to go away on its own for about a year.
[quote]CottonShoulder wrote:
I appreciate the advice. Still hesitant to resort to the NSAIDs ever since I read from the FDA that they have been shown to cause stomach ulcers and potentially cancer of the digestive system…
I’ll definitely research it more though. I’m still in the early stages of actually taking action about this pain, since I’ve been waiting for it to go away on its own for about a year.[/quote]
short term NSAID use is generally considered safe at reasonable doses, looking at your pictures you do have a mild scoliosis. does it sound like a few cracks and some stim will correct the problem to you???
To me it would seem you would benefit from a ton from a rigid postural intervention program
[quote]CottonShoulder wrote:
I appreciate the advice. Still hesitant to resort to the NSAIDs ever since I read from the FDA that they have been shown to cause stomach ulcers and potentially cancer of the digestive system…
I’ll definitely research it more though. I’m still in the early stages of actually taking action about this pain, since I’ve been waiting for it to go away on its own for about a year.[/quote]
short term NSAID use is generally considered safe at reasonable doses, looking at your pictures you do have a mild scoliosis. does it sound like a few cracks and some stim will correct the problem to you???
To me it would seem you would benefit from a ton from a rigid postural intervention program[/quote]
No, it definitely doesn’t. I just can’t believe these Chiropractors that I’m seeing. They’re so sleazy. I tried questioning him yesterday, to explain how exactly he proposes to fix my scoliosis by cracking my back, though I’ve been cracking it myself for years. He just says he’s been doing this for 25 years and “Supposably” (he actually said that) “what happens is your spine goes out of alignment, and what happens is we put it back in place”. Said that the cracking is just a noise and doesn’t mean anything. That they’re putting it back in place and that’s what’s important. The two chiro’s crack my back differently, oftentimes missing one adjustment or another.
I can’t believe this profession still exists with so many skeptics. I guess it’s that people recover by chance at the same time as they see the Chiro so they think it helped.
I’ve been holding my shoulders back and down, sitting at a kneeling chair in the office all day and it seems to help. I don’t feel pain in the rhomboids anymore but I do feel that my pecs are tight, especially the upper portion of the left one. I’ll keep this going and see if anything changes.
I am a Chiropractor and do not use the words alignment, back into place, hold, etc. These are antiquated ideas that several in the profession stubbornly hold onto. If a Chiro tells you he’s “putting the bone back into place” he is either deliberately lying to you or woefully ignorant of what he is doing. You typically will find the more evidence based Chiros usually advertise “Sports Chiropractic” and they’ll offer a more integrated treatment method than giving an adjustment and hoping it gets better. That being said, some Chiros will put “sports” in their title and know nothing of functional work, soft tissue modalities, motor patterns, etc.
So basically, if your doctor can’t explain the mechanism of what he’s doing without resorting to something that sounds like a religion, then they’re likely just making it up.
As for your problem, I would suggest (as usual) getting functionally assessed. Doing so will stop the pain chasing and help identify problems objectively. Your treatment should have objective goals. “Increase overhead squat from 1 (dysfunctional) to 2 (acceptable)” is an objective goal. “Get patient out of pain” is a subjective goal that is overused. Pain is the last symptom of dysfunction and the first to go away. I suspect this is the reason so many people have recurring injuries, because they stop their rehab at an arbitrary point (pain free) instead of an established observable quantifiable goal.
[quote]CroatianRage wrote:
I am a Chiropractor and do not use the words alignment, back into place, hold, etc. These are antiquated ideas that several in the profession stubbornly hold onto. If a Chiro tells you he’s “putting the bone back into place” he is either deliberately lying to you or woefully ignorant of what he is doing. You typically will find the more evidence based Chiros usually advertise “Sports Chiropractic” and they’ll offer a more integrated treatment method than giving an adjustment and hoping it gets better. That being said, some Chiros will put “sports” in their title and know nothing of functional work, soft tissue modalities, motor patterns, etc.
So basically, if your doctor can’t explain the mechanism of what he’s doing without resorting to something that sounds like a religion, then they’re likely just making it up.[/quote]
[quote]CroatianRage wrote:
As for your problem, I would suggest (as usual) getting functionally assessed. Doing so will stop the pain chasing and help identify problems objectively. Your treatment should have objective goals. “Increase overhead squat from 1 (dysfunctional) to 2 (acceptable)” is an objective goal. “Get patient out of pain” is a subjective goal that is overused. Pain is the last symptom of dysfunction and the first to go away. I suspect this is the reason so many people have recurring injuries, because they stop their rehab at an arbitrary point (pain free) instead of an established observable quantifiable goal.
/off my soapbox[/quote]
I do appreciate your information. Didn’t mean to question the entire profession. I have heard that there are two types of Chiropractors… I guess I got the “fluff” one.
Can you elaborate a bit more on what you said about getting my functionality assessed?
P.S. I may have mentioned already that I’ve been sitting on a kneeling chair at work, and trying to be very conscious about keeping my shoulders back and down. As a result, for the last two days my right lat has been very tight. Just feels like it has knots in it and I feel like constantly pressing on it, though it hurts. What could this mean?
I also hit my upper/mid back hard on Tuesday, doing every exercise I knew of for the rhomboids and lower traps and some lats. Should I be targetting and hammering these areas more often hoping for them to become more functional again? I’ve been letting them rest for a long time and that doesn’t seem to make the pain go away.
Functional assessment is a variety of movements that you do that are meant to diagnose impaired movement patterns. I focus a lot on breathing, squatting, and abdominal bracing because if you can do those things right then a lot of issues will resolve themselves. I basically grade them based on how the patient can perform the movements.
Then if the movement is found to be dysfunctional you can break down the specific faults and work on them individually, but always keeping in mind why you’re breaking them down. For example, I care less about a patient having N degrees of hip flexion. I’m more concerned with if a patient has enough hip flexion to perform an overhead squat correctly.
I can’t know for sure what your specific reason for your pain as I would need to fully assess you. I really can’t comment further than that.
As for hammering rhomboids, mid-traps, etc (all the muscles that are typically “weak”) that is all well and good, but remember to do it for a purpose. Does the extra rhomboid or mid-trap work allow you to extend your T-spine more and therefore flex your shoulders directly overhead? Always be improving on a measurable parameter. Let me know if this was entirely confusing nonsense.
So…
What is the functional deficit?
Why does the deficit exist?
How can I fix the ‘why’ to improve the ‘what’?
It’s not confusing nonsense, but you do use a lot of terms I’m not familiar with…
What’d you mean by flexing my shoulders directly overhead? And extending my T-spine? What you’re telling me sounds much more science-based than the BS I’ve been hearing from my “chiropractor”. I like your approach of measuring everything to track progress or lack thereof.
I guess I’m interested in the actual movements that I can do to test myself for functional deficits. I enjoyed the rotator cuff tests that I’ve found on some website, but even those aren’t very telltale. When I went to the ortho, he did those tests and concluded that my rotator cuff is fine. Although I had slight pain in a few of the tests, he said that my being able to apply force meant that there is no injury. So he directed me to a spine professional.
What would be a few examples of tests I can run on myself, perhaps taking a video of it to watch and analyze any functional deficits? I understand a squat holding a barbell overhead would be one?
The tests your ortho gave you were orthopedic tests. Those are designed to locate specific tissue that is injured. Since the tests that provoke various aspects of the rotator cuff did not produce pain or weakness, the ortho could cross rotator cuff off the differential diagnosis list.
Functional tests are somewhat different because a failed test doesn’t produce a specific diagnosis. It all depends how you failed and then it is up the the practitioner to figure out why you failed. It gives more of a general roadmap instead of a diagnosis.
As for shoulder flexion and thoracic extension:
Stand with your hands at your sides thumbs facing forward.
Raise your arms straight overhead by moving them forward, not to the sides
At the top your thumbs should be facing behind you
In an overhead squat test you don’t want to have anything in the hands. Holding PVC or a barbell will allow you to lock your shoulders into place and cheat the test. The test is basically do the above shoulder flexion and then squat down.
Also I would suggest you try to watch yourself breathe. This one’s hard to do alone because when you become conscious of your breathing you can change it. When you’re breathing look right above your clavicles and at your upper traps and shoulders. If any of these things are rising then you are breathing wrong.
Keep in mind these are just two tests and functional exams usually have somewhere around 7. I think it could give you a jumping off point and help you develop some goals that aren’t ‘be pain free.’ You could probably get estim and massage every day and be pain free, but you wouldn’t be better.
The midback pain extending into the shoulder strikes me as a t-spine issue more than a GH problem. The direct blow to your back makes me wonder if there is a thoracic spine instability; that would cause local musculature (traps, rhomboids) to spasm to protect the area. This leads to altered mechanics in the shoulder complex, overstressing tissues and causing your pain. I would see a rehab therapist (AT, PT, DO, DC, etc) and ask them specifically to check upper t-spine and rib stability. If there is an instability, you’ll probably be given intrinsic muscle activations to provide stability to the area, which will relieve extrinsic muscle spasm and allow you to change your movement patterns in the shoulder complex.
A Chiro manipulating an unstable vertebra is making the problem worse, I would stop going. Soft tissue work has also proved ineffective, this makes me think the problem is more structural than functional.
[quote]dzmendon wrote:
The midback pain extending into the shoulder strikes me as a t-spine issue more than a GH problem. The direct blow to your back makes me wonder if there is a thoracic spine instability; that would cause local musculature (traps, rhomboids) to spasm to protect the area. This leads to altered mechanics in the shoulder complex, overstressing tissues and causing your pain. I would see a rehab therapist (AT, PT, DO, DC, etc) and ask them specifically to check upper t-spine and rib stability. If there is an instability, you’ll probably be given intrinsic muscle activations to provide stability to the area, which will relieve extrinsic muscle spasm and allow you to change your movement patterns in the shoulder complex.
A Chiro manipulating an unstable vertebra is making the problem worse, I would stop going. Soft tissue work has also proved ineffective, this makes me think the problem is more structural than functional.[/quote]
What you are saying actually makes a lot of sense too. Can anyone comment on this?
What can I do in the meantime, before I can get to a spine specialist who would probably refer me to a rehab therapist, to strengthen and activate my intrinsic muscles?
What you are saying actually makes a lot of sense too. Can anyone comment on this?
What can I do in the meantime, before I can get to a spine specialist who would probably refer me to a rehab therapist, to strengthen and activate my intrinsic muscles?
That doctor is a physiatrist, I’d give it a very good chance he knows what he’s doing. Tell him you did a little digging around on the internet and you think you may have a thoracic spine instability from your fall, that’ll tip him in a very good direction.
As a physiatrist, he’ll have all the right exercises to give you and you’ll be fine, physiatry is the medicine side of rehab; he’s basically a super-physio.
Not sure what you can do at home for now, you need activation exercises with manual cueing… that requires a trained therapist, or in your case physiatrist. Google the multifidus for background information though, that’s the muscle you’ll be activating and strengthening.
Alright, good. Sounds like there’s hope on the horizon. I’ll be doing everything I can meanwhile to see if I can narrow my problem down more. The earliest I could get an appointment is April 9th, so I have some time still.
