Discussions By Condition: I cannot get a diagnosis.

Can't diagnose shoulder/upper back muscle tightness

Posted In: I cannot get a diagnosis. 4 Replies
  • Posted By: willthebold
  • April 28, 2012
  • 06:05 AM

Hi All,

Trying to reach out to the internet community to see if anyone can shed some light on what's going on with me. Here's my history:

I was playing softball in a recreational league for about a year (once per week), and was pretty casual about it. I do like to throw, though, and cut loose when I got the chance. A little over a year ago, I started getting a pain that would radiate up the right side of my neck to the back right side of my head, and some burning under my right shoulder blade (I'm right-handed). I decided to stop playing softball for a while to see if it would clear up, but that never helped. After a couple months I started having some aches in my mid-right back, and pain radiating down the outside of my right arm. I also get a little ache down around my bottom couple of ribs on my right side. My right scapula is winged just slightly, and sits a little lower than my left, and I get a little bit of grinding from my right collar bone when I rotate my shoulder around. There's no pain with any of the movements, just the general/persistent ache of the muscles and overall tightness of my right shoulder, neck and back.

What's been done so far:
MRI of cervical and thoracic vertebrae - Totally clear
MRI Arthrogram of right shoulder - Lots of inflammation in my subscapularis, some inflammation of my infrispinatus/supraspinatus.
X-rays - all totally clear.
EMG Nerve Test - Nerves all in great shape.
Corticosteroid Injection in right shoulder - no relief or change.
Lots of PT and stretching - no results yet.

I joined a gym about 2 weeks ago under the advice of my doctor to see if I could work out any possible muscle imbalances, but no results just yet (thought it's still pretty early.) I'm trying to focus on my serratus anterior to see if that is my problem from all the throwing I did in softball, but I'm getting pretty frustrated at this point. I've been trying to figure this out for about 16 months! Any insight would awesome!

Thanks,
Will

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4 Replies:

  • Hi - Being a veteran of seemingly every known (and unknown) back and or neck issue, I would say that with all the grinding etc going on in those areas there is likely some rhomboid muscle involvement, as well as the rotator cuff issues. you might well have some impingment syndrome going on in that shoulder. PT and anti-inflammatories are generally the most recommended treatment. next visit to your orthopedist or other dr you should have them put you through some standard manipulation movement exercises to see how likely it is that you have some impingment going on and if so, give you some exercises.Good luck!Linda
    PharMED 4 Replies Flag this Response
  • Thanks for the input Linda! I've had several manipulation tests for impingements before, but nothing seemed to be wrong on that front. I'm going to mention it again when I go back, but in the meantime I'm still trying to stretch everyday, and hit the gym about every other day. I think one thing that makes it harder for me to recover from this is that I have hypermobility in a few of my joints (shoulders especially) so stretching those muscles can be a little tough. Thanks for the help, and if you have any other ideas, I'm all ears!Will
    willthebold 2 Replies Flag this Response
  • Thanks for the input Linda! I've had several manipulation tests for impingements before, but nothing seemed to be wrong on that front. I'm going to mention it again when I go back, but in the meantime I'm still trying to stretch everyday, and hit the gym about every other day. I think one thing that makes it harder for me to recover from this is that I have hypermobility in a few of my joints (shoulders especially) so stretching those muscles can be a little tough. Thanks for the help, and if you have any other ideas, I'm all ears! WillWill - when you say you have some hypermobility what do you mean exactly? do you have something in the ehlers-danlos spectrum? you might want to rule that in or out because if it is at the root of your problems then your therapy needs to target that! Stretching can in fact be really tricky and somewhat detrimental if that is the case. Good luck!Linda
    PharMED 4 Replies Flag this Response
  • I don't think it's quite that extreme, and my doctors and therapists are aware of it. The laxity only shows up in a couple places. I can voluntarily partially subluxate my right shoulder, and my right thumb, though there is no pain associate with doing so. Right now, I'm trying to focus on why my right subscapularis is staying so inflamed, but it's hard to find causes for it. Can you think of anything that would cause persistent inflammation in that muscle? I've been trying to stretch it, and strengthen my external rotator muscles on that side. Thanks for all your help!Will
    willthebold 2 Replies Flag this Response
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