Discussions By Condition: I cannot get a diagnosis.

Can this really be just a muscle (trapezius) strain?

Posted In: I cannot get a diagnosis. 5 Replies
  • Posted By: Anonymous
  • August 31, 2010
  • 10:04 PM

Hi all,

I was hoping someone could help me out. I have had pain whenever I bend my head back for about three weeks now. Multiple doctors insist it is not a disc problem, but a muscle (trapezius) strain and though the pain has gotten better, it's still there. Shouldn't a strain be healed by three weeks?

Here is my entire history with this problem.

2-3 months before the injury:

I cycled and worked out regularly. My workouts involved no weights, only body movements (pushups, theraband exercises, planks, etc). In this 2-3 month time period, I felt that while doing a pushup or plank, it would seem that my upper left trap was carrying most of the boy weight on that side. In other words, I felt like I couldn't keep my scapula down while in a plank formation and thus was putting all my body weight onto my upper trap.

The injury:

I took a month off working out starting in July due to traveling. On August 12 (again, about a month since I had last worked out) I was doing some foam roller stretches before going to bed and felt a pull in my trapezius. The injury occurred when I was holding my body up with both hands planted firmly on the floor and using my arms to roll my calfs over the foam roller. In other words, I was at a 90 degree angle - hands, arms, and upper body straight - legs running horizontal to the ground.

While rolling my calves over the foam roller, I felt a little pull in my left trapezius muscle a little left of my spine and right above the inner corner of my shoulder blade.

It wasn't too painful, but it did feel like a pulled muscle. I went to bed and slept with no problems. The next day my neck was tender in the area and it only bothered me when I tilted my head back. I figured it would be gone in a few days.

3 days after injury - It still hurt to move my head back in extension (looking up to the ceiling). When I would try to do so, I would get a sharp pain right in my trap where I felt the pull.

4 days after injury - I woke up expecting the pain to be gone (as most of my other muscle pulls resolved in about 4 days), but when I extended my head, the pain was still there. The sharp pain stopped me from moving my head all the way back. I started feeling around on my trap and begun to notice that I could achieve full range of extension if I pressed on the area of my trap where I felt the pull and tilted my head back. However, if I just tilted my head back without pressing on my tarp I would get sharp pain.

7 days after injury - upon touch the area was no longer tender, but I still would get a sharp pain while extending my head. With the exception of pressing ******n the injured area, the sharp pain was still there when I extended my head.

That entire day I almost obsessively kept tilting my head back, testing my range of motion. As I kept doing it, my entire left shoulder started to ache, and then the top of my left triceps and my forearm. I got terrified that this was a disc issue and I drove to the ER.

At the ER, the doctor took an x-ray (results: vertebrae looked fine. Good space between the bones, no spurs, etc). He also did a lot of movement and range of motion tests. He tested for muscular weakness, pressed all over my spine, ect. His diagnosis was a trapezius strain and gave me a strong anti-inflammatory.

The ER doc said to follow up with my family doctor if I didn't feel better in a week. A week later I went to my family doctor. I still had the pain when bending my head back, but now I had greater range of motion before I would feel the sharp pain, and it wasn't as sharp. My family doc did range or motion tests on me and he thought it was also a strain. He noted I had bad posture and said physical therapy could be helpful.

A day later I went to a physical therapist. She also thought it is a strain. She noted that my left shoulder hung lower than my right and started me on upper trap, mid trap exercises along with serratus anterior exercises. She also had me start pec stretches. It' doesn't hurt me to do any of the exercises.

A day after that I went to a chiropractor and they also though it was a bad strain. I didn't have them do an adjustment because I didn't want to inflame the area.

My frustration is everyone thinks its a strain, but it's been 19 days since the injury and I still get pain when I tilt my head back. Granted, I can tilt my head back much further with sharp pain and my shoulder and arm only hurt (dull ache) in the morning when I wake up and start moving around or when I sit there and test my neck extension all day long, but... don't most muscle strains heal in two weeks? If it is a strain, why hasn't mine healed yet? There was no bruising when I had the injury so it can't be that bad of a strain.

Other info: I'm male, 33. I don't have any pins and needles feelings or electric sensations in my arms or hands. I sleep through the night just fine. As I said, it bothers me most in the morning when I first wake up and also when I go on walks. Sitting and lying down produce no pain unless I force head extension to the fullest. I can lift my arm and move it in any direction without pain. Shoulder shrugging produces no pain.

Bottom line: I'm worried its a nerve/disc issue. I'm worried that my "strain" hasn't healed yet and don't understand why I still have pain at extreme extension of the neck that travels to my shoulder and triceps when I force my neck back. All the information I find online says muscle strains heal in two weeks. Should I see another doctor?

I'm very grateful for any replies.

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5 Replies:

  • Yes - not your normal strain that is easily fixed but more like a repitive strain especially since one side is lower the other. You may have aggravated a long term small injury, and once the inflammation goes away you have a deeper strain caused by overuse including bad posture. Once it flares you have to aggressively retrain your body to strengthen surrounding musles and realign the ligament. It is not a quick fix. You can get massage also to help.
    Anonymous 42,789 Replies
    • October 1, 2010
    • 05:04 PM
    • 0
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  • Strangely enough on the 13th August I did exactly the same as you. I have also seen a doctor and chiro. I also have struggled day to day but have finally worked myself back into the gym. Changing your chair, pillow or bed can help more than you think. In addition, it is important to stretch and slowly start to work out with good form, so that scar tissue doesn't worsen the situation. Heat creams help, but I have found nothing makes a huge difference excluding healing time and a light workout. It has been tough as I had previously worked out daily. It seems this type of strain is a battle but with time you should slowly get there. I'm 31 and was very fit...iam now getting back to the gym and yesterday completed a full strength training workout, although a bit weaker, I can see that muscle memory will hopefully get me on the right road...How are you doing?
    Anonymous 42,789 Replies
    • December 16, 2010
    • 03:17 AM
    • 0
    Flag this Response
  • Hi guys,I think I am going through the same sort of thing. I have pain in the top of my back/bottom of my neck (trap region) when tilting my head back. When I push on the area and tilt my head back there is no pain.For me it is also causing aches in my triceps above the elbow like the inflammation in the back/neck near the cervical spine is putting pressure on the ulnar nerve and causing twinges down the arm. I can stretch and do normal things fine the pain is just mainly when I tilt my head back or if I do any strenuous upper body exercises that aggravate the trap region and it causes the ulnar nerve to become irritable.I think the problem started from bad form at the gym but I didn't really notice it as the pain was only when I tilted my head back, and obviously that's not a regular activity. It must have got worse and then caused the nerve pain so I've stopped the gym altogether and the arm pains have gone but I still can't tilt my head back all the way without pain.I even went for an MRI on my cervical spine as I was concerned about the nerve pain, but they said that everything was fine - hence I'm thinking it's a trap strain causing the problems.The only exercise I do now is swim and I find that after swimming the blood flow loosens up my neck and I can tilt my head back pain free, but a couple of hours after the swimming, when I've cooled down the pain comes back when tilting my head back.I find the worst thing for it is actually sleeping. I sleep on my front most of the time and I find after waking up from sleeping in that position my back/neck are quite tight and sore in the mornings.Not sure what to do now if I should only continue the swimming and wait it out or whether I should return to the gym and do some light back exercises to strengthen the area. It's been going on for about 4 months now and becoming really depressing as I want to get back to the gym. How can a trap stain last this long?! I can't see that it can be anything else though as it would have showed up on the MRI.How have you guys pulled up since the above posts? Any comments or recommendations would be greatly appreciated.Cheers
    ausguy 1 Replies
    • November 27, 2012
    • 00:26 PM
    • 0
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  • Did you find out what was it you had on trap? I got the same exact thing.
    Anonymous 1 Replies
    • August 21, 2015
    • 01:20 AM
    • 0
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  • Any more info or answers about how you all progressed? I have soreness that is almost as if I did some heavy lifting at the gym. The problem is it is over a week, much worse in the mornings, I actually didn't work on anything specific to upper body and I can't pinpoint a tear or strain, it is just generally painful to move my neck.
    Anonymous 1 Replies
    • November 29, 2015
    • 00:59 PM
    • 0
    Flag this Response
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