Pinching/Piercing Pain Under Deltoid When Raising Arm At 90 Degrees

[alophysio]

Thanks dsheri2...my question would be "why are the trigger points there in the first
- maybe the muscles are in a protective spasm for something like a stress fracture or labral tear?
- maybe he has a poor stabilisation strategyand the muscles are being used as stabilisers instead of movers
- maybe he has a motor pattern that overuses these muscles instead of other muscles
- maybe he has a neck problem causing scalenes, upper traps, levator scap, etc to overwork
- maybe the neck problem has a neural component
- maybe he really does have a rotator cuff tear - rare in a 21y.o.

All these questions can be answered with a good assessment mhewiit

Cheers!

[dsheri2]

Some good Points Alophysio..an assesment would be the best way to find out !!
- maybe the muscles are in a protective spasm for something like a stress fracture or labral tear? "On Both Arms?"
- maybe he has a poor stabilisation strategy and the muscles are being used as stabilisers instead of movers"Possible"
- maybe he has a motor pattern that overuses these muscles instead of other muscles 'definately possible"
- maybe he has a neck problem causing scalenes, upper traps, levator scap, etc to overwork 'definately possible"
- maybe the neck problem has a neural component "Trigger Points so close to the neck will definately cause neural problems"
- maybe he really does have a rotator cuff tear - rare in a 21y.o.
Knowing if mhewitt does weights regularly or has done in the past would be usefull.Or any other Exercise regime that could have bad form"

Just my thoughts
Cheers
Dan

[alophysio]

Thanks Dsheri2.

They are good points you raise and i agree...and i have seen protective muscle spasm on one arm worse than the other due to labral tears and poor technique (motor control)...more than a handful of times.

I guess my original intention was to agree that Trigger points are just one possible reason of many that might cause this problem.

The way i think is that problems can come from 6 general sources...these can be linked back to various authors but most prominently Diane Lee and LJ Lee's Clinical Puzzle which builds upon the work of others as well as their own.

1. Their Strategies for Functional Tasks - the way you do something
2. The person's psychosocial influences - what meaning do they place on the pain/problem, their representation of their virtual body, their story, their goals etc etc
3. Their articular system components - ligaments, cartilage, bones, capsule etc
4. Their myofascial system - muscles, tendons, fascia etc
5. Their neural system - motor control, nerves, central influences, etc
6. Their visceral system - the effect of the state of their visceral system on their neuromyofascial system, chemical imbalances etc

To me, trigger points fits into either the myofascial system or the neural system depending on the view you take of them...

...i was merely trying to hurriedly point out the other components in a practical way

Thanks!

[dsheri2]

Very Interesting alophysio...i will look out for those authors.

[mhewitt]

Knowing if mhewitt does weights regularly or has done in the past would be usefull.Or any other Exercise regime that could have bad form"

I do. I probably work out 2-3 hours a week. It's a lot of bodyweight exercise (pushups, pullups, crunches), and the weighted routines i do aren't anything extreme. I mentioned it in a previous post but in case you missed it, i did stop working out for a while (1-2 months) and noticed no difference. I realize that it could maybe take longer than that for something to 'heal', but im not the best with patience .

I also forgot to mention that before i went to physio, i actually did visit two doctors (not sure of their specific field) that tried to assess what it was that i had. The first was all hands on, just asking me to move my arms and upperbody in general in certain ways. Then asking when it hurt, when it didn't, how bad it was etc. They said it could've been a few things but they weren't too sure and i would need to visit someone else. I then visited someone who did an x-ray sort of thing. He said he couldn't see anything, and that's when i went to physio.

I realize i'm probably going to have to go back to my doctor again to figure this thing out, i just didn't really like how it ended up last time. A few people telling me they aren't sure/they can't see anything wrong, and shipping me off to physio where i didn't notice much of a difference.

Thanks again for all the replies