Superior Migration of Humeral Head

[John Lowe]

Hey John,

Sorry you are having a crap time. I am a physio in the States but am actually a Kiwi. Honestly MRI's xrays etc are pretty much useless in most cases. in fact I almost never look at them at all. There is so much research out there showing that if they show anything most times it has no relevance. Meaning the same "abnormalities" appear in a person who does not have pain. If you take 100 fellas over 40 WITHOUT any pain, 50% of them will have a rotator cuff tear. I have had people diagnosed with full tears walk out the same day with almost full pain free range and no strength loss.

OK I just re read your post. very high probability it is your neck. Do you have neck or upper trap pain, neck sitffness, shoulder blade pain? It is an easy fix. There are a couple of other things that cause numbness and tingling, but they are not very common.

Thanks for the reply, KiwiPike!

That makes sense about the MRI's then, no point having one if it wouldn't be of use.

The physio did say I have a stiff neck but then never mentioned it again or treated that area, and it does feel stiff on the right side where the shoulder pain is, with a very slight 'crick' in it too, but I wouldn't say it was painful, most of the pain is in the front of the shoulder, with some elbow and wrist pain too, I was getting numbness and tingling in my hand early on but that has improved a lot. Looking at a picture on google of the neck I would say the 'crick' is around the C4 or C5 area if that helps.

I have no upper trap pain, but again the physio has said the upper trap is tight and hypertrophied (as is the chest), I have been doing chest stretches but I wasn't given any sort of stretch for the upper trap, apart from just being told to try and relax it if possible.

No shoulder blade pain either, but it does feel very tight along the medial border near the bottom of the scapula, with some pain there when I try to stretch it.

What would the 'easy fix' be? I'm very grateful for your reply and willing to try pretty much anything at this point haha

[KiwiPike]

Thanks for the reply, KiwiPike!

That makes sense about the MRI's then, no point having one if it wouldn't be of use.

The physio did say I have a stiff neck but then never mentioned it again or treated that area, and it does feel stiff on the right side where the shoulder pain is, with a very slight 'crick' in it too, but I wouldn't say it was painful, most of the pain is in the front of the shoulder, with some elbow and wrist pain too, I was getting numbness and tingling in my hand early on but that has improved a lot. Looking at a picture on google of the neck I would say the 'crick' is around the C4 or C5 area if that helps.

I have no upper trap pain, but again the physio has said the upper trap is tight and hypertrophied (as is the chest), I have been doing chest stretches but I wasn't given any sort of stretch for the upper trap, apart from just being told to try and relax it if possible.

No shoulder blade pain either, but it does feel very tight along the medial border near the bottom of the scapula, with some pain there when I try to stretch it.

What would the 'easy fix' be? I'm very grateful for your reply and willing to try pretty much anything at this point haha

Hey John,
I would be comfortable stating that this is definitely your neck. Everything you have said screams cervical radiculopathy. Basically a bulge of a disc pushing on a nerve as it exits your spine. With sxs in your hand it will be a lower cervical nerve. WIthout knowing specifically which fingers it will be nerve root C 6, 7 or 8. Palpation, or your physio "feeling" your muscles and saying "oh its tight or got a spasm, is pretty bogus too. Palpation is lower inter and intra-rater reliability than anything. Meaning you could have 10 physios feel the same spot and all have different assessments. Its really subjective, thus crap!

Discs usually bulge posterior laterally, some have more lateral component some have more posterior. Hard to tell without seeing you move your head.
A good starting point to assess would be doing a cervical retraction and seeing what happens. I am most concerned with the furthest pain from you hand. Google cervical retraction exercise. Your best bet without forking obver money to me or a physio is to buy a book called treat your own neck by robin Mckenzie. It covers a lot of good things in general.