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  1. #1
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    Brief Medical History Overview

    Age: 35, Male, Presenting Problem Since: 7 years, Symptom Behaviour: slightly better, Symptoms Worse (24hr Behaviour): morning, Aggravating Factors:: doing nothing, Easing Factors:: stretching, foam rolling, ball rolling, Investigations: degeneration of c5 thru c7, No Diabetes, No history of High Blood Pressure, No Medications, No Osteoporosis, No Hx of Cancer, No Unexplained Weight Loss, No Bowel/Bladder issues

    Major problem / Symptomatic Areas

    Thoracic Spine

    Chest, Ribs

    Shoulder - Posterior - Right

    Shoulder - Anterior - Right

    Upper Arm, Triceps - Posterior - Right

    Upper Arm, Biceps - Anterior - Right

    Elbow, Forearm - Posterior - Right

    Elbow, Forearm - Anterior - Right

    Weak right / flat pec, weak tricep, spasming serratus, weak pressing movements

    This may be long, so please be patient.

    In 2009 (was 28), I was doing some pullups in my house. I was in the early stages of trying to be fit, so I was still weak. I got 4 and upon lowering myself, felt a tweak / twinge in what I believe is my right rhomboid / trap / upper middle back region. I felt it heating up and I figured it was like any other tweak...give it a couple days and it will feel better. This one didn't. Over the days, and weeks, just lifting my right arm into the Hitler pose, caused a great deal of pain in my right shoulder region and a bit in my neck. I suspect it was rotator cuff related looking back. Over the weeks, I pretty much lost any strength in my right arm and right side. My right pec began to atrophy, tricep, and bicep. I went from 20 pushups a day, to 0. If I leaned into a wall standing up I couldn't even press myself off the wall with my right arm. I went to do physical therpy, and they used some plastic tools on my back, and had me do some stretching. I honestly didn't think it was helping. A friend of mine is a chiropractor and I started seeing him, and he was giving me regular adjustments. Slowly, I began weight training months later. It wasn't till probably mid 2012 did I feel like my arm strength was more 'balanced'. Still, I always had tightness along my right arm. If I laid on the ground like jesus, arms laid out. My right arm would tingle and go numb usually within 1 minute.

    As time went on, my strength continued improving. I still fought tightness and impingement in my neck region if I tilted it back and to the right. And trying to pull both shoulders down always caused me to feel straight on the right side of my neck, down into my clavicle and shoulder region.

    I foam roll everytnight, and often use a lacrosse ball on my triceps,deltoids, and various other places.

    Fast forward to about 6 months ago. I hadn't done powerlifting movements in a while (bench, squat, deadlifts) and was beginning to focus on more hypertrophy movements and focused on mass. My right arm and right pec all these years was always a little weaker than my left. That injury just seemed to hang around. My bench press never seemed to improve much, with a 245lb 1 rep being my best. My chest has always remained small. I always suspected something was going on especially on my right side that prevented progress.

    I continued getting adjustments from my friend. Around this time, the strain along the right side of my neck was annoying. There felt like a mass of tissue/knot in the Sternocleidomastoid I believe, and applying direct pressure would send stimulation up along my skull and down into my shoulder / arm. I was trying to loosen it, and mashed it really good with my thumb and palm, really trying to massage it. My chiropractor friend always struggled with my right side, cause it was always so tight or wound up. I was trying to loosen it. So I saw my friend, and got a good neck adjustment in.

    Now, I don't know if it is related, but I noticed a gradual decrease in my right arm strength. My iso-lateral pressing movements were struggling, my wide grip pullups suddenly become very hard to do, and in fact noticed when doing them I would favor my left side...my right arm was dramatically losing the ability to pull, or push.

    I have 2 theories. Theory #1, I did something to the nerve during all that manual manipulation and massage, where I damaged it or hopefully temporary. Theory #2, my buddy when adjusting my neck (and my right side did well) may have inadvertently put pressure on a nerve. I feel more inclined to suspect theory #1 than 2.

    All this time, btw, I have had bicep tendonitus. In fact, the bicep tendons that lead toward my right shoulder, deltoid, and even pec-minor region always seem thick and 'bandy'. I do wonder if I have some other impingement going on.

    So, fast forward to about 3 months ago, and I wanted to try graston. I found a chiro in the area who could do graston on my right shoulder, neck, maybe rhomboid area. He wanted to do an x-ray and see what was going on. My c5-c7 are quite degenerated for my age, he suspected that was the root of the issue. We did some traction, an adjustment and did not do the graston. Around this time, I had trouble flexing my right pec or feeling it contract, squeezing or contracting my right lat, and all around had more weakness in my right arm.

    A few days after that appointment, I was feeling a bit down and wanted to try self-graston. I got a stainless steel butterknight, used the smooth handle and some massage oil, and got working on the right side of my neck where that knot was, down my trap, and a few areas on my shoulder. I did this again a few days later after the redness and bruising healed. The knot in my neck had reduced, and I can safely say for 60 days now, I have no pain when dropping my right shoulder down. No more strain etc...

    Now, during this time, I have continued focusing on my pecs, lats, deltoids, and back. I am making progress, I am getting stronger, however...I still have issues that aren't getting resolved. My right pec is still pretty flat compared to my left, and in fact the upper area of my pec, leading up toward my clavicle and toward my right shoulder is sunken it or has little resistance to it when pressed. I get a lot of spasms and twitching in the upper pec when doing chest movements. During chest movements, I get spasming and twitches in my right lat / serratus area as well. After a good chest session, my right pec essentially feels numb. I have trouble feeling it when trying to contract. When I go to the tricep machines (seated where you rest your arms on the curved pad), I get a good amount of strain in my right tricep (its always much weaker) but I feel alot of twitching/spasms along the right side of my body, but near where the lower right lat connects. There is a 'band' along the right side of my body, that I don't really feel on my left. So I have been focused on triceps a lot more because I feel it activates the serratus or lat, but also focuses on my weak tricep. When doing rope pulldowns, my right arm gives out quicker, and I get to the point where I can't even straighten my right arm out...I have no strength or activation to do so. I focus also on 1 arm cable rows, trying to contract the right lat / serratus. I've even done various serratus exercises

    Another note, the meat below my right clavicle (which is about 1/4" lower than my left, due to atrophied or weaker muscles) is almost non existent. My right chest slopes toward the shoulder more than my left does, which sticks out a bit more.

    I've been doing more pushups, and same thing my right arm gives out quicker.

    So a couple closing thoughts. On one hand, I can see how the vertabrae c5 thru c7 could be the issue, as googling it has led to similar symptoms. Now, on the other hand, the issues I am facing right now are very close to the original symptoms I had when I first faced my injury. I am much stronger now than I was in 2009. Were my c5-c7 an issue back then? Am I dealing with something else...impingement in my right shoulder? Something in my back? I know for a fact I have tricep and bicep tendonitus.

    I am seeing that chiropractor who does graston and did the x-ray tomorrow for an adjustment and I am going to speak to him more about what has progressed since my last visit.

    However, I am open to any thoughts, opinions, or suggestions any of you have.

    Thank you and I apologize for the life story.

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  2. #2
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    Re: Weak right / flat pec, weak tricep, spasming serratus, weak pressing movements

    Wow! Always good to see someone so interested in figuring things out! Of course, as you have found, it is difficult for people to figure these things our because of different approaches and skill levels of therapists as well as trying to clinically reason your own problem is difficult even for a therapist as it is very difficult to objectify yourself.

    My thoughts while reading were:
    • the initial incident years ago was likely just a strain
    • the related atrophy, tingling and nerve sensitivity is hard to say why without seeing you along the journey obviously. Just know that is very common for shoulder function to decrease with any injury or pain around the shoulder girdle and nerve sensitivity is often seen too
    • difficult to say what is going on in cervical spine without assessing


    I would say that for all conditions we look to restore full ranges of motion and strength. Yes manual therapies like graston and self directed work like rolling etc has a part to play. But what makes the effect is working on movement. Start looking at things like can you hold a strict dead hang on a pull up bar, a solid plank and side plank for atleast a minute and then more dynamic things like pushups instead of bench press, handstands instead of military press, dips, rows etc.

    Most importantly work on range of motion every day. Yoga has been around for thousands of years for a reason. It's the real deal. Take tissues to end ranges daily and look to progress positions. What is your melting heart position like (likely no good), can you hit a middle split with a side bend to open the ribs and side of the body etc etc.

    There is no quick fix for anything, that is everyones problem. The body is remodelling every second of everyday until you die. It remodels according to the demands you impose upon it. 12 months of daily well directed range of motion and strength practice will remodel your body well and you are young enough to remodel well.

    Just for reference there are 168 hours in a week. Say you saw a therapist for 30 mins for graston or had an "adjustment", there would be 167.5 hours left in the week.....now you should ponder what would impose more demands on the body to remodel.....


  3. #3
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    Re: Weak right / flat pec, weak tricep, spasming serratus, weak pressing movements

    Thank you for the response.

    I am now using some KT Tape on parts of my right arm and shoulder just as an extra thing to do lol. Had the graston done and I definitely have some knots / lumps in/around my right rhomboid area as well as the right lat.

    He wants me to continue focusing on traction (for decompression of the spine) as he believes there are still issues surrounding the c5 vertabrae.



 

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