winging scapula, scoliosis and more

hello

i don't know where to start, because it may be quite messy to understand the cause of my problem but i'll try my best

back when i was 14 a school nurse diagnosed me with scoliosis, i had the x-ray, went to a physio that had me balancing on some weird wheel to work the deep muscles of my back i guess and gave me a few exercises that i can do at home. doing exercises lasted only 3 days because i was stupid to say the least and didn't care about my health. note that i didn't do any sports (i had no muscle to support my spine, rounded shoulders, leaning forward etc.) since i was 10 and was severely underweight. fastforward 4 years i stand 190cm (6'2") and 58kg (~128lbs) and god knows how bad my back has gotten. eventually i got sick of being weak and skinny so i signed up for a gym (march or april of 2010). the first week passed and i got hooked although i didn't know what i was doing for nearly 6 months of working out. aside from training i was searching the internet for exercises, tips, tricks whatever, to get a better understanding what the hell i am doing and if im doing it right. so much great material out there it can get overwhelming sometimes. anyway, i stumbled across an article made exclusively for people with poor posture, that spend most of their time in front of a computer (which i was, since 13 as long as i remember). the article lied down the scientific "why and how" of how posture gets worse over time and it had a bunch of exercises that one can do to improve slouching etc. an exercise called "face pulls" i decided to try in my next workout which seemed pretty reasonable and effective. if i recall correctly i started my workout with flat bench (press), incline bench, triceps pull downs and did face pulls as my last exercise, so it could be either one of those that caused my nerve to pinch/damage, but most likely face pulls, because it was unnatural. i went home and either that day or the next day i had terrible sharp pain in my upper trapezius / neck area so i signed up to see a traumatologist. he said i need to do an x-ray, so i did, but the pain got really intense as i was waiting in line for the x-ray, i could barely handle and move my right side of the neck and shoulder. when i got the x-ray he said that there is no fracture of the scapula and sent me to see a neurologist. so i did and once i showed her my back she of course noticed my scoliosis and started asking questions about it. i was told to do a full body scan (computer tomography) and get back to her with the results. avoid sitting at any cost at home or school (because of my long spine), quit weight lifting and pick up swimming or "medical gymnastics". now, for the nerve i pinched/damaged she proposed injections and electrophoresis (i ignored the injections and electrophoresis, because i was told electrophoresis just eases the pain not permanently cures it). i got home and put on some grease i bought for muscle strain relief for the next couple of days and i got better with time. but a few days later, i got this weird tingling sensation which traveled across my right arm. i tried to search anything i could find about it on the internet and eventually i ran into a book about trigger points called (The Trigger Point Therapy Workbook - Your Self-Treatment Guide for Pain Relief by Clair Davies) which i later acquired. started reading it and got to the point that my tingling sensation dissapeared. one of the pages described exactly the same symptoms that i had.

"symptoms created by the scalenes are easily misinterpreted. upper back pain evoked by scalene trigger points is almost always wrongly blamed on the rhomboid muscles. restlessness in the neck and shoulder, a classic sign of scalene trigger points, is written off as a nervous tic. pain referred from the scalenes to the chest is mistaken for angina. when trigger points shorten the scalene muscles, they tend to keep the first rib pulled up against the collarbone squeezing the blood vessels and nerves that pass through the area on their way to the arm. the impeded blood flow and disturbed nerve impulses cause pain, numbness, and swelling in the arm and hand. the collection of symptoms caused by this compression of the nerves and vessels is properly termed thoracic outlet syndrome, although they're very often incorrectly diagnosed as carpal tunnel syndrome. when treatment fails to affect symptoms created by scalene trigger points, you may be told it's all in your head. given that all these effects occur so far from their source and are so variable, it's no wonder that their cause is minsunderstood. fortunately, once you do understand that all these things can be coming from the scalene muscles in your neck, the solution is remarkably simple and quick."

amazing. so i started working on my anterior, middle and posterior scalene muscles and immediately felt relief. after a few minutes doing the massage i did some dynamic stretching with my arms (like pulled my shoulder blades together etc.) and felt my right trapezius started working again, as if blood started to flow into the muscle and the tingling sensation across my arm disappeared. was really excited and happy at this point!


later on i signed up to see a physio which had me doing core exercises that work the deep muscles (bird dogs, scapula push ups, planks etc.). parallel to that, i completed computer tomography for my waist and neck (1 month interval) and was told that i shouldn't be doing it for my chest, because it's too much radiation. i went back to neurologist for advice but forgot her name so i signed up to see a different one. this one said that computer tomography wasn't really necessary and i should have done just x-rays. so i only did an x-ray for my chest / thoracic spine area. went back to the physio, he read through the results and said:

1) waist area: the very last vertebrae of my spine is 3-4mm "bending" to the side
2) completely forgot what he said about the neck, but it's pretty messed up
3) x-ray of my chest and thoracic spine showed a curve (scoliosis)

although it says so much more on the paper (it also contains compact discs inside, haven't checked them yet), i guess the rest is not that important? i'll try to translate what it says in the results:

1) neck area: deformed spondylosis and spondiloarthrosis in the neck area of the spine. the patient can straighten the physiological lordosis of the cervical spine by laying/sleeping on his back. circular kyphotic (not sure if i translated this correctly, might be something else) curve. C2 dens localized centrally in relation to the mass of C1 lateralis, sublocation or dislocation is currently absent. C3-C4 disc flat dorsal "arch form", which extend to the spinal canal about 2 mm with a small impact on "dural" bag from the front, can not exclude effects on the spinal cord. C2-C3-C4-C5, C5-C6, C6-C7, C7-TH1 disc abnormal "arch form" in the spinal canal is currently absent, if the clinical - neurological picture is still suspected of the intervertebral disc, spinal cord or root damage at the level of investigation, it's necessary to carry out MRI cervical spine.

2) waist area: deformed spondylosis and spondiloarthrosis in the waist area of the spine. lumbar spine arched sin. scoliosis vL2 level of the vertebral bodies of a small rotation to the left. vL2-vL3 disc flat foraminal "arch form" left side. vL3-vL4 dorsal "arch form" flat disk with little impact on "dural" bag from the front. vL4-vL5 dorsal disc flat, asymmetrical protrusion, which extend to the spinal canal by 2 mm with an impact on "dural" bag from the front. At this level, slightly narrowed spinal canal - the disc protrusion, hypertrophic yellow ties. vL5-VS1 disc dorsal median and left side "paramedian" protrusion which extend to the spinal canal ~ 3-4mm of the impact on "dural" bag, S1 "sin. ganglia". L4, L5 lower closing plate, concave, sclerotic contour - initial lack "Schmorl's hernia".

the only thing i understood is that i should be sleeping on my back in order to fix my neck or not? the physio said i should continue doing exercises that work my core at home. i also asked him if it was alright to continue weight lifting. he said yes (i should develop my back muscle, spinal erectors etc), i told him about my program which only consisted of compound lifts (multi join exercises that work the entire body like squats, deadlifts, chinups, pullups etc.) and luckily, he wasn't against such controversial exercises like the squat or the deadlift (both dangerous if done with poor form).

i signed up to the gym again. 1 month later i'm looking into the mirror and i see that my right scapula has some weird movement unlike my left one. at first, i thought it's "just" a winging scapula that is weak and needs work. so i asked a guy that is experienced in weight lifting if there is anything that i can do about it and he told me that i should stretch my pecs (minor and major) and upper traps. work my rhomboids using a scapula retraction emphasised horizontal pull (barbell rows, dumbell rows, rack pulls), strengthen both my serratus anteriors and make sure i'm standing up and sitting properly. but the more i think about this, the more confused i get. if i pinched OR damaged my nerve a few months ago what if it's the long thoracic nerve or the brachial plexus? i read that it heals about 1mm a day which sucks royaly. although i have no pain, i can move my arm overhead, to the sides with full range of motion, but having a little trouble when i try to reach my left scapula with my right arm behind my back, because everything is SO tight, i believe it's the pec major/minor. anyway, i continued working out and didn't pay any attention to my winging scapula until now, when i stopped working out, because my gym membership ended. at this point i worked out at home with my bodyweight and doing scapula pushups i feel weird/dull sensation under my lower scapula region. i applied a soft tissue massage to the serratus posterior superior which lies underneath the scapula with a tennis ball. that hurt like hell and it got a little better but i think it might be latissimus dorsi trigger point that's causing this not serratus posterior superior. and that's about it. through the course of these months i have also discovered about the spinal decompression that might help to straighten my spine but i haven't been doing it consistently. but my main concern is the winging scapula, what may caused this. weak muscles? nerve damage? scoliosis? poor posture that makes my first rib to be pulled up against the collarbone squeezing the blood vessels and nerves that pass through the area on their way to the arm? i have no idea. i would greatly appreciate if someone could nudge me into the right direction. i'm also thinking there must be some changes made to my spine since i did those scans months ago as i've been doing soft tissue and mobility work to my thoracic spine, foam rolling everything that i can think of and doing spinal decompression through-out the day or maybe not. i'm going back to gym on the 1st of july and i'll try to work on my back muscles more. i'll post a video and some pictures of my back tomorrow and try to scan the x-ray aswell

thank you