Shoulder Blade Pain

Hello all,

I'm looking for a bit of advice or insight into something I've been struggling with for the past 7 years.

In 2004, I injured myself doing a heavy bench press. When I lowered the weight and began to push up I felt a twinge in my mid shoulder blade area. It felt almost like a muscle knotted in my back. It didn't really hurt, more of a dull ache, so I didn't give it much thought and didn't seek treatment. Within a few months I was experiencing stabbing pain in the shoulder blade are and my whole shoulder complex hurt so much I didn't want to even move my arm. I saw a chiropractor and several massage therapists. I saw a GP who specialized in sports injuries and went for X-rays and eventually an MRI. I was diagnosed with arthritis of the AC joint. Was referred to a surgeon who concurred. I never had any localized pain in the AC joint. Dispite this, I ultimately have a distal clavicle resection in 2005. The resection didn't help and I've been living in pain ever since.

My athletic activity has been so limited that this year I decided I had to try to do something. I've been seeing a physical therapist but, truthfully, she seems a bit stumped. The majority of my pain is felt in the shoulder blade but I have tightness in the upper trap, the collarbone, pec minor, and some pain now in the ac joint. I can no longer do any pressing or even arm curls.

I tried to attach a recent video of me doing scap push-ups where you can see when I'm in the bottom position(shoulder blades are retracted) you can see the blade protruding from the bottom and out the side. I'll try to get it posted. Any insight would be greatly appreciated.

http://imageshack.us/clip/my-videos/823/pkji.mp4/

Is your PT doing posture correction with you? Is the humeral head sitting in the correct position, or is it set forward (anteriorly) from the joint? If it's out that can cause a huge amount of dysfunction that basically has your shoulder go immobile. All ranges painful. Taping for the supraspinatus is helpful for that, along with bicep and supraspinatus trigger point release (as per Simons and Travell notes) and posterior glenohumeral mobs to loosen up the posterior capsule. Your PT should know what all of these are.

When you had massage did they do trigger point release with you?

It seems like you've been cleared for muscles tears and tendinosis. Try the biomechanics of the joint approach to see if that helps.

Right and check out the scalene's for trigger point referral patterns and see if they coincide with your pain pattern. Have someone work on the scalene trigger points. Pressure will activate the pattern so you can see if it is similar to what you presently feel. Go to triggerpoinst.net to take a look at the pain pattern maps.

Thanks so much for the reply. Pretty much all we've worked on is strengthening the lower traps. I have noticed I have some posture issues I am working on. My arm on the right side definitely seems to sit more forward than it should. I've been working on stretching my pecs and trying to strengthen my posterior chain. My scalenes are wicked tight.
Thanks again for your input.

Hey, no prob. Hope it helps.