Frustrating injury - seeking advice

[Dryvlyne]

Hi all - I've been lurking around these forums on & off for awhile, but haven't registered until now. Basically I'm to the point where I'm getting very frustrated & need advice from people that actually understand what I'm going through because I feel like my family doctor, chiropractor and massage therapist are all sending me in circles.

Sometime around Feb 2015, just before I turned 35, is when I believe the original injury occurred. I'm not exactly sure which specific exercise did it, but it was something involving my traps & lats... I'm guess either pulldowns or seated cable row. Anyway, at first I experienced more soreness than usual on my right side and just chalked it up to an intense workout. I continued working out as usual for about 4-5 months and the soreness/tenderness continued, but it wasn't anything unbearable or that hampered me from doing exercises. Then I began to experience 2 things that started concerning me -1) swelling and inflammation in the right side of my neck, mainly at the top of the trap 2) muscle spams throughout my right lat, particularly at night when I would try to sleep. I continued working out, but not as intensely and would take a ibuprofen & ice the areas occasionally. The soreness/tenderness never completely went away but it wasn't as bothersome.

I saw my family doctor in July 2015 for an annual physical exam and explained what was going on. His initial diagnosis was that I just had a rib out of place after feeling some inflammation and small bulge under my right shoulder blade. He suggested seeing a local chiropractor that specializes in sports & soft tissue injuries. However, instead of immediately doing that I just convinced myself to take time off so I stayed out of the gym for 3-4 months and continued to take ibuprofen & ice the areas as needed. I lost about 15 lbs of muscle during this time which was really depressing. After the time off I feel like all of the soreness/tenderness has gone away so I start going back to the gym. Everything goes well for about 4 or 5 weeks and then the same symptoms start coming back. At this point I'm really frustrated so I setup an appointment with the chiropractor that my family doctor initially recommended.

The chiropractor didn't explicitly say not to workout, just to not do something if it hurts. Well the problem is I usually feel fine when I work out, it's 1 or 2 days later that these areas start acting up. Anyway, he does adjustments on me for 2 months. He thinks the problem is in my neck and radiating down into my lat area. The adjustments do help, but only provide temporary relief. When I tell him I still think something is wrong he sends me for an MRI on the cervical/neck (this is in Dec 2015); the MRI reveals a small bulge with the C5 disc. The chiropractor says that bulging discs are pretty common and that continued adjustments should help. Fast forward to Spring 2016 and I tell him I'm still experiencing soreness/tenderness in my neck & lat and he suggests adding in massage therapy once a month (specifically deep tissue massage). This seems to be help; the massage therapist finds several "trigger" points throughout the right side of my back... top of the trap, around the right shoulder blade and the bottom of the lat. During the Spring I start going back to the gym and for about 8 weeks everything is great; I'm gaining strength and weight back, finally!

Then... you guessed it, another damn relapse! I know exactly what triggered it this time... standing deltoid raises using the cable crossover machine. Since then I feel a significant lump/knot at the top of my right trap, where it meets the base of the neck. I have a similar thing on the left side, but it's significantly smaller so I know it's not normal. If I use 2 fingers I can push it back and forth... almost feels like a small sac in the top of my trap. Then there's the continued soreness/tenderness in my right lat, directly below the shoulder blade, going down and then wrapping around the side of my ribs.

I've contemplated asking for another MRI, but specifically asking them to target from the top of my shoulder to the bottom of my lat on the right side (remember the first MRI was just on the cervical/neck area). Part of me thinks it would be pointless though because even if it reveals a tear/strain I don't think my family doctor or chiropractor would advise surgery, probably just more of what I'm already doing. Plus the muscles in these areas are functional so it can't be fully torn, right? I mean, I could go to the gym right now and workout, but then my neck/trap area will get inflamed and my lat will become even more sore & tender. With the exception of 1 very light workout session at home last week, which aggravated my lat just from doing body push ups, I haven't been to the gym since 5/12/16.

Assuming I'm dealing with a nasty strain to my trap & lat... do I just continue to be patient and wait it out? Besides surgery, are there any other viable treatment options? Should I continue icing the areas? Maybe heat? I've been doing self-massage with an S-hook cane on the "trigger" point areas that my massage therapist identified and that does bring relief, but again only temporary.

I know everyone's healing time is different, but damn, I just would have thought between taking 3 months off once and almost 2 months off with this recurrence that would be more than enough. I'm seriously frustrated, and even depressed to an extent, from this injury. I've been working out since age 16 and it's soooo freaking hard for me not to go to the gym. And when I see how much weight I've lost since all of this started happening I just feel like I'm wasting away. It sickens me to think about how much time & effort I've spent on my body over the years to just literally watch it dissolve before my eyes.

If you've read all of this thank you for taking the time to do so and any advice, tips, encouragement, or similar stories of misery are welcome :-)

[EjnarKolinkar]

I feel like my family doctor, chiropractor and massage therapist are all sending me in circles.

Well 50 views and no comments, I felt for you OP. Not that anybody can diagnose you or respond with a 'fix' on the internetz

In addition to whatever medical follow up you plan to do, have you considered asking for a referral to a physical therapist? Mine was very helpful with shoulder and shin problems which had become chronic. I did some research after teh referral, but my Dr. sent me to a good PT, after some Q's in person the PT's lifting background was also a positive. This was after MRI and Dr's shrugged as cutting wasn't needed as a fix. RICE only gets you so far. And after an injury heals, if it does, you are not only left with whatever possible issues you had that lead to the original injury, but usually atrophied tissues from the 'recovery' period.

Chronic stuff can really wear on your mentally, sometimes it feels there is no escaping it. Can really get you into a negative mindset. Watch out for that, as it can snowball. Got to get on a positive mental plane. PT got me working, working helped with the bad mentality, and the work lead to some relief. IDK how that will apply to you after you follow up with whatever medial stuffs you plan to. But don't let yourself slip into depressed thoughts, fight back.

[Dryvlyne]

.....

Hey, thanks man for the words of encouragement. I go back to my family doctor this week for another physical so I think I will inquire about a PT. I guess the thought of seeing a PT worries me though because I feel like it will be one of those things that turns into perpetual visits. At this point though I'm ready to try about anything. This whole thing, like you said, has just worn on me mentally more than anything. Before it happened I felt like I was in a really good place mentally and physically. I guess I always knew though in the back of my mind that something like this was bound to happen as I got older and the wear & tear of almost 20yrs of workouts takes its toll. If nothing else maybe a PT can help me formulate a plan to slowly work back into my regular gym routine without further aggravating these problem spots. The big thing to me is I NEED to start doing something because it's driving me nuts just being sedentary (though my wife would probably disagree, lol).

[grubman]

I'm certainly not a doctor and I've never had a serious injury (knock on wood), but the most common muscle I used to pull or get a cramp in is in the same location you are talking about. I haven't pulled it in some time, and the only reason I can guess is that I don't do any machine or cable moves anymore. I'm not anti-machine, but about a year and a half ago I switched to a full body routine that doesn't include many isolation exercises, and includes no machines (other than my vertical leg press and calf raise machine). Since then I have only got a cramp in that muscle one or two times, and it usually went away by the next day.

[Dryvlyne]

I'm certainly not a doctor and I've never had a serious injury (knock on wood), but the most common muscle I used to pull or get a cramp in is in the same location you are talking about. I haven't pulled it in some time, and the only reason I can guess is that I don't do any machine or cable moves anymore. I'm not anti-machine, but about a year and a half ago I switched to a full body routine that doesn't include many isolation exercises, and includes no machines (other than my vertical leg press and calf raise machine). Since then I have only got a cramp in that muscle one or two times, and it usually went away by the next day.

Yeah, good thought to steer clear from any iso heavy exercises, at least for a good while. When I did workout I would always fully lengthen and contract the muscles I was targeting regardless if I was on a machine or not. In hindsight I wonder if that might have been contributing factor to my injury. I always viewed that as a good thing though because I see a lot of people at the gym doing real heavy weight, but either using bad form and/or really short contractions. Maybe I've been approaching it wrong all these years; I'm open to feedback on this.

Anyway, back to the injured areas. I found a couple of really good pics that illustrate exactly where my problems are. The first one is trigger point X6 in the Erector Spinae Muscle as illustrated on this page: www(dot)painotopia(dot)com/erector-spinae-muscle.html

I was confusing this with pain in my lat, but this is definitely where the pain originates. When I hit this spot with my Body Back Buddy massage tool... holy crap does it feel tight and sensitive!

The other trigger point is in my Levator Scapulae Muscle: www(dot)painotopia(dot)com/levator-scapulae-muscle.html#locate-the-muscle

This is where I feel a distinguishable knot and tightness. It got seriously inflamed the last time I was at the gym doing standing rear deltoid raises at a cable crossover machine.

The self-massage techniques (and massage therapy sessions) I've been doing to these areas has helped significantly, but clearly it's going to take more time and more gradual rehab to get back to where I was before all of this started. As much as I shutter at the thought, I think I need to prepare myself for possibly not hitting the gym for up to a year :-[

**NOTE**
Had to remove the "." in the web site address since I haven't made enough posts yet to add links

[michail71]

My first recommendation would be to see a good non-surgical sports orthopedic doctor. Stuff like this is their specialty.

I suffered for over 10 years with a similar issue although not as bad as yours. Mine wound up being a combination of things. Some of it was repetitive stress from computer use/desk work. Treatment involved a couple frightening upper thoracic adjustments. I also had some treatments with an ultra sound and electrical stimulation machine. For regular maintenance I have to make sure I keep my pecs stretched and avoid strain on my shoulders. He also recommended avoiding isolated deltoid work and sticking to compounds and functional exercises.

Basically, I needed to undo some imbalances and re-train my body to move correctly. Recovery has been fast. I've only needed two visits to the doctor so far and will probably be done by the third visit.

[Dryvlyne]

Well, at the urging of my chiropractor I went back from another MRI yesterday. This time it was basically my whole upper body. I won't review the results with my chiropractor until Tues, but based on the DVD of images they gave me it looks really bad.

I'm talking multiple herniated & bulging discs throughout my thoracic. There is also definitely some kind of mass on my right shoulder where the trap connects to the neck.

So at the moment I'm feeling very discouraged. My wife is trying to reassure me, but trust me the images between what few good discs I have and the bad ones are pretty obvious to me. So who knows when or if I'll ever be able to lift weights again. At this point I consider myself somewhat lucky that I'm not in agonizing pain and will feel fortunate if I can ever do any kind serious strength training again :-(

[wsteve30]

Chiros are alternative medicine. As such it holds no real healing legitimacy in medicine and the evidence supporting its efficacy is poor. You should go see a sports physical therapist and ditch the chiro. They have always helped me out.