I’ve struggled with a shoulder issue for the past few years, and I’m finally seeing a PT that gets it. Each week of PT means new workouts piled on, and it’s actually working. Every day of doing the workouts makes my shoulder feel better.
It’s looking something like this at current:
How Did We Get This Way?
It seems that my shoulder has had some weakness in it for a very long time--likely from habitual computer/mouse use without much physical activity as a kid. Muscles never strengthened or used properly helped developed a grotesque (in the Sherwood Andersonian way) existence over the years.
I went through a power lifting phase and I think the intensity of that weight helped bring it out further. I could never bench properly due to this strange asymmetry in my form, resulting in my squats and deadlifts going way up and my bench remaining “poverty.”
Eventually the feeling of not “acute pain” but instead an untreatable stiffness and irritation developed in the rhomboid area.
Trying to massage or stretch this area just resulted in more misery, though.
Why Didn’t You Go to a PT?
I did!
Well, not at first.
I tried to YouTube my problem for a bit. The answer seemed to be that STRENGTHENING the surrounding muscles was the key. And it is… but without being able to have someone else see how you’re moving, a proper assessment can’t be made. Cherry picking approaches from the internet won’t get you far because none of it is tailored for You.
The thing about the internet is not that it has bad info (which it does)… Rather, it has a lot of GOOD info, but all of that information is categorized and hyper-specific. There are many names for shoulder, rotator cuff, and neck issues that all sort of addressed my problem, but none of them really got the root. You really have to go see a specialist in the end because the issue at hand might not fit any specific category.
I did eventually go to a PT, and armed with lots of knowledge, soon realized that this PT was not addressing the root of my issue. They were at best addressing the symptoms with weekly massages. This is the common “scam” that many find themselves in when going to PT or chiro for chronic issues.
I thought you said PT is working?
It is, but hold on.
After I stopped going to that first PT, I went back to research. I basically read these books trying to figure out my issue:
Becoming a Supple Leopard: The Ultimate Guide to Resolving Pain, Preventing Injury, and Optimizing Athletic Performance - Kelly Starrett
Treat Your Own Neck - Robin McKenzie
Treat Your Own Shoulder - Robin McKenzie
I learned a heck of a lot through all of these!! Body mechanics are pretty interesting. I understand why injuries happen in the body. When anyone tells me about pain they are feeling, I am very curious about it.
Reading all that stuff also gave me a much better idea that my issue might actually be more related to my neck than my shoulder. The rhomboid pain wasn’t the rhomboid, really, it was likely just referral pain from stiffness in other areas. But turns out, this explanation was half right and half wrong!
I tried the methods from each book, and they were working… to an extent. But after a couple weeks of each, I still had lingering pain that wouldn’t go away.
So you finally went to PT again?
Yes!!! I met someone who used to work at a neurosurgery clinic. On a whim I brought up my shoulder and they gave it a feel. In their assessment, they said I had pretty knotty shoulder tissue that was likely pinching the nerve--hence why I was feeling the referral pain in my rhomboid and why nothing was working. Their bias told them that I should just go get surgery. I’ve long decided I’m never gonna do that for something like this though, so I told them that’s off the table. They said ok, then go see a PT and let them know about your fucked up shoulder.
At this point I’d long dropped power lifting and was now doing a body weight routine. I like this routine because prisoners do it and when I see Goku and Krillin not using weights either I’m like damn that’s me. But still, some of the same issues were coming back. One of the biggest was that my push ups were not lining up. See, I’d put my hands up on the wall or on the floor, and the right hand would be naturally “up” by about an inch!!! Doing the pushup felt equally awkward.
So I decided I’d give it another try, this time armed with all of my knowledge. I showed up to my appointment and vomitted all my buzz words I’d learned:
Serratus anterior
Referral pain
Scapular retraction
McKenzie Method™
Shoulder impingement
They totally knew what I was talking about and we got to work… after the first day, when I only had 6 exercises to do for that week, I was already feeling progress! But I have felt the illusion of “progress” many times through my quest, so I was skeptical… But then when I went back for week 2, I told them my observations, and they actually listened!! I got feedback about where I was right and wrong on my own assessments (which made sense somewhere in the swirling logic of everything I’d shoved into my brain), and they modified my routine to improve what was working.
Not only that, but after the first week, my pushup form had already repaired itself. I’m not strong enough to do proper pushups still, but I’ve just recently started introducing some elevated ones again.
So you fixed it?
Hopefully!! I don’t know! Everything feels like it’s getting gradually better. I can only go up from here.
Ultimately what the PT says is that it’s like this:
Weakness in shoulder
Other muscles are overcompensating
Joints are getting too tight around this area
Strain is causing irritation to the nerve
So by fixing the weakness, ultimately everything else should start falling back into place and pains will resolve themselves. It makes sense because all the different methods I tried were addressing some of these things but not all of them, so that’s why I’d sometimes feel relief but not for long.
The thing I said earlier, about the neck thing being only half-right, was because the issue was not in the neck, but I WAS experiencing the same nerve irritation that you would get from issues with your neck.
Ok I have to pee bye. Everyone should be their own advocate but know when it’s time to see a specialist--though I think you’re totally right to distrust them sometimes. K bye.