T Nation

Chronic Neck/Back/Trap Issues

I am at my wits end dealing with these issues, and hoping someone here might have some miraculous insight or could help.

Quick version:

For years I have had issues with tightness/spasms in my traps, particularly on the right side, starting with a bjj injury.  Also, my traps were taking over for my upper back muscles during movements.  I have been working to correct this but the more I do the worse pain gets in my upper back.  There is now pain to the point where working out hurts almost too much and I don't want to for fear its making something worse.  Just doing a bent over rear fly with no weights at all hurts my shoulder blade area.  This pain is also brought on anytime I extend or rotate my thoracic area.

Novel version:

About 6 years ago, I was put into a can opener during bjj.  I should have tapped right away, but I fought and escaped (bad idea...for those guys that do bjj, remember to tap early and often.  It's not worth an injury to fight it).  That night, I had pain in my right trap area and couldn't turn my head to the right.  It healed up after a few weeks and I went back to bjj.  For the next two years, I would occasionally tweak my neck again, and have to take a week or so off, but it always healed up fine.

About 3.5 years ago, I hurt it badly.  Someone had my back and an arm around my head, and I was twisting to turn into his guard, and heard a crack-crack-crack sound in my neck.  Or maybe pop-pop-pop, or something like that.  Pain gradually came on over the course of an hour, and, like the first time I hurt my neck, I couldn't turn my head to the right.  Unfortunately, this time it didn't get better like normal.

After a few weeks, I went to the doctor who gave me and MRI which was fine, and sent me to PT for a few months, which didn't help.  After that the Dr. referred me to a pain management specialist who just said take Ibuprofin when it hurt...not much help.  After that I went to a chiropractor, who took X-rays and said I had a loss of lordosis in my neck.  I went to him for two months or so, and when he cracked my neck I felt great for about thirty minutes, but it had no lasting effect.

I tried going back to bjj a couple times, but any time someone grappled with my neck it caused my trap muscles to spasm and caused pain for a couple days.  At this time I was getting real busy with school so I stopped trying to go back to bjj and dealt with moderate pain/tightness in my traps and upper back for the past couple years.  It basically felt like my traps were always spazzed out and trigger points constantly between my shoulder blades, but no acute pain.  I was able to lift weights, but not grapple.  Any time someone got a hold of my neck, my traps would spasm out more than normal and cause pain for a couple days.  I dealt with this for a long time; I couldn't do bjj, but at least I could lift weights.  And, I always figured that I'm young, and it'll go away on its own some day (wrong).

A few months ago I tried doing dragon flags for the first time.  I can't do one, so I was working on just negatives.  For the first few reps, I felt pain in my upper back, like the bench wasn't padded enough or something, but then I realized the pain was coming from like the muscles in my upper back and not just from rubbing on the bench.  I stopped doing them, and a couple minutes later noticed my right trap start to spasm out and clamp up again.

6 months or so before this I had gone through surgery for a hip impingement and labral tear, and liked the doctor I had seen for that so I went to see if he couple help me at all.  Said I had a trap strain and bad posture (upper crossed syndrome) and sent me to PT.  As I worked with them, they said that every time I did a horizontal row or something like that, my traps took over at the end and when I squeezed my shoulder blades together, I shrugged up also.  So, for the past couple years, any time I did a row thinking I was helping strengthen my upper back, I was really worsening the situation because my traps were taking over.  They worked with me on the muscles in my upper back and also cracked my back and neck to loosen things up.  This is when my upper back began to hurt any time I did an exercise involving it, such as fly's, rows, ext.  The pain was manageable and I worked through it.  After PT for 8 weeks or so, there was no improvement, so the doctor tried giving me trigger point injections at a couple spots in my right trap and shoulder blade area.  Back to PT for 8 more weeks, and again, no improvement.

They said basically my posture was bad and I needed to work to correct my muscle imbalances and it would take a long time to improve due to a lifetime of bad habits.  (I agree I need to work on this).  I stopped going to PT and kept doing exercises to correct my posture.  Any time I hit the muscles between my shoulder blades there was some pain, but I could work through it.  I decided to go to a chiropractor who does Graston technique to see if he could help things for me.  For a couple weeks this seemed to not really be helping or hurting.  However, last week, my upper back and neck started killing me.  I had started doing exercises to stretch into thoracic extension, so that might have hurt it, or maybe he cracked my back in a certain way to hurt it, I don't know.  But now, if I extend or rotate my thoracic spine there is pain between my shoulder blades, which is way worse than its ever been.  I can't do exercises with my upper back due to pain.  I just got x-rays taken, but have not been back to the chiropractor yet.  Thinking of telling him to just Graston me and not crack me.

I would love to be able to do bjj again but realize that will probably not happen.  However, at this point, I just want to be able to lift weights again and get through the day without having to get up at work every 15 minutes and rub a lacrosse ball on my back due to things spasming, and constantly rubbing my neck due to traps that feel locked up all the time.  If anyone has any insight as to what could be going on or anything to help me, please do so.  I can post my xrays if that would be helpful.

Thank you very much,

tl/dr version:
-Neck and upper back piss me off, can’t workout without pain or do bjj.
-If extend or rotate my thoracic area, there is pain.
-Need to exercise to correct muscle imbalances, but can’t without acute pain. (Should I push through it? it seems the more I do the more it hurts…)
-fucking help please.

Holy crap, I am dealing with the exact same issues. Different cause, but same issues. I have yet to find the answer. Been battling this for 4 months now.

Have seen a physio, 2 physical therapists, 4 chiros, and have used 3 forms of muscle relaxer. Only one chiro came close to helping with some ART and acupunture, but after a couple hundred bucks, still no permanent solution. Have been stretching and doing soft tissue work 2-5 times per day for months with no success.

[quote]howie424 wrote:
Holy crap, I am dealing with the exact same issues. Different cause, but same issues. I have yet to find the answer. Been battling this for 4 months now.

Have seen a physio, 2 physical therapists, 4 chiros, and have used 3 forms of muscle relaxer. Only one chiro came close to helping with some ART and acupunture, but after a couple hundred bucks, still no permanent solution. Have been stretching and doing soft tissue work 2-5 times per day for months with no success. [/quote]

I am seriously sorry to hear that you’re having the same issues. From where I am, 4 years out, it seems almost hopeless. I read your post about mental difficulties and can definitely relate, going from 175 lbs at 6-7% bf and thinking about having my first amateur fight, to being 180 lbs and basically average and untrained looking, its absolutely kind of depressing.
Between my ongoing hip issues from arthroscopic surgery and the back/neck issues, about the only exercises I can push myself on pain free are bench/shoulder press/pushups etc… but the catch is… Those exercises are going to worsen our rounded shoulders/excessive kyphosis issues! So we can’t even do them haha. FML
Out of curiosity, what was the cause or start of your problems?

check out mckensie method, or however its spelled, if its a disc issue this should help, if not, u can be happy its not a disc issue.
Also look at dave tates iron evolution phase 7 on this site, you may need to do some individual programming if u cannot get help from a good pt or whatever, your body most likely needs how to properly function, light cable rows with sholders down, neck out of the movement, squeeze the shoulder blades, retract the elbows along ur sides etc… push yourself on fucking cardio if u cant do anything else, i would not, repeat i would NOT push urself on pressing exercises even if its pain free. Something is seriously out of place, and u need to take the time to adress and figure it out.
Ive been in the same boat before, the method i mentioned helped alot, but it ended up being smart programming, LAst year this time ic ouldnt bench 135, could curl 20lbs, my shit was fucked. I can bench over 250, squat and dl over 225 all pain free. I dont give a fuck what anyoen says, i never thought id lift again, and despite the little weights, this is huge for me. LEARN YOUR BODY AND DONT GIVE UP OR UR BODY WILL GIVE UP TOO

Rule out slipping rib syndrome. It’s not a sure shot that it’s your problem, but it could be, or it could be contributing. It can cause extreme painful muscle spasms and trigger points to develop. It’s often overlooked by typical doctors.

[quote]bignate wrote:
check out mckensie method, or however its spelled, if its a disc issue this should help, if not, u can be happy its not a disc issue.
Also look at dave tates iron evolution phase 7 on this site, you may need to do some individual programming if u cannot get help from a good pt or whatever, your body most likely needs how to properly function, light cable rows with sholders down, neck out of the movement, squeeze the shoulder blades, retract the elbows along ur sides etc… push yourself on fucking cardio if u cant do anything else, i would not, repeat i would NOT push urself on pressing exercises even if its pain free. Something is seriously out of place, and u need to take the time to adress and figure it out.
Ive been in the same boat before, the method i mentioned helped alot, but it ended up being smart programming, LAst year this time ic ouldnt bench 135, could curl 20lbs, my shit was fucked. I can bench over 250, squat and dl over 225 all pain free. I dont give a fuck what anyoen says, i never thought id lift again, and despite the little weights, this is huge for me. LEARN YOUR BODY AND DONT GIVE UP OR UR BODY WILL GIVE UP TOO[/quote]

THIS.
Well said.
I had a wrist injury that became a shoulder injury that became a hip imbalance that caused valgus of the knee and a lame ankle. After doin’ the regular thing (ridiculous rehab exercises, pain killers, “pushing through the pain”, 3 chiros, 2 doctors, cortisone shots, acupuncture, and even a fucking therapeutic hypnotist) I realized that maybe nobody can help me but myself. It was by no means easy, but know there is definitely hope.

I thought I’d never overhead press again due to the mind-numbing pain of reaching overhead. It is now my favorite lift (next to the DL). Listen to your body; it will not only tell you when you’re fucking up, but also when you’re locking it down.

[quote]Ray567 wrote:
Rule out slipping rib syndrome. It’s not a sure shot that it’s your problem, but it could be, or it could be contributing. It can cause extreme painful muscle spasms and trigger points to develop. It’s often overlooked by typical doctors.[/quote]

I have never heard of this but I have a rib that keeps slipping out on my right side. My injury is on the left, and the past few days I have growing suspicion that there are ribs on my left side that are slipping as well.

The scary thing about individual programming is that I am completely unsure what I should/should not do. Even if something is pain free, it could end up being dangerous, and with spinal injuries, you don’t want to fuck around. So far the PT’s have offered no help on this matter.

[quote]howie424 wrote:

[quote]Ray567 wrote:
Rule out slipping rib syndrome. It’s not a sure shot that it’s your problem, but it could be, or it could be contributing. It can cause extreme painful muscle spasms and trigger points to develop. It’s often overlooked by typical doctors.[/quote]

I have never heard of this but I have a rib that keeps slipping out on my right side. My injury is on the left, and the past few days I have growing suspicion that there are ribs on my left side that are slipping as well. [/quote]

Definitely get that examined. Other approaches may be able to work out trigger points and tight muscles temporarily, but unless you can get at the genesis of the problem, the pain won’t go away.

[quote]howie424 wrote:
The scary thing about individual programming is that I am completely unsure what I should/should not do. Even if something is pain free, it could end up being dangerous, and with spinal injuries, you don’t want to fuck around. So far the PT’s have offered no help on this matter.[/quote]

start with what is known to be safe based on loading. Example, for 1 month get rid of any direct spinal loading, i.e all back work should be chest supported/from cables rather than bent over rows, all leg work should be single leg, db loaded, core work should not be focusing on flexation, but rather stability i.e plank variations, cable shit ect… you gotta do some of ur own research and find what others have found, except apply it to your situation. Shoulders hurt? stick to partials with high reps to facilitate blood flow ect… doing cable flys on a bench can help stretch the fuck outta ya pecs and retrain ur whole shoulder gurdle to have proper ROM.
Learn how to not use your neck to lift, i.e maintain a neutral head position, no tucking, extreme looking up, keep those traps down, try tempo techniques to learn how to use ur muscles you want to target.

that help?

i like upper/lower/off/upper/lower/off/off, excpet on my off days i still do cardio, upper back work(cable pullaparts were huge for me) and core work. BALANCE THE FUCK OUTTA YOUR BODY AND TEACH IT I SAY TEACH IT HOW TO MOVE PROPERLY.

our bodies are incredible at adpating, hell i have no fluid in most of my lower discs and im 20…i pinched a nerve in my shoulder 1 year as mentioned, have dealt with chronic neck spasms for 4 years plus, and havent had one in the past 6 months now. havent had a back spasm in a year and 6 months. All do to proper training for ME, not because of ‘rehab’ exercises. Your body knows what you teach it. Teach it to perform and it will, teach it to rehab and thats all it will know but that aint shit unless it move properly.

[quote]bignate wrote:
that help?
[/quote]

Yes. You have been a huge help for me so far, and I hope the others who are dealing with injuries are taking something out of your posts as well. I’m going to see a chiro tomorrow afternoon so check out my ribs, and I have a physio appointment scheduled for early next week basically as back up. I have a great chiro so hopefully she can get to the bottom of this Scooby Doo mystery.

[quote]howie424 wrote:

[quote]bignate wrote:
that help?
[/quote]

Yes. You have been a huge help for me so far, and I hope the others who are dealing with injuries are taking something out of your posts as well. I’m going to see a chiro tomorrow afternoon so check out my ribs, and I have a physio appointment scheduled for early next week basically as back up. I have a great chiro so hopefully she can get to the bottom of this Scooby Doo mystery.
[/quote]

sounds like a plan, and yes, i hope others who are injured can get something out of my posts, its about the only topic i really have any use in now hahaha, either way just dont let other peoples opinions get you down. I was told never to lift again, that made things 10x harder to be proactive when everyone is telling you to not do what you love. Post an update when ya get one, i try and browse these forums pretty often and wouldnt mind hearing what ur chiro says, and what you plan on doing/how it pans out.

I’ve got an appointment with my chiro tomorrow also, just got x-rays that he’ll look at. I’ll ask him about slipping rib syndrome.

Thank you everyone for posting, it’s giving me some ideas and hope that i’ll get better.

Howie, how is your posture, and have you had any imaging done? I know I have somewhat excessive kyphosis in my thoracic region and my neck is almost completely straight, hardly any curve at all. Let us know how your appointment goes tomorrow.

OP,

First off, you’ve been dealing with this issue for 6 years. In light of this, your issue is less likely an ‘issue in the tissue’ and more likely due to a sensitivity change in your nervous system. The physical therapists you’ve seen are telling you what they learned in school, which has no evidence to support it’s effectiveness. Overall, the only prognostic indicators for neck pain chronicity are psycho-social factors, not physical or postural changes. The ‘fix your posture’ stuff is code for ‘I don’t know what’s wrong with you.’ A loss of lordosis has no correlation to neck pain in any subjects, especially those with chronic neck pain. Further prognostic studies demonstrate that subjects with neck pain greater than 52 weeks do not have resolution of those symptoms in long term follow-ups.

Some would take this information as a downer and you should not. What I’m trying to do is save you time and money and educate you. The good news is that your nervous system is plastic, meaning it can ramp up and down it’s sensitivity based on your thoughts, emotions, stress, lifestyle and sensory stimuli you provide it. With that said, use the idea of watering the grass for your return to activity: too much (dead), too little (dead), small frequent bouts (bingo). Continue with all the exercises that do not increase your symptoms and very lightly initiate the aggravating activities in a very low level, lightly progressing fashion. This is called graded exercise. Do not worry about ‘hurting your posture.’ This is nonsense. These so-called physical therapist are not up to date with research.

The last suggestion I have is to read this…

http://www.scribd.com/doc/76262847/Explain-Pain-Dr-David-S-Butler-and-Prof-G-Lorimer-Moseley

Of course everything I’ve said may not be what you want to hear and you may continue looking for someone to ‘fix’ you. Only you can fix you. Cracking your neck, sticking needles into sore spots, rubbing your skin with random tools and being told to sit up straight is not going to change you (and gets expensive). If you take nothing out of this I would recommend reading the link.

All the best

[quote]engineer21 wrote:
Howie, how is your posture, and have you had any imaging done? I know I have somewhat excessive kyphosis in my thoracic region and my neck is almost completely straight, hardly any curve at all. Let us know how your appointment goes tomorrow.[/quote]

I have not had any sort of imaging done.

I seem to have (by feeling with my own hands) an excessive curve at the beginning of the cervical spine, and I also generally have quite a bit of pain in that area. I tend to look down and/or have my head forwards at most times. I get pain from standing for too long, and it gets worse when I sit. My chiro also tells me that the thoracic curvature comes down a little further than normal. but says that this isn’t really much of an issue.

In light of all of this, I have been able to improve most of my posture. I have come a long ways in walking more upright and being able to keep my shoulder blades back and down/keeping a big chest. I have also come a long ways in maintaining a neutral pelvis (still have a ways to go as far as hip flexor mobility is concerned). I have always had an APT but am doing much better with it.

I personally don’t think that these issues are related to my back spasms. While I have been working to improve these, I am seeing no let up in the spasms. I have a feeling that there are some ribs out of place, but I definitely need work on my neck as well, as this is causing issues of it’s own. It feels as if a nerve may possibly be pinched (maybe even causing the spasms?).

So far the physio/pt’s have told me it is mere myofascial pain, but with all of the soft tissue work that I do, there is no way that it is a possibility. If it were myofascial pain, I could have worked it out with a lax ball within a month at the most. I can work the spasm out within 5-10 minutes, BUT it always comes back within a few minutes. There is definitely an underlying issue, there is not a shred of doubt in my mind.

I will check back in after my chiro visit tomorrow. Good luck!

EDIT:

To go along with the post above this;

I have spent the past few months steadily improving my posture - walking tall, sitting tall, standing tell, shoulders back and down, chin up, chest up, etc etc - and I have to say that I have felt NO decrease in pain. In fact it’s continuing to get worse.

Seen my chiro today. I had 6 ribs that were not moving properly/out of place. Most of them were on the right side (and I can feel that some have slipped out already). The left side is where the spasms are taking place, and it feels to have let up a bit. We will see how the next few days go, and I will be doing some light soft tissue work on the spasm. Hopefully the ribs will move properly and stay in place.

I see the physio next week Wednesday as “back up”. I see the chiro on Monday, and if we have recurring issues than I will bring it up with the physio (although this chiro has done way more for me so far than the damn physio).

I am dealing with this issue right now…THIS SUCKS!!! I have to fight in 02 days and haven’t been able to train in like 2 weeks! About all I can do is shoulder presses, and light shrugs for heavy reps. Can’t sleep in certain positions. Tried rolling lightly with trusted friends and it feels great when warmed up. BUT, as soon as someone pressures the neck (Cranks, or guillotines) I have to tap. Gonna try to find a new Chiro this week…

I am seeing success with focusing on mobility/soft tissue work on the anterior hip and the rib cage. Check out mobilitywod.com for more info. I use flossing bands religiously on the hip.

After 1 week the pain is much less severe, and non existent at times. This week I will ad in some reverse crunches courtesy of Eric Cressey, as well as some glute bridges, and possibly some hollow body work.

If things go well, the soft tissue work coupled with the positional work should do wonders.