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Neck Muscle Experts

Hi all. I don’t want to go into too much detail about past injuries, to avoid diluting the topic at hand. A basic summary (earliest to most recent): impingement syndrome in left shoulder, osteolysis and surgery in right, instability in left due to laxe joint / weak suprispinatus / overactive trap.

My current issue is primarily in the left shoulder. It is very laxe, and has been for many years. I do a lot of strengthening work, rehab band work, cuff exercises, stabilizer work etc. What I have found is that it is not just the shoulder and associated stabilizers, but also the neck and pecs which are heavily involved in the problems. This is as follows:

  • I find the left pec activates during many shoulder exercises / rehab work. I tried doing a lot of stretching but it still gets heavily involved
  • together with this, there is stress/tightness running all the way from the pec insertion point, into the delt and up the neck
  • it goes all the way into and up the anterior of the neck, sometimes as far as the lower face (especially movements such as shrugs)

I would like to know if any experts on musculature out there can help possibly identify what the issue can be, how to ease or resolve it (any exercises, strengthening or stretching??)

I do not know the structure too well but from some research I think the muscles involved are:

  • chest: pectorals
  • shoulders: anterior deltoid, other muscle around front of shoulder / chest region
  • neck: this is where I tried to focus my research
    — Sternocleidomastoid (sternomastoid): ear to clavicle
    — Platysma: fascia covering superior part of pectoralis major and deltoid
    — Sternohyoid: origin at sternal end of clavicle

Any assistance, advice or suggestions are welcome!

X

BUMP…can anyone perhaps help out?

Do your scapula’s wing out? or lay flat?

Wing out. I’ve had scapular winging for as long as I can remember.

[quote]xenithon wrote:
Wing out. I’ve had scapular winging for as long as I can remember.[/quote]

TADA!

read Eric Cressey’s “Shoulder Savers” articles listed below. These may help you out.

Shoulder Savers I
http://www.T-Nation.com/readTopic.do?id=1053531

Shoulder Savers II
http://www.T-Nation.com/readTopic.do?id=1055409

Shoulder Savers III
http://www.T-Nation.com/readTopic.do?id=1153915

Also read this:

Neanderthal No More Part I
http://www.T-Nation.com/readTopic.do?id=459379

There are 5 articles in this series so make sure you read them all.

External Rotations and Scap Push-ups will be your best friend for now on.

You might want to send Eric a message also since it sounds like you have some pretty serious issues here.

Good luck and keep us updated.

I can’t imagine how you skipped over the scalenes. These can be huge fucking troublemakers. When you said “up the anterior of the neck” I immediately thought they might be part of the problem.

Try some neck strengthening exercises (head hanging off the bed works…just keep your neck straight for an extended period of time), check your forward head posture and DON’T CHEST BREATHE. I have a feeling this is what got you into the trouble you’re in.

Chest breathing highly overtaxes the scalenes and can make them clamp down on vessels, nerves, whatever. Sucks. What you want to do right now is work those deep neck flexors, the ones that keep your chin tucked. Tuck your chin on all of your big upper body lifts-bench and rows especially, but also overhead presses to make sure the traps don’t take over.

On shoulder exercises, try to push your deltoids DOWN while raising the weight. I have some shoulder issues similar to yours and am able to skirt them (although not entirely) by doing this.

Also, I would get off all shrugs for at least a little while. I have a feeling your scapular elevators and anterior neck muscles are stressed enough as it is. Get some massage (deep tissue or trigger point) or ART if you can afford it, or you can do-it-yourself at home. Good Luck.

Hi there and thanks for that info. I will try those exercises. I have indeed stopped shrugging - I do a different type though now (horizontal - essentially like a shrug on a cable row machine) which is meant to strengthen the lower traps and help prevent the upper traps take over.

A good way to describe what I am feeling is that my left pec takes over many pressing and other movement. Furthermore, the left trap “shrugs” during many movements such a pressing movements and this in turn puts stress on the neck too. It feels like the pec ties in with a nerve right into the neck/face.

X

[quote]xenithon wrote:
Hi there and thanks for that info. I will try those exercises. I have indeed stopped shrugging - I do a different type though now (horizontal - essentially like a shrug on a cable row machine) which is meant to strengthen the lower traps and help prevent the upper traps take over.

A good way to describe what I am feeling is that my left pec takes over many pressing and other movement. Furthermore, the left trap “shrugs” during many movements such a pressing movements and this in turn puts stress on the neck too. It feels like the pec ties in with a nerve right into the neck/face.

X[/quote]

I’m pretty sure a nerve does run down your neck, into your pec, and down your arm.

I have some shoulder issues similar to those described – don’t know if they are related to the neck or not. I don’t, to my knowledge, have any of the “pec take-over” issues the OP described.

I’m interested in this, though, and just wanted to ask the OP to give an update – in some weeks, months, whenever – as to how he’s doing and how he responded to what treatments/exercises.

Thanks.

Will do. I currently already do quite a lot of work/exercises based on the rehab I got post-op, primarily for shoulder. Includes :internal/external rotations with DBs and bands; scapular pushups, scapular shrugs, laterals with thumbs pointing down and to 30 degrees in front of body (targets suprispinatus) etc.

I will be adding the suggested exercises hanging neck over edge of bed; as well as stretches listed here: http://www.nismat.org/orthocor/programs/neck/neckex.html and a broomstick exercise suggested by someone on a nother forum who has the exact same symptoms and issues. Essentially involves just holding a broomstick and, with arms remaining straight, very slowly raising it to eye level and then raising it above the head. This is done very slowly and focusing on keeping the shoulders back and down and tight, so that the pec/neck/trap/lats do not take over. If they do or if any pain starts on either side, restart. He also suggested going BTN presses with the broomstick while keeping the shoulders very tight - to practice and develop shoulder girlde stability.

Cheers,
X

As a heads up, I would be very cautious when using the “supraspinatus raises”. The thumb down position internally rotates your humerus which in turn will decrease sub-acromial space. This is a major site of impingement issues. One of the major compensations for pain secondary to impingement is shoulder shrug compensation (over-firing of upper traps).

While I am no expert in Neuroanatomy, it seems as though your problem likes in the upper neck, close to the base of the skull. Look on google or another site for a diagram of cervical nerves, paying attention the first 4 (C1-C4) and you’ll see what I mean. The best person to help there would be a chiropractor, and mention to him/her what you have said here.

The exercises proposed so far seem good, however to truly overcome the lax shoulder will be deeper than a few exercises. Spend a good amount of time stretching, focusing mainly on the upper neck/head region. Anway, a chiropractor would be able to gently knock your vertebrae back into place, and release some of the pressure being placed on these cervical nerves.

The reason for this laxness from your injuries follows the “use it or lose it principle”. Since you’ve had many injuries you’ve obviously used the muscles in this area to a lesser extent than someone without injuries, so the rehab work your doing will help to rebuild the muscle memory loss (what I mean by this is that it will literally build new synapses between the pyramidol motor neurons terminating in these areas). However, looking at a dermatome graph of the human body, the problem your not seeing the results you want could be due to you working an area that is seemingly at the problem site, but it terms of the nerves is below it.

Again, I am no expert in this area, just well read. I wish you the best of luck.

Hi guys and thanks for the info.

dra - will do about those suprispinatus laterals. The exercise I was given didn’t actually state thumbs down (I added that) so I will stop that to prevent further possible impingment. The key was to bring arms 30 degrees in front of the body and to try keep the traps inactive.

I actually have an appointment with the chiro tomorrow…what should I actually tell him. With the influx of info I am somewhat confused about what to explain and what to try target.

Is it the laxe joint? Overactive trap, neck and pec? Nerves?

Thanks in advance,
X

[quote]

I actually have an appointment with the chiro tomorrow…what should I actually tell him. With the influx of info I am somewhat confused about what to explain and what to try target.

Is it the laxe joint? Overactive trap, neck and pec? Nerves?

Thanks in advance,
X[/quote]

Basically just tell him where you hurt, where your strength losses are. He’ll probably give you a full adjustment, but if you mention things like that they’ll pay more attention to the area in question. These guys go through just as much training as MDs, so theres no need for you to know anything more about the injury that to be able to point to it in this case. Good luck with the future