Pectoral/Lat Atrophy

Bigger Stronger Leaner Injuries and Rehab
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Alrighty, I had a similar issue for 2+ years

Good to see you are going down the avenue of seeing a neurologist, ticks potential variables off the list of things that could be wrong with you.

I had the same issue with a hollow lat, pec atrophy, albeit my pec atrophy was pec minor.

Eventually my index/pinky finger became weak, as did the muscles that I use to externally and internally rotate my arm/shoulder.

What was wrong with me?

Well… apparently I had been repeatedly dislocating my shoulder for years. I was always of the opinion my dislocations were sublaxations as I was always able to pull on my arm, thus leading to my shoulder re-locating within it’s socket, or the shoulder would pop out for a few seconds followed by excruciating pain before popping back in

With each subsequent time this happened, the side affected would get weaker. My issue was likely an injury to and/or chronic compression of axiliary nerve + brachial plexus mediated by accumulativd damage to my shoulder that took place over years because I have lax connective tissue.

I eventually required fairly extensive recomstructive surgery because I kept ignoring pain/weakness as I didn’t want to stop training… I didn’t want to believe something was wrong.

Do you have any shoulder issues? Can you cross the arm on your affected aide over to the other side of your body?

If you perform cable internal rotation for reps do you have any pain? During external or internal rotation, do you feel one side of your shoulder girdle/rotator cuff complex contracts harder than the other?

Can you contract your traps (lower and upper) equally on both sides

Just going by what happened to me… your pathology may have nothing to do with your shoulder. Biggest irritance for me was weakness and eventually substantial atrophy in pec minor and lat.

Labral and RC tears can be degenerative as opposed to acure in nature. If the above describes you an MRI WITH contrast or MR arthrogram (latter is best with contrast injected into joint) is gold standard for diagnosing pathology of shoulder tendons and cartilage. These tears can irritate nerves surrounding, particuarly axiliary nerve which is the nerve that innervates lattisimus dorsi. Especially if imaging identifies paralabral cyst

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@Winston79 you live in a land rich of all kinds of great practitioners there in San Francisco. Just a quick search and found many great contacts for you. Here are two among the many:

DR. ALLEN WOOD DC
ULTIMATE SPORTS MEDICINE

Phone: 415-563-1655
woodmac@sbcglobal.net
www.ultimatesportsmedicine.com/
3727 Buchanan St., Suite 203, San Francisco, CA 94123

DR. TAMMARA MOORE DPT

Phone: 415-755-3654
www.tammaramoore.com
300 Tamal Plaza, Suite 100, Corte Madera, CA 94925

Both practitioners are very qualified to help you with dysfunctions similar to what you are reporting, or help detect many other neurological and biomechanical causes. At the worst, they probably have trusted referral sources to help you get to the bottom of this.

Please, let us know how it goes and what you discover. Just like @unreal24278’s post, it may help someone out there.

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@unreal24278, fantastic post. Thanks for sharing that!

You found a great neurologist who obviously did a great job of deduction. The neurological symptoms in your index/pinky and your report of shoulder pain and dysfunction is a clincher.

Building off what you said, looking broader than the apparent area of symptoms is important. Symptoms such as an atrophied muscle, pain in a specific area, etc can get us as practitioners hyperfocused on the obvious points of pain. Getting a comprehensive history and sharing with your practitioner everything going on, even when it does not appear related, can be extremely helpful in diagnosing the problem.

Thanks for sharing your experience.

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Believe it or not, it was actually a GP that deduced the problems were related to my shoulder

He sent me off to an orthopaedic suregon, suregon ordered MR arthrogram as i’d specified my last non contrast MRI for my shoulder hadn’t shown anything

Extensive damage was found, even had a paralabral cyst alongside multiple tears.
@Dr_Grove_Higgins

Real question is… how long does it take to get the muscular strength back? My pinky/index finger, lat and pec are getting stronger again.

But can only contract these muscles like 70% as much as the other side (used to be like 30% pre surgery)

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That makes more sense. Not a typical Neurologist area of experience.

Healing of the nerve has a couple of aspects to it that determine how long healing is and complete it can get.

  1. One answer is how extensive the actual damage to the nerve is. It takes a long time for nerves to regrow their axons. There are things to do to improve that rate, but if the damage is extensive enough, it may be limited.

  2. A more positive aspect may be that the area in the brain that drives the sensory (signals coming from the area to the brain) and the motor (signals coming from the brain to the muscle) have been impacted and need to be retrained. Strength is about the recruitment of the muscle by the nerve going to it. But that starts in the brain, where the brain has a “map” of the area made up by the sensory input coming from it (joints, skin, spindle/golgi organs, etc) and the motor “map” of the area that the brain has to activate the muscle to make it contract the way you want it to. This is over simplified but basically the way it works.

So, if that is true, coming up with a training program to enhance all aspects of the sensory input from those areas the nerves go to, the pinky/index finger/lat/pec, and stimulate the area in the brain to rebuild may enhance strength through rebuilding lost neuromuscular recruitment.

I have asked my partner to join T-Nation Community because he is really good at putting together programs specific to this kind of problem, and I want his voice in on it. Look for a reply from @Coach_Pat_Marques here very soon for you @unreal24278 .

The cool part is that this same idea we use in the clinic enhances athletes’ “normal” strength and performance too. He can speak to that too.

Nutrition, red light, magnetic therapies, electrical stimulation, and such can be helpful too.

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Hello all,

Obviously impossible to give individual-specific advice without a ton of history, assessments, etc. But in situations like this we are looking at trying to find input at various levels that improve output. In this case, we would look at sensory receptors, peripheral nerves (and perhaps spinal cord), parietal lobe (where the sensory cortex lives) and frontal lobe (where the motor cortex lives).

Your first goal is to find a reliable functional assessment. From this discussion it sounds like grip strength (for the issues in the hands) or isometric strength (pectoral) would be good. I then test various sensory input on the dysfunctional muscles areas, and immediately reassess. In this way we can find if there is a particular sensory input that increases motor output.

Easy example: Flexing the left pec as hard as possible to get a sense of force output. I would also do the right pec so you have a “norm” to measure against (this assumes you don’t have a dynamometer to get objective measurements). Then apply vibration input to the left pec for 30-60 seconds - you could use any vibration device like a percussion gun, vibration ball/roller, massager, etc. I’ve even had clients use the bottom of an electric toothbrush! After applying the sensory input, immediately reassess the left pec force output. If you feel even a little bit of increase, then you know that sensory input is positive and you’ll want to use it very often.

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@Dr_Grove_Higgins

Thanks I will explore these options. Here is a 5 sec video of someone with C7 nerve compression and pectoral muscle wasting.

It’s how my chest feels.

https://www.instagram.com/p/CLOEB62jQQI/?igshid=YmMyMTA2M2Y=

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@unreal24278 Wow that’s a story.

I have a history of Shoulder issues on the same side. ( inflammation flare-ups and slight instability).

Int/Ext rotation seems to be the same on both sides.
Lower traps contract the same and the upper left trap slightly less.

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@Coach_Pat_Marques

Have you seen electrical stimulation help with muscle wasting from nerve issues? (Note: Without the EMG this is me guessing)

This input/output interplay is very interesting.

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It certainly could, as something like a TENS unit would not only be driving muscular contraction, but also sending signal to the brain (input) that would better map the area.

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@Coach_Pat_Marques

Do you have a at home TENS unit recommendation?

Its my left chest area (heart) so I couldn’t use it?

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@Winston79 TENs can definitely give you some stimulation benefits. There are so many and cheap units on the market now that you can’t lose. Here a bunch off Amazon that look good: Amazon.com : tens unit muscle stimulator I’d go for the one with the highest rating and number of reviews that sounds like you.

To step it up a bunch, since it sounds like there is no ongoing progressive nerve damage, you may try doing something more aggressive that targets enhancing the connection between the muscle and nervous system directly. The Neufit neuromuscular training system may be of significant help. Go to a practitioner, and if it does help, you may consider getting certified and owning a unit yourself, even if you only use it yourself. Here is a link about it: Treat, Recover & Train with Neuromuscular Electrical Stimulation | NeuFit®

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@Dr_Grove_Higgins safe to use on left pec? Obviously don’t place on top of heart area.

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Yes, should be.

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