T Nation

Right Pec Won't Fully Contract


#1

SKIP TO “SYMPTOMS” IF YOU DON’T WISH TO READ BACK STORY

So the injury is a little more in depth then tittle leads on. Summarised backstory: I went to a month long fighting class there were a lot of bumps and bruises, but there was only one memorable hit I took to the right shoulder. A little pain initially didn’t think anything of it.

Noticed week three my incline bench was very weak. I thought I was still just dinged up from fighting so I have been taking it easy. It’s been three more weeks and I’m starting to worry. My right arm is extremely weak I can’t do more then 20 or so push ups or bench more than 45 lb dumbbells. (I went in the class doing around 80-100 push ups nonstop and incline pressing 120s for 6). Tricep on my right arm also very weak struggled to hold 20 pounds over my head. No pain in chest shoulder or tricep just extreme strength loss and quickly fatigue. The only source of pain comes from behind my shoulder blade almost exactly opposite of my nipple. I have very slowly been getting some strength back but I mean like a couple extra push ups a week. Up to 20 from 5. Biceps are oddly not affected.

SYMPTOMS:
Right pec won’t contract upper portion right under clavicle. Almost looks deformed next to my left pec.

Right tricep weakness.

Pain in back behind shoulder blade. Feels like a huge knot. Difficult to completely retract scapula or engage lat.

Difficulty pressing or completing a pull up.

Immediately following the class I had elbow pain on the inside of the elbow. (Gone now)

In closing I have seen the doctor took some x-rays to check neck and shoulder. Scheduled a MRI and Physical therapy next month. They think it could possibly be labral related. I have full range of motion in the arm and shoulder.


#2

For once I can’t call what’s up with any certainty. If you’d humour me could I ask a few more questions?

Were many tests performed on you? Do you remember what they were?

Neurological symptoms? Numbness, tingling, loss of sensation e.g. at some of your fingers?

Location of back pain: The shoulder blade is pretty big. Is your pain unilateral near midline near the top of your shoulder blade (or bottom of the neck) or lower?

Shoulder Abduction, internal rotation or external rotation weakness?

Am thinking nerve but you’ve no pain or other neurological symptoms aside from weakness.

Possibly:
Brachial Plexus injury
Nerve root injury/impingement
Nerve entrapment
Peripheral neuropathy
Thoracic Outlet Syndrome

May not be nerve related e.g pectoralis major injury.

Anyways you can see that without some examination and imaging we’ll not know exactly what’s going on.

Monitor symptoms for now. If there’s change probably best to inform your healthcare professional.

Keep us informed and good luck


#3

So far only tests that have been done are x-rays (neck and shoulder came back normal.) When I went to the doctor he grabbed my arm by the wrist and moved it around, across my body, over my head, then we put the arm behind my back and I pushed against his hand. He explained he was looking for clicking, popping, or catching of the shoulder. It did click once but he could not re-create it after the one time.

The pain in my back is very centralised. Just using them as reference points it is inline with T6 T7 vertebrae behind the shoulder underneath the trap (pain is not in lower trap it’s self but underneath it.) Towards the center of the Rhomboid if I had to guess. Also when I turn my head to the left and look down I can feel it in the spot I described faintly. If I pull my arm across my body and press my right shoulder (back facing wall spot that’s in pain pressed against wall or object.) against a wall or a Lacrosse ball it almost takes my breath away. This is definitely the culprit for the in ability to do pull ups because my body is just not allowing me to fully retract that scapula and engage all of my back. The pain is limited to the right side.

Now for the pressing and tricep weakness I am really unsure. Let’s start with neurological indicators: one day during the class my right pec was spazing or twitching almost every time I’d sit down between drilling it would twitch. I just massaged it and shook it off and didn’t think anything of it. As for numbness I have none and no loss of sensation. The only other possible indicator is that when I press my hands together (as if praying) and flex the right side upper pec remains flat on the top just under the clavicle towards the sternum, as if it were not firing in that one location. Bottom portion of the chest flexes normally. Tricep on the right side also very weak mostly when activating the long head.

Shoulder feels unstable at the top of a pressing motion almost at lock out. No issues with internal or external rotation. No loss of strength while doing abduction exercises. (Lateral raises) while doing reverse pec Dec flyers I did have to ask someone if my trap on the right side was activating because I could not feel the pressure from it contracting like I normally do at the very end of that movement.

Overall no pain in shoulder, chest, tricep just weakness and inability to correctly perform exercises when using weights. If I get anymore insight from my MRI or physical therapy next month I’ll update you on what I have been diagnosed as having. Thank you for reading hope this sheds some light.


#4

Tbh shoulder issues seems a leap at least to me but maybe your doc got other some info from the history/mechanism or injury or testing.

The back pain and other symptoms may not even be related. Often if one increases and the other increases also then they can be said to be related. You could have two injuries concurrently with the combined symptoms you have now making hard to figure out what’s going on.

Along with careful monitoring especially for deterioration in your condition, make sure your doc or anyone else you come into contact knows the full extent of all your symptoms. A referral letter may not pass on all the information

Gud luck.


#5

Did you ever figure out what was causing weakness in your right pec and tricep? I’m currently going through the same issues and the symptoms you described are spot on with mine, especially the location of the pain in the back.

If you could give an update, it’d be much appreciated. Hopefully you’re all healed now.


#6

It has been 3 months since the time of my injury. The strength I lost has slowly came back. Strength in the Tricep came back first, pressing took a while longer, and I still get pain in the back from time to time. Chest on the right side fully contracts, however it is still not normal for sure.

I received a X-ray, MRI, and attended physical therapy. Due to poor communication in the medical community I still have not gotten the results from my MRI. Physical therapist said I had slight winging of the right scapula and started treating me for a rotator cuff injury. I eventually stopped seeing the physical therapist when they could not explain why they thought it was my rotator cuff. It just felt like I was on some generic plan someone had drawn up and they didn’t do well listening to my concerns about my chest. Answer I was given is that “it’s all connected.” I had attended 8 of the 10 appointments before I made that decision.

Definitely take it light for a while it felt good to keep lifting while I was healing, but be honest with yourself if it starts to hurt or you know you are compensating just stop and walk away. The desire to see how much your strength is coming back will be a huge temptation. I almost forgot to mention I would get a noticeable difference from left side of the body compared to the right when I had a pump. Left arm or left side of my back seemed to be larger I assume this was compensation. Perhaps I’ll have a imbalance to deal with down the road who knows I’ll cross that bridge when I get there as long as I am not comprising my form it seems trivial.


#7

That’s crazy as I have been going through the same exact thing only on my left side. I’ve had a small disc bulge in my C6/C7 that was hardly noticeable by any doctor. I’ve had the same slight irritation in my shoulder/tricep and pectoral. The most i’ve noticed is when I have done any chest work afterwards it would almost look like my left pectoral was permanently flexed vs my right that just looked more full. I am able to get a small contraction out my left pectoral but not nearly as well as my right and almost seems like I have to move my shoulder to flex my left pectoral.

I’ve gone through the physical therapy as well and might honestly look into getting an EMG done just to be sure. Pretty much given up the gym at this point and trying to focus back on functional health until I can get a handle on this. If you have any other information on your progress I’d appreciate any updates because I am just as fed up with feeling a little better and going to to the gym and trying to rush the process.

Best of luck to your recovery.


#8

Hey gritty I’ve had the same issue for about 4 weeks now
Right side is weaker when pushing - benching - triceps - pull-ups
Been seeing my chiropractor a few times now
Right pec got smaller because of this issue
Scalen muscles are tender and causing pain under the shoulder blade as well
It’s gotten a bit better than it was 4 weeks ago but still pec / lat / tricep won’t fully engage or get a full squeeze on them

How have you been making out ??