T Nation

Right Side Issues: Atrophy/Pelvic Tilt/Scapular Winging

Hi all,

Sorry for the long topic, but I seem to have some ongoing issues that I need some potential advice on. First I would like to say I would not normally post to look for answers like this, but I’m in the field and usually help people with their issues/injuries. Currently I’m unsure which of these issues came first, but they are all pretty present now and causing me many problems. I can add whatever pictures anyone will find helpful.

A while ago I noticed that my right arm/shoulder seemed to hang a bit lower than my left, but never really thought much of it. Over time It seemed as though it was also a bit more forward rolled and potentially winging in certain positions (for example when pressing my right arm feels longer). Along with this I started to realize my right pectoral was starting to indent from the inside and atrophy (currently it is almost full atrophied). When i attempt to flex the pec I can’t really see any muscle fiber firing.

Along with the right pectoral atrophy I started to realize that even the glute/hip/lat on that right side all seem to be smaller/atrophied compared to the right side. For example, it seems that my right serratus is taking over for activity my lat should be doing (I feel my serratus is much more muscle massed than my left). Overall I just feel like nothing is working and my body is completely off balance.

I read in another injury topic on here something that I’ve also been experiencing. It feels as though my abs/glute on that right side have a hard time contracting as good as the left. Just about all muscles on that right side in general seem to have that problem (which could potentially be from a pelvic tilt?)

To give a bit more background:
-I’ve been to multiple neurologists
-I’ve been to the Ortho
*I don’t think it helped that I came in overall decent shape to the “eye” because they assumed it couldn’t be that serious (even with a current loss of entire pectoral) and couldn’t find anything directly wrong

If anyone could give me something helpful to go on that would be greatly appreciated. Let me know if you guys would like me to upload some pictures

From what I understand of the matter, all of these issues could potentially be caused by a pelvic misalignment. In the mirror, does your pelvis look uneven? Is your gait awkward? Does 1 knee hurt more than the other? I would start with working on aligning your hips. Here is a video to get you started.

Thanks for the reply. I don’t look terribly uneven, but I’m not sure what the overall cause was in all of this.

I know how a lateral pelvic tilt can really cause a bunch of issues, but the amount of pectoral atrophy I have makes me really question the root cause.

Crooked hips, crooked shoulders.



Crooked shoulders, offset arms/grip

Pulled forward, rounded over shoulder

If you’re kinda twisted with a rolledforward shoulder and winged scapula your arm is in a spot where its hard to use the pec. Other muscles (maybe serratus or front delt) take over.

Figure out how to pull your scaps into place with mid/lower traps. And how to use your lats and serratus to keep things stable. And your rear delts to get your shoulders in place.

And square up your pelvis so you don’t tilt, twist or slump into bad alignment which dumps your shoulder forward.

Thank you for the info. Seems my serratus has taken over (its much larger than the left one now) since my scap has been wonky. Hard to get the lat to do much on that side as well.

If i posted a few pics up would you take a look?

This whole experience has been the most frustrating

It’s frustrating to have people tell you you’re crazy and that you’re just imagining it! I’ll take a look at your pics if you want.

Really briefly, you could try something like this to loosen up the tight meat under your arm.

Then something like this to get your lat working.

Then when your shoulder is more stable something like this, squeezing until you teach your pec to work again.

I’ll grab some more tonight but here is an example of one from straight on…The right pectoral is completely hollowed out (if i turn to the side you see nothing.

Yeah man, especially from the back you can see the high left shoulder, droopy right shoulder. Tight left mid back and tight right lower back.

Do you have a smaller thigh, and sorer knee on one side? With a sore hip on the opposite side?

I’m following this because my lower back has been F-ed for two weeks, PREACH!!

That sucks!

Maybe loosen up your QL. (i think right side for Fedor).

And do some adductor pull backs (laying on side) like at 5:10 in this video.

Then never, ever squat!

Yeah I’m def shifting in my squat I’ve noticed and now my back is jacked, I’ll look at these videos tonight after work and gym lol. But I will do my defranco agile 8 and the adductor, abductor routine from that hotty earlier in this thread posted by @spiceweasel. Thanks @FlatsFarmer and hope u get sorted out @cfedoriska!

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Its tough to say because I don’t fit the “exact” problem. I know im def missing some meat on the lower right side in the bottom of the back/top of glute. Right quad visibly looks bigger but pretty sure the leg itself is actually smaller. The left trap is very very tight (constant tension) and some pain/tension in lower left back.

Thanks for a lot of the info in this thread. I suppose my final question would be what would be the best order to try and attack these issues?

I see the head physician for the Eagles on Monday morning and I don’t exactly have much hope LOL

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@FlatsFarmer, as always, is giving very good advice. I really don’t see any reason not to work on all areas every day, preferably multiple times per day. Any video by Athlean-X is gold, I’ve received a lot of help from him. Guerrilla Zen is another guy with good tips. Bob and Brad are good as well; start watching as much as you can from all of these guys. Find what’s useful, discard what’s not. This is how I keep my F-ed up lower back in check.


I agree with weasel, find a few exercises for upper back/shoulder and a few for hips/glutes and do 2-3 sets here and there when you have a minute.

Athlean X and Guerilla Zen are good. Move U guys have great visuals aids and go fast. Also you’ll probably have to try some things that don’t work so great in order to find some moves that help you.

Here’s a breathing/bracing drill from @MarkKO

"Try this:

Lie on the ground with your knees at 45 degrees. Pull your abs in, away from you waistline. Then hold your pee, take a big breath into your back, squeeze your glutes and push your hips up. Do three sets of 10.

Then set up in a 90/90, so feet flat on a wall and knees at 90 degrees with your back flat. Do the same process, abs in from waistline, hold your pee and breathe in then squeeze your glutes. this just just hold that squeeze for 10 seconds. Do this 10 times.

Then stretch your glutes, hips, hams, lower back and lats.

Do all three once morning and once evening."

This link is to another guy with shoulder issues. There are some moves and pictures. And a video of some neck/trap stretches.

Here’s a long one about serratus, scap tilt, rear Celts, etc.

A simple routine to get after your hip tilt could be

Clam shell x 8
Reverse clam shell x 8
Seated Psoas Raise with hold at top x 5
Glute Bridge with hold at top x 10


Any news from the Doctor?

Thanks for checking in.

The Dr noted the pretty much full pectoral atrophy and some atrophy in my upper back on that side. He feels a nerve problem/damage is the only possibility at this point (rotator cuff etc was fine).

Now I need to go to another dr for a more detailed emg of the upper right side and take it from there. My serratus is very hypertrophied on that same side.

Super frustrating

Hi all,

Just an update to give anyone following/going through something similar some information. I had a upper extremity emg at UPenn by the chief of the Nueromuscular division. Surprisingly, he found very little evidence to support a nerve issue causing the problems (I still have continuous muscle fasciculations/twitches throughout my body).

I’m once again left with more many more questions than answers. I’m set to meet with Eric Cressey in Mass at the end of the month. Hopefully if it is anything structural he can really get to the bottom of this.


@cfedoriska… any update? Just found this post and I’m going thru almost the same thing. Right side atrophy of pec, delt, back, some scapular winging. Also went to UPenn for EMG, nerve conduction, MRI and nerves look good, blood work for muscles came back normal. Definitely have pelvic tilting (been seeing a chiro for years to help with pain). Muscle wasting of right side upper body has been ongoing for about 1.5+ years. Very pronounced when flexing.

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Just returned back from Boston early Friday after meeting with EC. Had a great visit and he is even better in person.

Unfortunately…it was much of the same with little found structurally that should be causing this much pectoral atrophy. He said I only have a little bit of the pec major left. He recommended seeing a diagnostic physician in Jupiter Florida to try and put this all together.

If you would like to exchange emails/numbers to compare more let me know.

Sorry to hear it. Are you thinking about going down to FL?

I’m definitely interested in exchanging emails… not sure how to direct message on here thou. Just signed up yesterday after seeing your post.