T Nation

Scapula Rib Head Problem

I have had back pain, dull ache that keeps me awake at night for 4 months now. I have not worked out in over 2 months. Been to many Physical therapists and chiros and they simply do not help. Every exercise they gave has caused more pain.

Basically this is what I have below:

“What you have is a scapula problem. That is a bone that slides around and moves over the back of your rib cage. You need lower traps, rear delts basically everythig around the upper back shoulder area to start pulling back more so it doesn’t get pulled forward by your stronger chest muscles. Read about aligning shoulders and pulling back the scapula.”

Basically I am wondering what exercises I can do at home to rehab myself?

I think the problem with the Physical therapy was alot of the exercises they made me do. They made me do like 15-20 reps and the lats would end up coming into play causing injury. If I can avoid that like very strict rear db flies I figure that might work? But I dont know what other exercises can help. I do know any rowing is a no no and upright rows hurt me last time as well.

Google “Diesel Shoulder Rehab”, follow that. Also do incline scap push ups daily (50 reps, 3-4 sets), and unweighted prone Y’s and T’s every day to help activate the lower traps.

I had this with my right scapula mainly, though my left one wasn’t much better. Scap pushups (start with an incline, im still doing incline scap push ups even after 4 weeks of doing them), push up plus, DB pushaways all hit the serratus anterior (when doing these, it’ll basically feel like the lat under your armpit doing the work. it’s not).

It’s been 4 weeks for me, and most of those exercises I started doing on my own after my own research, the PT only had me do scap pushups and way to light DB pushaways. It’ll take some time, but my PT has seen great progress on my winging scapula.

Also stretch the pecs and lats, and make sure to stand/sit with good posture. Everyone (chiro, PT) told me rear delt exercises wouldn’t really help my issue, though yours is slightly different so if you can do rear delt flies go ahead, though I would avoid having your hands pronated like the machine forces you to do. I’d recommend neutral grip (palms facing each other).

and avoid pressing movements. Basically you’re trying to loosen up your front and tighten/strengthen the back of your body.

It takes time, your likely not going to do this for 2 weeks and be cured, but it helps. After 1 week the improvement on my right scapula winging was significant, though not “normal”, and it still isn’t normal but it is much better.

the problem is none of these exercises hurt at the time. Its only hours later at night my left lat area will throb keeping me awake. And usually it will take 1-2 days before the throbbing stops and I can sleep again. Although I know if I dont do anything, I can sleep better but it never heals.

Which exercises hurt it? Every one of them? pressing movements? scap push ups? prone Y’s?

If your scapula is winging or pulled forward, you have to loosen up the pecs/lats and strengthen the lower traps, rhomboids, and serratus anterior.

Do you sleep on your back? Side? stomach with your arms under your head?

Pain in the upper back could be caused by anything. If I had pain that kept me up at night for 4 months in the thoracic region I would go see my general practitioner to clear anything sinister. If you have already done this, ignore.

you should probably row…just dont use ur neck.

[quote]McMusclesNHam wrote:
the problem is none of these exercises hurt at the time. Its only hours later at night my left lat area will throb keeping me awake. And usually it will take 1-2 days before the throbbing stops and I can sleep again. Although I know if I dont do anything, I can sleep better but it never heals.[/quote]

This is a long shot but if you take any supplements like curcumin, resveratrol, maybe even grape seed extract, cut them out. I had a similar sounding delayed onset throbbing/stiffness like you describe in my rt trap. It mostly went away when I stopped taking resveratrol, then it went away even more when I stopped taking curcumin. Hate to say it, but it came back when I tried Brain Candy so I cut that out too.

[quote]McMusclesNHam wrote:
the problem is none of these exercises hurt at the time. Its only hours later at night my left lat area will throb keeping me awake. And usually it will take 1-2 days before the throbbing stops and I can sleep again. Although I know if I dont do anything, I can sleep better but it never heals.[/quote]

I have similar issues with my right scapula. Been going on for ten years. I had quit weight training all together and just ignored it until this past year when I started actively looking for solutions. It sounds like your PT might be on the right track. Like you, I can do most exercises pain free but suffer with pain and muscle tightness/spasms later. I’ve been told this is because of basically developing dysfunctional muscle firing patterns and whatnot. My scapula is hiked so the supporting musculature isn’t functioning as it should. You souls like you’re in the same boat.

are you shrugging up / using your traps?

don’t do that.

can you set your scapula down (anti-shrug) then retract it back (squish your shoulder blades together at the back)?

do that.

work the lower part of the lats rather than the upper lats / upper traps…

to help your scapula so it doesn’t wing out away from your body / so it doesn’t jam your shoulder joint / so it doesn’t impinge your suprascap.

maybe.