Collarbone and Shoulder Pain - First Rib?

[beefnewton]

Been having issue lately with left shoulder. Collarbone pain in one spot along with shoulder pain. It's been an ongoing issue that seems to be related to left scapula. The best I've been able to determine, it's something to do with that first rib but could be wrong. If I raise my right arm laterally, the right shoulder can touch my ear near effortlessly; motion is fluid with no resistance. However, if I do the same on the left side, I start to feel resistance, and there is a very visible gap between left shoulder and left ear... and that's if I force it all the way up because it starts taking increasing effort to raise all the way up. It feels like there is some kind of internal resistance under collarbone in that first rib area. I think the pain in my left shoulder is due to stress being shunted where it shouldn't because I am compensating due to decreased mobility in that area. Laying on and massaging out a Lacrosse ball on my upper left back is painful, and while it does help, it doesn't cure.

Anyone have an idea what I could be doing wrong or should be doing? Another symptom is with dumbbell shoulder presses. The right side can move straight up and down easily. The left side, however, about 3/4 of the way up, that internal resistance starts being felt in left collarbone area and I really have to fight against it to keep my left elbow from flaring out. Also feels like I have trouble activating left lat at times.

I have an appointment with a deep tissue massage therapist on Monday. It's helped a lot in the past, but would like to try and figure out what I'm doing to cause it in the first place. I try to keep my scaps pinched together in nearly every motion, but I can't do it 100% of the time because some motions are complex enough I can't keep focus on multiple things.

 

[beefnewton]

Got a deep tissue rundown on upper body, focusing on left side, shoulder and back. Excruciating as usual. Shit makes my eyes water, and at times I gotta say "hold up" while I catch my breath. Left side was predictably fucked up, particularly left scap. Both sides' traps and tops of lats, like spot where it meets armpit were also horrible. She feels like it is definitely scap related, particularly a strength disparity. I looked back, and this also started a few months after I got t-boned in the driver's side. Air bags were deployed as well. She feels like that also has some definite involvement. I had been lifting 3-4 years prior to that accident and never had this problem. My coach today also had me do some motions that really exploited any difference in strength between either scap, and it was so obvious. I think I stopped being able to effectively activate it after that wreck with that scap weakening since everything around it was trying to compensate, so now I'm left with some fuckery painted into a corner of pain. Have a PT appointment on Wed. I'll keep this updated in case anyone else has a similar issue in future.

 

[beefnewton]

Had a great visit with physical therapist. She ran through various mobility tests and pinpointed the problems straight away. I don't know what caused it. Maybe the wreck did something, and I started overcompensating. Then it just snowballed from there. But the basic problem is when I pinch my scaps back I am not pulling them down. I remember being told that before, but over time, I lost the "down" part and had just been pinching them together horizontally. My right side must be doing it still to some extent, but my non-dominant side not so much. My pecs are also really tight, which have a tendency to pull my shoulder forward. So what happens when I'm doing any motion where I should be pulling scaps back and down (just about everything) is my shoulder is still rotated forward a bit, which ends up putting stress into that area. She had a lot better explanation with more accurate wording, but that's what I got. This has been a long-term issue that my previous gym/coach never figured out, and I'm pretty fuckin' annoyed given that's supposed to be one of their strong points. Got some homework, now. She did some deep tissue on lat, pec, and scalene area, and my shoulder feels pretty good right now.

TL;DR for all of this. Pinch your scaps back and down so shoulders get fully rotated back to put things in proper positioning.

 

[beefnewton]

Follow-up. Everything has been wrong. Not to say I didn't have a strength disparity with the left lat and scap, as well as bad tightness in left pec. I've been getting better about stretching and balancing that out, and that mind-body connection with my left scap seems to have improved. But at the end of the day, after an x-ray and a few chiro sessions, I was told I simply have arthritis in my shoulder and that any further adjustments wouldn't help and in fact could make the pain worse. I'm stoked to have a diagnosis of arthritis. I love getting old.

I did start some low-dose NPP which I will ramp up by 5mg increments every 7 days until I find a minimum effective dose.

Not really much to be done other than approach things from a... palliative... direction.

 

[genetic freak]

Sorry brother, I am just reading this. I would have guessed it was arthritis from your description. I had something similar and tried physical therapy on and off for a few years. I had x-rays and an MRI and the orthos never said anything, kept sending me back to physical therapy. Finally, I got a new PCM who happened to be an orthopedic surgeon. He took one look at my images and said you have been wasting your time and the only way you can fix that is surgery. I was in surgery two weeks later and they just cut out the arthritis at the end of my clavicle. Never had an issue since.

 

[beefnewton]

Sorry brother, I am just reading this. I would have guessed it was arthritis from your description. I had something similar and tried physical therapy on and off for a few years. I had x-rays and an MRI and the orthos never said anything, kept sending me back to physical therapy. Finally, I got a new PCM who happened to be an orthopedic surgeon. He took one look at my images and said you have been wasting your time and the only way you can fix that is surgery. I was in surgery two weeks later and they just cut out the arthritis at the end of my clavicle. Never had an issue since.

Well that's interesting. I honestly don't know much about arthritis, but I had no idea affected areas could be simply removed. I get a lot of popping clavicle area along with trap pain (center) and pain dead-on in the shoulder joint, which is the worst of it. How long was recovery?

 

[genetic freak]

Outpatient surgery, only took pain meds the first day, sling off in two weeks, full ROM in 4 weeks and I was in the gym in 8 weeks lifting more than I was before the surgery.

They literally just chop the end of the clavicle off, about half an inch. They also had to do a little rotator cuff clean up, but not much.

 

[beefnewton]

Circling back to this after all this time. My shoulder continues to improve. This was an interesting problem.

1. I was not truly and completely pulling my scaps back and down when doing pressing motions like Bench.
2. Over time, I developed an imbalance, pushing more with left side than right. But also because of the lack of scapular engagement, too much stress was being dumped into that left shoulder causing chronic pain and issues with other motions.

Now when I Bench, I am conscious of trying to push equally with full scapular engagement, and that last rep, the one where I need a spot, that right pec is clearly weaker because I've been favoring the left side so much. But with that spot, I still force myself to try and push equally. I can feel it happen as I will start shifting leftward so I can get that stronger left side under the bar more... so I just force myself back into a neutral position.

Not a damn thing to do with "first rib," and it was nothing any chiropractor could fix. Furthermore, the physical therapy I had was a freakin' waste of money and time. It took a good coach to figure out the root problem and not try to keep fixing the symptoms.

I did Bench tonight, and my shoulder feels pretty damn good. That constant pain where even just daily living was being affected is gone.

 

[genetic freak]

The body can be weird. A slight misalignment or nerves not signaling evenly when performing movements can cause issues that only get worse over time due to overcompensation of other muscles. I am glad you were able to get a coach to be able to notice this. I have found the best coach for noticing stuff like this, posing coaches. When you really struggle to get into positions or get specific muscles to fire, a good posing coach can almost always diagnose the issue.

 

[Yano]

I just found this and got it all read , my first thought was pressure on the brachial plexus or injury.

The space between your first rib and collarbone is called the thoracic outlet and there is a lot of stuff in there. I'm not a clinician at all or even been to school past 10th grade but ,,, it sounds like TOS of some form or another.

 

[Yano]

The body can be weird. A slight misalignment or nerves not signaling evenly when performing movements can cause issues that only get worse over time due to overcompensation of other muscles. I am glad you were able to get a coach to be able to notice this. I have found the best coach for noticing stuff like this, posing coaches. When you really struggle to get into positions or get specific muscles to fire, a good posing coach can almost always diagnose the issue.

I'm going through that with my back and left leg,, I think i'm walking fine until i see myself in a mirror and realize how im standing and moving to compensate the quad in my leg not getting proper signal.

 

[rawdeal]

I just found this and got it all read , my first thought was pressure on the brachial plexus or injury.

The space between your first rib and collarbone is called the thoracic outlet and there is a lot of stuff in there. I'm not a clinician at all or even been to school past 10th grade but ,,, it sounds like TOS of some form or another.

Wow, my limited reading first saw a reference to TOS in an article in the late, great PLUSA mag, authored by the late, great "Dr. Ken" (Leistner).

Leistner was the blue collar guy whose love for lifting heavy things, and for those who do it, led him to pursue a career as a Chiropractor. His practice probably included regular folks to pay the bills, but his passion was for guys who challenge their bodies with as much Iron as possible. For years, you could not go to a major PL event without seeing him scurrying around doing on-the-spot pro bono work for the lifters.

You may be on to something, Yano.