Pain in back of upper arm (2)
 

Posting this again after the data loss on the weekend. Dont worry guys I work in the business and it happens to the best of us.

I had previously posted regarding pain in my right upper arm. It flares up most when I play golf so have not played for a couple of weeks to let it rest but I have not seen any improvement. When not playing golf the use of my arm is fairly normal and pain free but It does hurt when I move my elbow straight back behind me or when I reach behind my back, say to tuck my shirt in. The pain seems to come from just below my shoulder joint and radiates down the back of my arm toward the elbow.

Vickie had responded something along the lines of it being an aligment which was effecting my brachial plexus (I recall that thoracic vertebrae, subluxation, cervicals and shoulder girdle were mentioned :confused1 ) and was going to come back with some suggestions for me.

Thanks,

Doug.

Shoulder Pain is a pain
 

Hi dougt, Thanks for the recap. You remembered correctly and I will add that one of the culprits is a rotator cuff muscle, specifically the subscapularis, in conjunction with the pectoralis (chest) muscle and the lattisimus dorsi (large back muslce). Since your pecs and your lats work together to keep the joint open for arm movement, as they attach similarly on the arm bone for movements across and behind the torso small alignment imbalances do not allow the rotator cuff muscles to adequately perform and impingements on the nerves insue. It's a little circumspect without doing some mind kinesthetic testing but I will be on later today and post some exercises that will let you isolate and replicate these movements under controlled conditions, yes that's the exercise segment purpose, with the goal of allowing the body to begin to renegotiate the agonist and antagonistic relationship during a golf swing. It doesn't happen immediately but within a few weeks you should begin to see some improvements. Vickie

Thanks Vickie.

Just a Beginning
 

Dougt: I am putting up two, just two movements for you to initiate and be sure your alignment is working in your best interest. These are foundational movements and I will post more soon.

Standard Form (Basic safety position for all exercises)
Stand with your feet shoulder width apart, weight evenly distributed
between your hips.
Let your weight move back to your heels which will encourage you to
bend your knees slightly to keep your balance.
Your back should still be straight .
Lift your shoulders straight up toward the ceiling as high as you can trying to touch your ears.
Push your shoulders back as far as you can still keeping them raised.
Draw your neck back and up (pulling your chin under) to be even with
your shoulders.
You will feel your neck lengthen as you keep your chin down.
Note: You will feel your back and your chest stretch in this effort. Do Not let your head rock back to hyperextend (your chin would lift to the ceiling in this inappropriate position).
Deliberately bring your shoulders down allowing your chest and back to
expand to full breadth.

Key: In this position your chest will feel forward and 'soldieresque' .This does not feel natural! But we all know exercise is NOT natural, but it works.


Shoulder Stretch Deltoid / Rotator Cuff Joint
Lie on the floor on you back, with your feet flat and your knees bent,
arms byyour side with the palms down
Your shoulders should be down and your lower back will have a natural
curvature, in some cases keeping your low back off the floor.
Do not allow your back to change position through out the movement.
Lift one arm completely straight up, around, and over the shoulder to lay
it along the side of your head with the palm facing the ceiling.
Keep your arm straight through the elbow and hand and only stretch as
far as the shoulder joint will allow. Never force it or just let the hand
fall to the floor.
In the early stages (or on tense days) your arm may not go to the floor
but with time it will comfortably rotate around.
Hold for 20-45 and then engage your shoulder to lift the arm around
to the starting position.
Check to be sure your torso is flat and relaxed. Repeat on the other side.
Key. Your goal is not to lay your hand on the floor, Your goal is to create enough flexibility capability in the shoulder joint that the arm bone can smoothly complete a 180 degree rotation that results in your hand being on the floor.

Read one exercise, try to do it, then read it again to see which little piece you didn't get. Since they are not normal nor familiar they will be hard to impliment in the beginning. But you will get the feel quickly if you give yourself several tries.

Repeat the Standard Form exercise several times everyday to encourage better neck and shoulder alignment. You can do it seated also. I would encourage you to do it in the mirror initially to give yourself some reinforcement.

Repeat the Shoulder Stretch slowly and with great attention to keeping the elbow straight three times on one side before moving to the other side. Initially just do these once a day and after a couple of days try to do the in the morning and again later in the day. By then I will have more movements to incorporate the rotational aspects of your problem.

There is a second pectoralis muscle that greatly inhibits your ability to allow the shoulders to drop into a naturally relaxed position. If this tension holds itself continuously it contributes to the very conditions you are describing.
To check yourself lay down on a hard floor, carpet is ok, and see if your shoulders drop to the floor. If you can't feel it get your beloved to tell you if both shoulders are at the same relaxed lever. The lower pec can absolutely hold your shoulder forward and instigate this issue. These exercises, listed above create an ititial way to address the path to a new function. So wait a few days and I will list the next level of exercises. Do these two movements two to three times a day and then build slowly. You will create permanent changes so you don't have to keep reinventing the process.

Stick with me and I think with your feedback we can create the best exercises for your unique malfunctions. Til, appx Friday for new exercises.

Vickie

Thanks Vickie. I have been experiementing with these two excerises already since I saw that they seemed to be a failry common starting ground from some of the other threads that I have read. Now that I know that I should be doing them I will be more dilligent :)

My Physio referal finally came through so I went along to see what what he had to say. He though it may a nerve issue as Vickie suggsted but couldn't put his finger on any specific alignment issues. After various tests he suspected that it is a Tricep strain that I may have picked up at the Gym. He gave me a good stretching out and gave me some tricep stretches to take away until my next appointment on Tuesday.

I have been combining these with the excercises that Vickie sugested and have been seeing some mild improvment. :)

I also asked my wife to check my shoulder level and although both shoulders seem to touch the floor ok she thought that my right side generally looked higher overall while I was led on the floor. Interestingly I tried a stretch for my lower pec and found that the arm behind the back pain eased slightly for a few seconds after the stretch and then returned.

Yes!
 

Great Dougt, The response from the exercises will increasingly give you immediate feedback. Then your body will return to the existing default position. The more frequently and consistently you make the movements, make the request of these new tension agreements, the more your body will begin to comply on a regular basis. This means that in the short run the relief of symptom is short but as the changes become more permanent you aleviate the source for the problem. Muscle tensions change with immediate attention. The structural changes comply slowly as many more factors have to change.

Keep up the work and don't be discouraged when you feel like you have become 'stuck' or like no progress is being made; often referred to as a plateau. This is when your body is making permanent committments to the new changes and if you keep up the work you will find that eventually, hopefully sooner than later, the progress picks back up.

Also, don't stop as soon as you think you are out of trouble. Your body will need some time to be reminded that you want these changes to be permanent and will create a new default. Often people begin when the pain disappears only to find it comes back in a few days or weeks. It doesn't mean 'it' didn't work but that there was no reason for the body to stay committed since you didn't.

I'd like to know what you are doing with the physical therapist, so as not to be redundant, and add the next level of work if you like.

Glad you are enjoying some relief. Vickie

Moving along
 

Hi Dougt, Wanted to go ahead and add my next favorite movement and clarify the process. Your therapist confirmed that there was nerve innervention so atleast you know we're on the same page. The symptom that you are experiencing is a result of this impingement and will always be vulnerabale unless you correct the cause of the problem. Certainly the tricep pain is the symptom and must be addressed but often the positions that we accidentally create as we address exercises perpetuates the impingement although it may change the way it manifests in our body.

The brachial plexus, that I mentioned before, divides into a number of branches that affect the shoulder and arm muscles. Often, by addrssing the symptom you only create an opportunity to move the pain to another aspect of the muscular system this nerve impacts. So all of the movements, that I will suggest will address first the origin of the problem and only secondarily the symptom. We can be greateful for the symptom at this initial, acute phase as it may be circumventing a larger and more permanent problem in the future. The very painful motions you are suggesting make your problem easy to diagnose but not always easy to correct. It's just to easy to try to look at the pain source and not the pain cause.

All of this to say your therapist is focused on the problem and that will allow you to feel purposeful. I will encourage you to look at the larger structural problems that allowed this painful experience to manifest.

The following next exercise if very specific; as should all exercises be that are designed to change your structural alignment. The text is very tedious as I am trying to help you get into the most effective positions. Sorry, it's easier to hear than to read and impliment but it works.

Atleast it's not interferring with your golf, yet. And now it doesn't have to. Let me know if you need more clarification. Vickie

Standing Abduction Band Stretch
Place a therapy band under a door and close it securely. ( Be sure to tie a knot large enough to make sure that it will not pull under the door in a state
of tension.)
Stand in Standard Form with your shoulder perpendicular to the door then turn 30 degrees toward the door.
Holding your band in the hand furthest from the door and just at the front of your thigh with your elbow tight at your side, hold the band taunt but not stretched.
Hold the band with your palm facing the door.
Stretch your arm (and band) up to shoulder height and perpendicular to the shoulder. Do not allow your shoulder (from your neck to the shoulder
joint) to lift but create the motion completely with your arm and shoulder
girdle.

Key: Be sure you bring the fist fully into place, often feeling like you
have to pull the arm back slightly. You may feel your chest lift slightly
and your shoulder blade tighten and move toward the center of
body; inevitable if you are in proper alignment.)

Resist the tension as you bring the arm back to your side without rolling your
shoulders or leaning forward. Try to hold the lift you feel in your torso.
Repeat 6-10 repetitions then repeat on the other arm.

Thanks for you continued support and advice Vickie. I'm very keen to attack the root cause and prevent it from occuring again so this just what I need. Will incorporate the latest excerise in to my routine from today and report back on how I'm getting along.

I played 18 this weekend after a 3 week layoff but unfortunatley the pain was getting in the way. I found that It was hurting through impact which really threw me off. I started to back off the shots and not commit which only resulted in bad shots which hurt even more :crybaby:

Getting Better
 

Just wanted to add an update, I've been doing the excercises layed out by Vickie and have been having sessions once a week with the Physio and am starting to see some progress.

Managed to play 18 last weekend without the pain getting in the way of my swing too much. It's still there but not to the same degree of a few weeks ago. :)