Hello all,

I've recently suffered an injury leading to what I surmise to be cervical radiculopathy based on symptomatology and the assessment of a couple of athletic therapists. I thought it might be constructive if I post my experience as it unfolds to sort of chronicle my journey to rehabilitation so that others might benefit from my experiences (taking into consideration that every injury is case-specific, of course).

THE INJURY
I play rugby for a high-level rugby academy team in Canada. One of the requirements of my position (loose-head prop) is forming the front row of a scrum - neck injuries and disc issues are not uncommon for front row players due to the aggressive and high-impact nature of the scrum. During a practice session, I lost my form and my neck entered the scrum in a precarious position, I felt a pop, but this regularly occurs with blows to the neck and head. Nonetheless, I was able to carry on for the rest of practice with no real issues. This was approximately 3-4 weeks ago.

SYMPTOMS
In the coming days I began to notice an incessant nerve pain that felt localized to beneath my left shoulder blade, radiating slightly toward my lat, tricep, and as far as my finger tips. Having a back injury years prior due to incorrect deadlifting form, I was all to familiar with the pain and immediately recognized the issue. The pain was dull, but enough to cause noticeable discomfort. Sitting, laying down, standing, all positions felt relatively painful. All together, I would have to describe the pain as a constant 5/6 out of 10, enough to make me irritable and cause consistent discomfort and issues with sleep.

TREATMENT
Expressing my concerns to an athletic therapist, after an assessment they concluded that it was likely a nerve impingement related to soft-tissue injury. They completed some soft tissue work around the C4/C5 vertebrae, and some blading near where the pain was localized. Following treatment I felt immediate relief and was cleared to continue practising (including contact). The injury was relatively well-managed until I took a hit to the left shoulder (approximately 3 weeks ago) going into contact, and immediately felt a flush of pain in the aforementioned area. The pain eventually subsided during practice, and has since remained in varying degrees of intensity. For the most part, the pain is barely noticeable, and does not interfere with day-to-day activities, but sitting for too long or sleeping on the wrong side will agitate it.

STRENGTH LOSS
As neck/shoulder injuries are common in this sport, and I've experienced similar pain before, I thought the best course was to simply ride out the pain and in time the issue would eventually subside. Where this injury was different, however, is the gradual, albeit SIGNIFICANT decrease in power output and strength levels in pushing movements/presses. A week after the injury I noticed pressing to be a little more difficult, but the strength loss wasn't anything alarming - enough for me to figure it was simply fatigue from a heavy training week. The real alarm arose, however, when we were testing our 1RM and I failed on a warm-up set of 300 (a weight I can hit for endless sets of 5, even on my absolute worst days). Again, I figured it was likely due to the heavy training volume from practices and lifts, and that after some time off things would be back to normal.

Fast forward two weeks and we've ended our in-season training allowing me to take an entire week from any physical activity. Feeling relatively rested, I was eager to get in some light volume work in on the bench press. To my shock, I warmed up to 225, only to be completely fatigued after 5 reps - I backed off and did 4 x 5 at 205lbs. Just a couple of months prior I could easily rep 225 out for 20+ reps, even on the worst of days, and now it felt like heavy work. This was when I knew something definitely was not right. When I contracted my left side, my pec and tricep didn't feel as hard or as contracted as my right. This was further reflected in doing any unilateral work as my left side failed much more quickly than my right.

I experienced strength loss to one side before a number of years ago from what I retrospectively suspect to be a similar injury. This resulted in backing off for a number of weeks until I felt "balanced" enough and my strength returned. At the time, I could incline press 120lb dumbbells for high rep sets, but struggled to manage 70lbs for more than 8 reps - a similar situation to what I'm experiencing now.

I'm hoping it's a similar situation in that it will resolve on its own with minimal intervention over time, but I'm also trying to be smarter this time around in managing the injury.

MOVING FORWARD
Speaking with another AT, they agree unequivocally that my pain, severe decrease of strength, and description of injury are consistent with that of a pinched nerve/root compression. They recommended I visit a doctor immediately to get some imaging done so that the injury can be properly diagnosed and treated. The fact that I can still do most movements, albeit with lighter weight than I'm used to, is suggestive of an obstructed neuron pathway rather than any real damage to the nerve itself. Of course, this is the best case scenario, and strictly conjecture at this point until it is properly assessed by a GP.

They recommended ceasing any heavy overhead movements, any chin-ups, or any training that would necessitate any bracing or straining from the neck. Likely, what I'll do is 4 x 8 incline press with light weight - aiming to increase the volume week by week to maintain mass in the pectoral/deltoid region without overdoing things. Further, they recommended doing chin-tucks and some 10RM bicep/tricep testing with each arm to assess strength levels and establish a baseline to see if the condition is improving. I've also seen some literature to suggest that NSAID therapy can help in nerve regeneration/healing - though I've always been relatively averse to NSAIDs due to their impact on recovery from training and masking of injuries leading to exacerbated injury.

Hopefully not too much of a journal, but I'll try to update as time goes on and I find out more about the injury and how to rehabilitate.