Lev Scap Nerve Issue - Weakness Lev Scap Nerve Issue - Weakness

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Thread: Lev Scap Nerve Issue - Weakness

  1. #1
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    Default Lev Scap Nerve Issue - Weakness

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    Background: Male 34, 6'0" 205 lbs. Preinjury - Bench 270, Squat 295, DL 365, OHP 160 all novice linear progression sets and reps.

    About a month ago I started getting tightness and discomfort in the neck/upper back area. First noticed sitting at dinner on the Saturday evening, most recent training was the day prior. Sunday through Wednesday the tightness and discomfort grew and started getting numbness and referred pain down my arm, into the pec, trap, serratus anterior. Discomfort, numbness and pain was disrupting sleep and became too much so I went to urgent care. I was given muscle relaxers and NSAIDs until I could get in with my primary care physician.

    Primary care physician did a bunch of "put your arms at different angles while I push on you" stuff and came up with the idea that I was functional enough. She thinks it is some form of nerve interference near the neck or stenosis or arthritis in the neck. Gave me more muscle relaxers and referral to a specialist. The pain and numbness began to go away but when I first tried to train again when I believed everything was calming down I found I had severe muscle weakness in my pec, tricep and lower trap. I started with a warm up 135 bench press and could barely get the weight up to re-rack it (obviously more weakness than i expected from atrophy from a week off training). Specialist looked at me and said I had minor scapular winging but didn't have a good answer for me after his evaluation he sent me to PT. PT evaluated me and doesn't have a good diagnosis for me either just put me on a rotator cuff strengthening (that 5 lbs band shit) and pec and neck stretching program.

    I am now 4-5 weeks in from symptom onset and am still only able to bench 155 lbs with significant difficulty. I'm able to perform chin ups but I'm extremely unbalanced and my body takes about a 30 degree angle towards the healthy side. I filmed the chin ups and it appears to me that the lower portion of my traps just aren't contracting. I am able to contract the pec on the affected side but it is much less firm than the healthy side, the same goes for the lateral head of my tricep. The numbness is gone but I can get some pain in the lev scap area (not sure if it is the trap or deep enough to be lev scap) and tricep after training or after driving or working at a desk for a substantial amount of time. I have been stretching the lev scap fairly aggressively since onset of symptoms as it was my first hypothesis with some help from google. I have been stretching the scalenes and traps intermittently. I can replicate symptoms if I get really deep into the lev scap stretch and stay there for a bit; the numbness will radiate all the way to my hand. I can get pain on the anterior proximal head of my humerus when I move my head back and to either side (directed towards my back pockets, if I just let head hang back in that direction I don't get pain anymore). My guess here is that I'm contracting the lev scap and clamping down on a nerve but I know that is also about the area the subscapula connects...not sure what's happening.

    My next steps are to request imaging if I get the same BS from the PT at my next appointment but in the mean time: I'm not sure where the problem is originating still so I'm not sure how to modify my course of action to get relief and return of full function. Any advice/direction is greatly appreciated. I know with nerve issues time is REALLY of the essence and I've already wasted 4-5 weeks with only a minor improvement in strength.

  2. #2
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    Do you have any visible atrophy comparing the left and right sides of your body? Did any provider you saw do the basic reflex testing with the hammer? Is the general symptom trend getting better, worse, or staying the same? Can you cause the symptoms by simply moving your neck?

    It does sound nervy, but I would not attach a specific narrative to it yet. If it is nervy, you are right where I would expect you to be in the process. The time horizon for "making the turn" for these guys is longer than you think/want and typically in the 3-6 month area. If you do not have the lower motor neuron red flags of things like atrophy, fasciculations, paralysis, hyporeflexia, hypotonia, etc., and your symptoms are more along the lines of loss of strength, numbness, and shooting pain down the arm (and generally these are improving, even if you occasionally have a bad day), I would stay the course and see how things are at the 12-week mark. If some of those red flags are present or things are getting worse, you should get an image.

    I hope this helps!

  3. #3
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    Jul 2019
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    I literally experienced every single thing the OP had happen to them. This was about 4 years ago. I swear, I thought I was reading my own post.

    It was 6-8 months before mine began to offer some reprieve. I wasnít into lifting heavy at the time, but swimming DID help tremendously. A swim coach had me do seated rows with something like 15 pounds for 3 sets of 100 every other day and my scapula laid back down. Not sure if thatís a logical solution anymore, but I think it worked for me.

    I suffered pretty bad neck pain for 3 more years before I discovered the OHP. I was weak... Barely able to do the bar, and it still lags my other lifts after my NLP, but it is my go to exercise every single time my neck starts giving me fits.

    I was diagnosed with a mild herniation at C6-C7 and, I think, an osteophyte complex at C5-C6. I still have a crunchy neck thatís tight, but the press keeps me sane. Good luck, OP. I donít wish it on anyone, but you will heal! It just takes forever. Also... I often felt like stretching did more harm than good, but that was just me.

  4. #4
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    Nov 2020
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    Thank you for the response Nick! It is greatly appreciated.

    I do not have visible atrophy. I have not been reflex tested with the hammer. The trend seems to be getting SLIGHTLY better. I can't cause symptoms by moving the neck, I can only get symptoms when stretching (for > 30 seconds) the head forward and away from injured side (chin to front pocket) or stretching head back to back pocket.

    I guess I shall stay the course and see where the next ~ 8 weeks takes me. Thank you.

  5. #5
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    You're welcome randomuser. Continue to train to the best of your ability. Prioritize doing the movements or a close relative of them and getting in what you can. Be patient with the process, and do not push it on the bad days. Goodluck!

  6. #6
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    Hey! I have been there. Just keep motivating yourself and work on your training slowly. Take things slowly. Give sufficient rest to your body. When I was going through something similar, I did a therapy that uses shockwave. It helped me to work with my nerves and muscles and made me feel better with my movements. You can also consider that during your rehab process.
    Last edited by Nick D'Agostino; 11-27-2020 at 04:34 PM.

  7. #7
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    Shockwaves? Like a TENS machine or like a dry needling process? PT hit me w/ the dry needling procedure but didn't do anything for me. I have looked at TENS machine to possibly keep some tone stimulus to the un-recruited portion of the triceps while things start waking back up.

  8. #8
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    He had provided a link to an ultrasound/stim combo treatment website. I've had it done on me, and it does feel good. I deleted it because it is one of these types of treatments that feel good at the moment, but the people who give the narratives about what is happening during the treatment end up doing more harm than good. Because people experience muscle contraction while the treatment is being done to them, they end up thinking that something is wrong with that specific area and that they need the specific ultrasound stim combo to get better. This goes against the general idea that I was trying to communicate with you.

  9. #9
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    Thanks Nick. Quick update if anyone is interested = seems to still be waking back up very slowly. I can aggravate w/ poor posture at the computer for work but when I feel the tingles I know to sit up straight and it will pass. I'm bench sets across at 190 lbs. now so I'm about 50% of the way between pre-injury and post-injury. Fingers crossed a few more weeks and I will be almost out of the woods.

  10. #10
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    starting strength coach development program
    You're welcome! I'm glad things are moving in the right direction. Stay slow and steady. Prioritize consistency and don't get discouraged if you have a bad day. If you have to take 10-20% off the bar because of a flare-up for a couple of sessions that is ok. Just take it in stride and continue moving forward.

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