Lower Trap Strain

[bmcd]

Hey everyone, I'm Bob, i'm new to the forum. I would appreciate anyone's input and advice on this, it is bothering the heck out of me. Thanks a lot!

6 weeks ago, i was doing chinups with a weighted belt going for a 4 rep max. I got my 4th rep, felt good and went for a 5th, i got it, then on the way down from the bar i felt sort of a tear/rip in my back.. Didn't feel too severe, but more of a dull aching pain.

I went to PT for a few weeks, and i seem to make progress, then try to do very minimal lifting or workout on my rowing machine with very low resistance and then i'm back to ground zero. Even opposite arm and opposite leg lifts are troublsome (because it involves raising and holding the arm above shoulder level) She diagnosed it is a lower trap strain. When i first went in, she said it was a grade 2 strain because it hurt upon contact and was very swollen, etc.. I think it has improved to grade 1 status, so basically it doesnt' hurt upon contact, but range of motion and stabilization is troublesome.

The things that cause pain are: lowering my arms to my sides against resistance(like an iron cross, the opposite of shoulder lateral raise i guess) also raising my arm overhead causes pain, and stretching sometimes causes pain, also at random times back flexion or extension can hurt like bending over to pick something up (so squatting also causes pain trying to keep the back flat), BUT sitting for extended periods of time is the BIGGEST TROUBLE!. (I am a college student, and it is difficult to sit through 50 minute classes, especially 4 or more of them per day.

I saw a chiropractor, he thinks it could possibly be a ligament strain in addition to a muscle strain, and he said to do hot/cold alternating for 10 minutes each for an hour. After the soreness is mostly gone (which it is pretty much, it is more a nagging pain that comes up when i sit for too long), then do 3-4 times per day just moist heat. Is this the right approach?? Also, i have been recommended that i wear a back brace and rib binder to help retain heat to help repair the muscle. Any thoughts on this??

I don't know, it is really getting on my nerves. I am ticked because i love my workouts and it is a huge stress reliever for me. I would just like to be able to do squats, and bench and biceps, triceps etc.., and things that aren't directly involving that muscle area at least to begin with. I know it will be a while before rowing and chinups again.

I know i need to rest for a couple weeks, but should i also be stretching? or just leave the dang thing alone and let it rest completely. Stretching seemed to be doing good, and then yesterday i stretched after the moist heat and i felt the nagging pain all day off and on. I wonder if static stretches is not a good idea because i need to be able to properly warmup and muscle and get it moving (which i cannot because i am not lifting...grrr...)

Also does anyone have advice on how i should progress once (if) the pain goes away for good? I have thought i could first do things that don't directly involve that muscle, like benching and biceps, triceps, legs (isolation work rather than squatting since that requires a lot of back stablizing) Any thoughts?

So does anybody have any advice. I know i gave a lot of information, sort of a brain dump. But thanks for your time. If something i said isn't clear, please ask me because i need any help you can offer! It seems to get better ever so slowly, but i want to be sure i am on the right track and taking the right approach because it seems that i am becoming increasingly limited in the activities i can do..and maybe complete rest (no stretching even) is the best idea. But how to deal with the sitting in class also is a big issue as well.

Anyhow

Thanks everyone

Bob

P.s. I attached a couple of pix to see where the strain is. Also, i am a side sleeper, any thoughts about this? Thanks

[Heidi]

Hi

I can see from your photos that you have a bit of a problem with posture. Your right shoulder is raised and you appear to have a lot of muscle tension. I think this may be the reason why your injury is taking so long to heal.

A muscle strain and possible ligament sprain are likely injuries, which would normally heal quickly. However, if your posture is not good, extra strain is put on the injured muscles, slowing its progress. This would also likely explain why you get pain when sitting for long periods.

My advice is to go to someone who knows about posture and re-education of posture. They will most likley give you exercises to stretch certain muscles and strengthen others.

In terms of what you have been doing with ice/heat, now that it is a chronic injury (a few weeks old) heat is definately the way to go.

[extremeskins]

Hi Bob,

A ligament sprain is typically caused by a "twisting" injury... or a hyperextension/hyperflexion injury. Given your mechanism of injury (ie. chin ups)... and symptoms (ie. dull ache)... I'd confidently say that it rules that out.

On the pictures you've provided.... the area you've encircled goes BELOW the Lower Trapezius (T12... the last rib). And given the mechanism of injury (ie. shoulder extension).... I'd say that a strained Latissimus Dorsi muscle is what you've encountered.

And it could easily be confirmed AND differentiated from Lower Trapezius with quick and simple muscle tests... that any licensed/registered massage therapists should be able to perform.

You should always be stretching a muscle injury beyond the acute stage (2-3 days)... within a pain-free range. It's going to assist with the strengthening/lengthening of the scar tissue. Heat beforehand is advisable.

The PT should have had you start with some simple proprioceptive work.... then progressing to isometric exercises.... before you attempt to begin isotonic exercises.

As far as treatment..... I'd suggest you see a chiropractor or massage therapist that performs A.R.T. (Active Release Techniques) -- probably the best soft tissue release technique for muscle strains.

Best of luck.