My shoulder hurts. I swear it's not a heart attack.

January 5, 2009 1:39 PM

What can I do to prevent/reduce the muscle knots and pain in my shoulder?

Ever since I was a teenager playing piano, I've been prone to getting huge knots and tightness in my shoulders (mostly the right one). I've been to physical therapy a few times, and it helped, but I am think that was primarily because they were giving me a massage twice a week! I have an excellent massage therapist, but I can't afford her every week forever. I recently started regular piano playing again, and the pain has gone from regular to nonstop. Piano isn't the only thing aggravating the shoulder, sitting in front of a computer all day doesn't help and I'm not sure if rock climbing and swimming help or hurt.

I don't want to give up any of my activities, so I'd like to do anything and everything else possible to keep the knots under control. Ideally, I'd like to get rid of the knots and then do some kind of regimen of motion/stretching stuff to keep them from reforming. I do yoga a couple times a week, and recently I've started putting a heat pack on it in the evenings, but please hit me with everything you've got. How should I be sleeping? Will those therma patches help? Muscle relaxants? Rolling around on tennis balls? Special magic shoulder stretches? Special magic yoga moves?

posted by lemonade to health & fitness (20 answers total)

Rolling around on tennis balls is supposed to help, in all seriousness. I've never succeeded in balancing my weight with the ball under my shoulder, but I know that some weightlifters do it, and they also do something called "foam rolling" -- I guess you can buy some "foam roller" thing pretty cheaply and do this.
posted by creasy boy at 2:04 PM on January 5, 2009

I sometimes get crazy shoulder knots, and I find that heating pads and self-massage on the knotty spots help. I also take pain relievers at the maximum recommended dosage (2 advils every 6 hours, maybe? whatever the "do not exceed" dosage is on the bottle) for several days. Even if it doesn't hurt that bad, I notice that the pain makes me hunch up more to protect the area, which makes the knots worse. Taking the pain relievers helps me not tense up, which helps the knots work themselves out rather than getting worse.
posted by vytae at 2:05 PM on January 5, 2009 [1 favorite]

Here is a good article on preventing stress and injuring when playing piano. Skip the first part and scroll down to the section entitled "Some causes of stress". He covers lots of possibilities and offers many helpful suggestions.
posted by ubiquity at 2:08 PM on January 5, 2009

Both my physical therapist and massage therapist recommended heat - my PT recommended the thermacare pads, but I hated them. I was also told to roll around on a tennis ball. I think exercise helps, too, but I can't say that I've actually done that.

So, nothing that you haven't heard before, but that's what people keep telling me to do.
posted by bristolcat at 2:21 PM on January 5, 2009

Read The Egoscue Method. Get a copy from your library. It's an interesting book whose premise is that pains in one part of the body may originate through imbalances in other parts of the body.
posted by Barry B. Palindromer at 3:39 PM on January 5, 2009

Since you mention the connection with piano playing and the problem is specifically in your right shoulder, I would guess that you are left-handed, right?
If yes, write me a message and I'll guide you to a series of posts on my blog about this.
Maybe not, however. Then the hanging back stretch, done frequently and gently, with a lot of good breathing, will be your friend.
Read Madeline Bruser "The Art Of Practicing" (Bell Tower 1997)
posted by Namlit at 4:05 PM on January 5, 2009

I do the tennis ball for my shoulder knots (I'm a swimmer, so they can get pretty bad). Almost as good as a massage. But you have to be patient and lay on the ball so that it hurt for a few minutes per knot. You also need to roll around and move your arm to get it in the right spot. Anyway, my life with the ball is so much better than without.
posted by dame at 4:32 PM on January 5, 2009

sitting in front of a computer all day doesn't help

Are you right handed? Do you mouse right handed? And this is your right shoulder? Hmmm....

I've been dealing with perhaps the same exact thing for the past 15 years. This has also traveled down to the elbow from time to time. I agree with everything you've mentioned above but would like to add _keep_moving_around_ especially the shoulder. Don't do anything stressful or jarring to it (like the grunt and twist stuff) but things like reaching up with just the right arm, slowly coming down. Pull the elbow to/from - forward/back. Can you mouse on the left? Are you into key combos (e.g., alt-f, s, esc, tab) as opposed to mousing everything? As for yoga, check out the arms in cow face - Gomukhasana , see the Bikram variation of half moon - Ardha-Chandrasana . Another one is to use a door frame, put the palm and elbow along the left and right (sort of like a "field goal" pose but get your elbows down to form right angles) then gently lean into this. You'll feel the pectoral muscles stretch along with the shoulders, shoulder blades come together.

Good luck with this. It sounds like you'll have it managed at some point but it could take years! There was a doctor that once told me without hesitation this was a build up of repressed anger. That too is something I've explored over the years.
posted by ezekieldas at 4:32 PM on January 5, 2009

I am going through this now and have had sucess with the tennis ball. I agree with dame, you have to let the pain happen and leave the ball on each knot even when it hurts. Another thing I read online is to put the ball in a sock, and then stand by a wall and put the sock plus ball between you and the wall. This way you can use the sock as a "handle" and the ball won't pop out and roll away.
posted by sweetkid at 4:42 PM on January 5, 2009

I used to have pretty terrible neck and shoulder pain and I spend a lot of time in front of the computer, too. One thing that has seemed to really help is taking short breaks. I use a program called Workrave. From a previous answer:

Basically, it locks my screen for 30 seconds after extended periods of computer use. If I'm right in the middle of something, I can dismiss it but I usually just huff and then do my neck twists. It's been about six months and I'm still injury free!

While I have had one bout of stiffness since then, it was after a period of time when I started ignoring the Workrave popups! The exercises I do are pretty basic, suggested by my PT: turn head to the left/right and hold for 10 seconds, look up/down and hold for 10 seconds, roll shoulders forward/backward for 10 seconds.

Please do post back if you find a solution that really works for you. Chronic neck and/or shoulder pain can be such a downer. Good luck!
posted by funkiwan at 5:17 PM on January 5, 2009

I am right handed, I started mousing left handed a couple years ago to help shift some of the workload that way.

I like the idea of the tennis ball and the wall--it seems a little less tricky than the floor method.

Say I manage to work all the knots out--how do I keep them from re-forming? Are there certain movements that warm/loosen those areas? How often are you stretchers stretching?

I don't really think I'm full of repressed anger, but more like a little Type-A stress-ball!
posted by lemonade at 5:41 PM on January 5, 2009

Running.

I sit at a drawing table or Cintiq tablet all day and I couldn't survive without going for a 1 or 2 mile run every other day. It straightens out the back and the "jouncing" action loosens my neck/shoulder in a way that no amout of massage or muscle relaxers can. I am no kind of athlete, by the way.
posted by bonobothegreat at 6:19 PM on January 5, 2009

I would say that in the longer term, there is no magical way you are going to work out all the "knots." There are a lot of smaller things you can do to prevent them from becoming so painful that they interfere with work and hobbies.

As a massage therapist, I would say that massage helps in the immediate term, but you should really be considering ways to get out of that piano-playing/desk-sitting posture. Rock climbing sounds like it would also stress your neck and shoulders. Swimming could be better, depending on which stroke you favor.

I recommend strength training. You need to strengthen the muscles that are not being used, such as the pecs and lats, in addition to the core. A strong core (meaning the lower back and the abdominals) will go a long way toward lessening the strain on your upper back.

The suggestion for yoga is a good one, as long as you take it nice and slow, and not rush through the poses.

How about a weekly hot soak with epsom salts and baking soda? Sink in all the way to your chin.

Have you considered visiting a chiropractor to have your spinal alignment assessed?
posted by computech_apolloniajames at 7:30 PM on January 5, 2009

I swear I don't work for them, but for a pre-Christmas gift, I got myself a Wii Fit.

I used to suffer from chronic back pain, where I would have to ask my spouse for a deep tissue massage every night before bed, just so I could bear the pain long enough to fall asleep. And ever since I started using this thing, I have not asked for ONE single massage. It's been about a month now (I know, 'cause the Wii Fit keeps track of me with a built-in calendar, ha!). I only do it about 30 minutes a day. Maybe it's the Yoga or the Strength Training, or hell, maybe the Balance Games, but I feel so much better.

I swear, I don't work for them. Just sharing what's been working for me!
posted by polyester.lumberjack at 7:34 PM on January 5, 2009

I used to get those hard knots too (sometimes still do); they always tend to flare up when I've been overdoing it *and* not taking proper stretching breaks when using the computer. You absolutely have to force yourself to take proper breaks -- no matter what. Get out of those fixed positions and stretch, go for a walk, run, whatever it takes --just get your body moving. That goes for your piano playing too. Workrave is a good program, but there are cheaper and free apps available too.

Massages were only temporarily helpful in my case; what really worked for me was acupressure. If you can't reach the areas yourself, get someone else to do it for you. You have to press the knots very firmly -- hard objects or my husband's elbow work best for me, but YMMV -- and keep pressing until they start to soften and break down. Sometimes they'll seem to roll away, but don't give up. Reposition and start again. If you start to feel nauseous or too sore to continue, stop and do a bit more the next time. Took me about 6 months to get rid of all of my knots, but they've never been that bad again. When I have a flair up, I can treat myself in about 20 minutes by laying on a hard little massage ball and repositioning as necessary. As long as I take proper breaks between activities, I can stay pain free for months at a time.

Someone posted links to some good "trigger point" acupressure books on Amazon a while ago -- you should do a search for them. I bet you'll find them very helpful.
posted by LuckySeven~ at 9:49 PM on January 5, 2009

I've used a Backnobber for pain relief and found it really helpful. Some people prefer the Thera Cane. Either one will do the trick. You can get either one for about $30. Definitely worth it.
posted by marsha56 at 9:59 PM on January 5, 2009

Are you right-handed? I knew a massage therapist who called people's knots in their right shoulders/shoulderblades/arms their "mouse muscles". Maybe get a more ergonomic mouse setup for your computer.
posted by Jacqueline at 10:49 PM on January 5, 2009

Maybe you could look into learning some Alexander Technique or something similar? Professional musicians often have chronic pain, and there are lots of different approaches aimed at retraining how you use your body to maximise efficiency and minimise injury.
posted by Emilyisnow at 11:50 PM on January 5, 2009

@LuckySeven~: Workrave is a good program, but there are cheaper and free apps available too.

Workrave is Free, GNU GPL. Perhaps there are other alternatives out there that have features that Workrave lacks but it's hard to go cheaper than free. Have any suggestions?
posted by funkiwan at 12:27 PM on January 6, 2009

Oops! Thanks, funkiwan. I mixed up the name with a similar app called Desk Doctor. Workrave is indeed free; Desk Doctor, however costs $129.00 (hence my warning).

A few others that I've tried are TimeOut (free/donationware), Anti-RSI (free/donationware), and FlexTime($18.95).
posted by LuckySeven~ at 7:21 PM on January 6, 2009