December 16, 2004

9:23 AM

Some muscle in my upper back, on the left side just inside my shoulder blade, has balled up and is really sore. I don't know how I injured it, but I do know I had trouble sleeping last night and this is the fourth day in a row it has hurt. I know a guy who is training to be a chiropractor, but I'm a little suspicious of going to a chiropractor, let alone a not-yet-quite-certified chiropractor. What would you suggest? A deep massage? Just wait for it to work itself out? See a real doctor? Or just keep popping the ibuprofens?
posted by billysumday to (26 comments total)

Deeeep massage--I know exactly the muscle that you're talking about, and it never went away for me completely until I did two things:

1) Went to a massage therapist who basically crushed it,--after she worked it over, she told me to stay hydrated and take Advil, since she (claims she) had released the lactic acid that had built up in that area, and that the whole area would feel like an over-exercised sore muscle the next day. (She was right--it didn't feel _bruised_...it felt like I had lifted too much.) I went to her several times, and it really made a difference.

2) Changed my working position at my desk--I realized that, for me, it was really a result of how I'd been sitting at my computer for several hours a day. Even with the massage, it didn't go away for good until I sat differently while I worked.

In the meantime, one of the best interim solutions I found was a tennis ball, or even better, two of them tied inside a sock. Put the ball on the floor, lie back on it so it's pressing into the knot, and use your body weight to work on it.
posted by LairBob at 9:36 AM on December 16, 2004

For long-term relief LairBob is probably right, but I've also had good luck going to the gym, finding a machine that hits the knotted muscle (in your case, maybe the lateral pull-down? or nautilus?), setting it to a REALLY light weight (10-15 lbs or less), and going through 30 or so reps VERY slowly. Count 12 seconds down, 12 seconds up. The resistance your body will have to create to keep the weight from flying out of control tends to get the smaller muscles in the area involved without overtaxing them, which helps "unkink" the sore muscle a bit, and just working the sore muscle gently like that does take care of some of the lactic acid build-up.
posted by occhiblu at 9:44 AM on December 16, 2004

LairBob has it right. I've had these, and a good massage therapist will 'crush' it, and give you the instructions to keep hydrated after. And it works!
posted by eas98 at 9:49 AM on December 16, 2004

Here's a "pretzel" stretch, described as well as possible without diagrams.

Sit in a chair, both feet on the ground.

Lean forward. Place left elbow on left knee, palm of left hand flat on top of right knee. Your forearm should be perpendicular to your knees.

Bending forward, with your right arm straight, grab the outside of your left foot with your right hand. (Your right arm should be in front of your knees+left arm.)

Now that you've assumed the position, slowly straighten your back until you feel that muscle stretching out. Hold for 10-15 seconds.

Hurts like hell, but it's a good way to loosen it up.

Repeat on the opposite side. Do this several times a day.
posted by mudpuppie at 10:01 AM on December 16, 2004

sorry about your pain billysumday. I am assuming that the ball of muscle is on your back, not on top of your shoulder blade as I make the following suggestion --

here's something you can do now to deal with the 'ball' in the muscle. Do you have any tennis balls at home? Or golf balls?

Lie down on the ground, and place the tennis ball between the ground and your shoulder muscle, and using your body weight, roll the ball on the ground while you massage the muscle. The massaging motion should get the tension out of the muscle.

Re your chiro-student-friend, you might want to delay the visit until s/he is certified. If you insist on visiting a chiro, then ask for Active Release therapy - this is localized deep tissue massage.

I'd limit the Advils as they wreak havoc on kidneys when taken in larger quantities
posted by seawallrunner at 10:03 AM on December 16, 2004

It's injured and fully of blood - all irritating it further.

Ice. Ice, ice, ice. Ice is a natural anti-inflammatory. 15 min on/15 off (use at least a layer of cloth to prevent the ice from burning your skin.

Ibuprofen is a general area anti-inflammatory. Additionally you may be sleeping in such a way to irritate it - it's also your neck.

I'm not a big chiropractics fan - but that's mostly due to the lack of controlled studies with chiropratics.
posted by filmgeek at 10:04 AM on December 16, 2004

I've had quite a bit of experience with both deep tissue massage and chiropractic... I think you should see a massage therapist for immediate relief, and take Advil only as needed (as Seawallrunner pointed out, it's taxing on the ol' kidneys).

For longer term relief, you should investigate why this happened. Repetitive stress syndrome from typing all the time? You getting regular exercise? Are you stressed out? Etc.

If you need an actual spinal adjustment (which might be the case), you've got to get the muscle to stop spasming before the adjustment will hold.

Incidentally, my body does not respond well to the crunchy kind of chiropractic, so I have very gentle adjustments done. It's amazing what a difference it can make. So if you want to work with your friend, I suggest you go gentle at first, and see if your back responds positively.
posted by Specklet at 10:21 AM on December 16, 2004

See a real doctor. It could be a heart attack, or vascular problem.
posted by Faze at 10:31 AM on December 16, 2004

Mudpuppie, thanks for the strech info. I had a similar ache after sleeping oddly last night, and that stretch really helped!
posted by robocop is bleeding at 10:39 AM on December 16, 2004

I get the same thing if I use a mouse too long. The constant light tension on that area turns into a burning, seething knot. Whenever possible, I use a pen tablet as a mouse substitute, and if that knot comes back, a massage, even a casual one, helps relax it out.
posted by Tubes at 11:01 AM on December 16, 2004

I've no idea of how this impacts treatment, but the other night I was looking up lactic acid buildup for my gf and discovered recent research indicates the soreness is actually caused by small tears in the muscle fibers. Searching for the medical term in that article turned up a few results which seem to corroborate that.
posted by jwells at 11:25 AM on December 16, 2004

I'm a little suspicious of going to a chiropractor

why? are you chirophobic?

this, almost exactly, happens to me once-twice each year. i ride bikes, ski, and fall/crash/stumble from time to time, broken a rib or two and a clavicle, so im rather naturally crooked now. anyway, my chiro says my back-shoulder pain has something to do with my sternum amongst other things (i don't really understand). when he works on me it always goes away, until it comes back again, post-biff. never had a massage for this; the chiro co-pay's just too cheap.
posted by RockyChrysler at 11:31 AM on December 16, 2004

Thanks everyone. I do think it probably has something to do with my posture, with sitting all day, and from using a mouse too much or typing a lot. I'll start with the tennis ball thing and some exercises, then try to scrape some money together and see a massage therapist.
posted by billysumday at 12:23 PM on December 16, 2004

also, salon pas patches are great.
posted by mudpuppie at 12:41 PM on December 16, 2004

since she (claims she) had released the lactic acid that had built up in that area, and that the whole area would feel like an over-exercised sore muscle the next day.

or maybe not. Wikipedia:

"Lactic acid is a chemical compound that plays a role in several biochemical processes. It is the acid that gives old milk its sour taste, and it accumulates in skeletal muscles during extensive anaerobic exercise, causing temporary muscle pain. Lactic acid is quickly removed from muscles when they resume aerobic metabolism. Delayed onset muscle soreness usually becomes apparent more than 24 hours after exercising and is not caused by lactic acid buildup".
___

"Delayed Onset Muscle Soreness (DOMS) is the pain or discomfort often felt 24 to 74 hours after exercising. Once thought to be caused by lactic acid buildup, we now know that it is caused by tiny tears in the muscle fibres caused by eccentric movements, or unaccustomed training levels".
posted by matteo at 1:12 PM on December 16, 2004

Maybe, matteo--I was careful to qualify how I repeated her assertion...all I know is that I know what having sore muscles from overexertion feels like, and it definitely felt like that the next day.

Maybe crushing a muscle knot with your elbow causes tiny tears, or maybe it's completely some other cause...I dunno.
posted by LairBob at 1:17 PM on December 16, 2004

I'd take some muscle relaxants, pain killers (tylenol) and use some heat (may seem like overkill to some but why suffer?). I get the same problem but on the right side and comes back from time to time. It can be really painful and I've been known to use the corner of door frames to try to work the knot out. Lots of stretching - rolling head in a circle, tilting head from side to side and back to front, lifting your shoulders to you ears and moving shoulders in a circular motion clockwise and anti clockwise.

I'd avoid the chiropractor but I'm biased (screwed my neck up after claiming to treat my migraines, what didn't crack before did after I saw him, wasn't impressed in the slightest). Personally I think they are verging on being quacks.
posted by squeak at 1:45 PM on December 16, 2004

Damn mudpuppie... that's a good one!

I get the same thing all the time. Once I found a good chiropractor, visiting him once a month keeps me loose and feelin' good. But not all chiropractors are created equal. Massage for me only feels good for a day or two, then I'm back where I started. YMMV.
posted by spilon at 2:04 PM on December 16, 2004

My reaction was "massage therapist" too. It's all about the postural problems -- not necessarily one thing bothering that shoulder, but weeks or years of something little turning into something big.

I get the same sort of deal from sitting and mousing all day, but I have the advantage of dating a massage therapy student. She says, paraphrased: Can't tell without actually examining you, but the balled-up muscle is likely trigger points plus hypertonicity — you'd benefit from a full posture workup and some exercises to balance out muscular imbalances (stretch the ones that are short and hypertonic, strengthen the ones that are weak) plus massage treatments.

And heat's not overkill, it's a great treatment. (Also I have to recommend this whole business of dating a massage therapy student.)
posted by mendel at 2:07 PM on December 16, 2004

The aside comment "(may seem like overkill to some but why suffer?)" was in wrong location I guess, should be after, "muscle relaxants, pain killers (tylenol)" Sorry for the confusion.
posted by squeak at 2:25 PM on December 16, 2004

Treating the symptoms is not going to fix anything. The cause of the symptoms must be found and dealt with in order to elimnate the problem.

Squeak: it's unfortunate you had a bad experience with a chiropractor, but I encourage you to be open to the possibilty that chiropractic treatment is a valid and useful therapy. There are bad chiropractors out there, just like any field of practitioners. But what I really wanted to say was: you might not want to roll your neck to stretch it, it's pretty hard on the connective tissue. Much better to tilt forward, hold, release tilt to the side, hold, release, etc.
posted by Specklet at 2:27 PM on December 16, 2004

I've had very mixed results with chiropractic. I get a knotted pain in my back near the shoulderblade that is clearly stress-related. Moist heat, valium at bedtime and aspirin all help. Reducing the stress also helps.

Once the current pain is resolved, try to get in better shape, as that really helps your back, and the rest of you.
posted by theora55 at 3:18 PM on December 16, 2004

You need to find the cause of your symptoms. Just treating pain can be dangerous. You body is trying to send you a message that there may be something going on you need to pay attention to.

See an MD, not a chiropractor! Chiropractors can cause actual harm. They are not medical professionals.
posted by cahlers at 4:06 PM on December 16, 2004

That's interesting, I find muscles in my body "ball up" if I tense them in a certain way, very painful, but I could do it voluntarily to about half a dozen muscles in my body.
posted by Dillonlikescookies at 5:33 PM on December 16, 2004

First, wait for the painkillers to wear off so you can feel what you're doing.

Then have a nice hot shower.

Then do the ball-between-your-back-and-the-ground thing, then stand up and stretch your arms out wide, then raise them up slowly until you're reaching for the sky, then put them out wide again, then get back in the hot shower and tilt your head forward and tuck in your chin and tilt your head a little sideways until you can feel the knot stretching out.

A good massage will feel amazingly good but in my experience it will not undo a knotted shoulder blade any faster than the procedure above.

Then rearrange your workspace so that your seat is at the right height (thighs horizontal when your feet are flat on the floor) and your screen is directly in front of you with the top of the screen at the same height as your eyes.

If you're using a laptop on your desk, plug in an external keyboard and sit the laptop up on blocks to get the screen high enough.

Do not use a computer while leaning back in your chair with your feet up on the desk and one arm on the desktop. You can get away with this until you're about 25, if you're fit; after that it will hurt you.

Also, keep a large bottle of water on your desk and take a sip every time you feel the slightest bit thirsty.
posted by flabdablet at 4:54 AM on December 17, 2004

Just to say that going to the doctor might not be a bad idea...

I once had a pain just inside my shoulder blade that I couldn't explain--turned out to be a spontaneous pneumothorax (collapsed lung).
posted by ssmug at 5:12 AM on December 17, 2004