Exercises, stretches, or other ways to relieve repetitive strain in shoulder and upper back?
June 19, 2012 9:53 AM   Subscribe

Exercises, stretches, or other ways to relieve repetitive strain in shoulder and upper back?

You are NAD, NMD, and I should go see a doctor. My doctor is going to tell me I need physical therapy. I have no insurance to get physical therapy.

I am right handed. The muscle right around my right shoulder blade has a dull ache in it.. this ache is sometimes unnoticeable and sometimes flares up to the point where it radiates up to my right shoulder. This especially happens if:

1. I sleep on that side (which I am trying my best not to do but I don't sleep as well on any other part of my body)

2. I use a mouse at a computer. Especially at work. (Can't not do this, my job revolves around working on computers)

I've tried elevating my chair, using wrist rests, not using wrist rests. I've even explored using the keyboard for navigation as opposed to the mouse.

I thought if I could do stretches or somehow exercise the shoulder I could help reverse the problem.

Also, does anyone know if I should be using heat or ice on it? Both? How do I apply the heat/ice to that spot? Your shoulder blade is kind of one of the areas on your back that you can't reach on your own.

Any advice you have would be appreciated.

Again, I know I should see a doctor. I am asking for ideas and suggestions that I can try before I resort to racking up high medical bills (will physical therapists even see someone without insurance?)
posted by royalsong to Health & Fitness (14 answers total) 13 users marked this as a favorite
Advance warning: Looong reply ahead.

Because it needs to be said: Seeing a doctor for a consult would be a good idea. That said, IMHO doctors are way too keen to prescribe meds or tell you you need some kind of physical therapy. A few years ago my mum's primary said she needed major surgery on her shoulder blade due to the exact kind of pain you're describing. Instead she had me (I am not a doctor, physical therapist, massage therapist, etc) come over a 2-3 days a week and massage it. Turned out there was a muscle knot near her shoulder blade. I had her stretch a few times during the day, swing the arm around a little (she has lymph node problems so she can't do too much with her arms), and otherwise did nothing but the massaging. Within two months she was 100% better and the shoulder has not bothered her since.

I tell this story because what you're describing sounds exactly, or very close to, what my mum experienced. If you can't reach your shoulder blade, work on your flexibility some. Muscle knots can develop from underuse - barring injury, you should be able to physically reach every part of your own body. Look up some basic shoulder stretches you can perform at work - the one where you put a hand on a doorframe/filing cabinet/whatever and rotate your body as far as you can without causing pain (discomfort is good) is my personal favorite.

Exercise may or may not help depending on whether it's a strain or a muscle knot. I don't know medical terminology, but in my own vocabulary strain is caused by overusing a muscle and causing it to tear, while knots (which I get all the time and am constantly massaging away in my left shoulder/neck) are caused by long-term tenseness and/or small movements, like moving a computer mouse.

While at your desk, try to relax your shoulder while using the mouse. Put your elbow on the desk (or find some other position that's comfortable) and try to relax all the muscles in your arm except your forearm and wrist while you're using the mouse. The kind of mouse with a roller ball on top instead of the kind you need a mousepad for (not sure what they're called) may help in this respect. I hate them, personally, but other people swear by them.

Most of all though, I recommend finding a friend with strong hands who isn't afraid to poke and prod you in the back for a while - someone who can tell what a muscle knot feels like and work away at it. If you're having a similar problem to what I/my mum have, there will be a hard knot somewhere (not necessarily where it feels like it hurts, mind you) that's like a little stone stuck inside your muscle. Massaging gradually around that, using a steady rhythm (no "deep-tissue" stuff - you'll just tense up from the pain and make it impossible to work with) and a careful touch, will help immensely. It will also hurt like a bitch, as fair warning.

This is all presuming you do not, in fact, have some kind of ligament/bone/nerve problem. A medical professional can rule that out. If it turns out to be muscle related though, I've found a friend unafraid to see you in total agony (though preferably sympathetic about it) can be much more helpful than physical therapy.
posted by Urban Winter at 10:10 AM on June 19, 2012

IANAD. Can you do shrugs with heavy weights in a weight-lifting routine? That can do double the benefit - stretch out your trapezius muscles when your arms are down (with the weights) and also strengthen those muscles holding everything together.

In a previous job, we also had to do some ergonomic exercises every two hours (our department that spent 12 hours a day at a computer). We'd scrunch our shoulders up to our ears for a five count, then push our shoulders down as far as we could for a five count. We'd do that 3 - 5 times in a row every 2 hours or so. It only takes a minute, it's quiet (you won't need to interrupt your coworkers) and I found it helped a lot of the tension I had in my shoulders from being PC bound all day.
posted by jillithd at 10:15 AM on June 19, 2012 [2 favorites]

I have had really good results with a tennis ball and a wall (or floor). Just put the tennis ball between your upper back and the wall and roll around on it. You will laugh / cry and possibly shriek, but it will help the knots.
posted by Duffington at 10:38 AM on June 19, 2012 [2 favorites]

Massage and stretching will probably help. The tennis-or-lacrosse-ball trick is great for self-massage, but I think it's worth it to find a massage therapist who specializes in injury work... one or two sessions might be enough to bring some initial relief without breaking the bank. Conquering Carpal Tunnel has a lot of great stretches, as does Treat Your Own Neck; Youtube is also a surprisingly good place to find free info on stretches you can try. This video practically saved my life, and this one and this one might also help. Don't discount stretches which don't seem to address the exact spot the pain is in; the muscles in your hand, arm, shoulder, and neck are all connected, so the problem may not be limited to the area which hurts. Be gentle and take it slow.

I also strongly suggest strength training once you're feeling better. Dumbbell work (shrugs, rows, front raises, and overhead press) along with pull-ups and chin-ups will help you build strength and mobility in your shoulders and upper back. In my experience, lifting regularly is one of the keys to keeping this sort of pain from coming back. I wouldn't try it until the pain is gone, though -- if your muscles are super-tight, lifting might make things worse.

That said, I think the first thing you should do is stop using your mouse with your right hand! I understand that you can't not use a computer at work, but fortunately there are options beyond using a standard mouse with your right hand. Something you can do right this minute is switch your mouse to your left hand -- this is frustrating for the first day or two, but you'll catch on quickly (this has the added bonus of making you much more ambidextrous in the long run). You could also try a Wacom Bamboo tablet instead of a mouse: the pen format causes you to hold your wrist and hand in a more natural position, which often helps with RSI. There are also other mice which enforce this kind of handshake-grip, or you could try a trackball. I ended up with a regular mouse on the left side and the Bamboo on the right -- that way I can switch whenever one or the other starts to bother me.
posted by vorfeed at 11:17 AM on June 19, 2012 [1 favorite]

Physical therapists are not super expensive and can really help in just a few sessions -- I would skip a doctor and go straight to a PT for 3-4 sessions, and make sure that the PT understands you're looking for things you can do at home & work to improve your posture and reduce strain, rather than three massages. (Although massage can help a lot too.)
posted by yarly at 11:24 AM on June 19, 2012 [1 favorite]

I have a similar shoulder issue. Although I can't claim that it never flairs up, I've gotten it under control 95% of the time.

I give most of the credit to T-Tapp exercises. Learning the routine is a bit of a time investment, but it's really paid off for me. Once you've gotten the hang of it, the T-Tapp "basic workout" is only about 15 minutes, and I've found that doing it 2 or 3 times a week is plenty to keep my shoulder in check.

I've also switched to a memory foam pillow (Tempurpedic "comfort" pillow), and trained myself to mostly sleep on my back instead of my side. It's kind of expensive, but I've been using it for six years when I wouldn't usually keep a cheap pillow for more than two or three. I've seen special side-sleeper memory foam pillows, too, but I haven't tried them.
posted by Kriesa at 11:52 AM on June 19, 2012

I've also switched to a memory foam pillow (Tempurpedic "comfort" pillow), and trained myself to mostly sleep on my back instead of my side. It's kind of expensive, but I've been using it for six years when I wouldn't usually keep a cheap pillow for more than two or three.

If you'd like to try one of these, Foam By Mail has them for a fraction of the price. They might not be quite as good as the Tempurpedic brand -- never tried one of those, so I'm not sure -- but they're light-years beyond a regular pillow, and at $30 or so they're easy to try.
posted by vorfeed at 12:17 PM on June 19, 2012

I am a crossfit coach with a certification in mobility from a DPT. I highly recommend the mobility WOD website to anyone with pain. It is www.mobilitywod.com/
You may have to scan through a bunch of archived videos to get one specific to your problem. And you may have to incorporate ideas from multiple videos into a daily routine. But the information is invaluable. Also, ice the problem area 10 minutes of every hour (or as often as possible) until it is completely better. Once or twice a day is not enough. Good luck.
posted by AmyKR at 12:39 PM on June 19, 2012

I have this issue in my left shoulder blade area. First do see an MD. IF this is a muscle issue, following has helped a bunch:

1. Massage. Including self massage from just under your chest on the right side up toward your armpit. You'd be surprised how often a sore muscle there is causing the pain, and how much massaging it can relieve your shoulder.

2. Embarassing but effective neck-based stretch: roll your head as far back as possible, with the idea of looking at the ceiling without bending the rest of your body backward, then hold. Next roll your ear toward left shoulder as far as possible, then hold. Now forward, bringing chin to chest, and holding. Now ear to right shoulder and hold. Repeat each stretch once.

3. Heat, preferably moist, on sore area.

4. Acupuncture with traditional Chinese doctors.

5. To avoid recurrence: sitting upright, yoga, and strength exercises. And yes, sleep on your left side.
posted by bearwife at 2:05 PM on June 19, 2012 [1 favorite]

Oh, and to apply the heat: obviously warm baths and showers are good. Also, heating pad. Also, adhesive medicated pad which produces a sensation of heat.
posted by bearwife at 2:10 PM on June 19, 2012

I've got a weird birth defect going on with my skeleton that causes pain exactly as you describe, which I was never aware of until I got it x-rayed (when the pain got so bad I couldn't type without weeping, actually, because I'd begun training for Golden Gloves boxing and didn't know there was a giant gaping hole in each shoulder blade, which is where strained muscles would swell into - and then audibly creak every time I moved my arms).

Turns out that rubbing the muscle that hurt was actually re-injuring the muscle over and over again, so on the off-chance that you have something other than garden-variety repetitive injury muscle pain going on, I'll refer you to this page about rotator cuff syndrome and another on shoulder impingement syndrome.

Both of them will help you figure out what to do in the short-term, but I highly recommend not raising your right arm over your head unless you can help it, using your right arm sparingly, and sleeping flat on your back until a doctor can properly diagnose you. These innocuous things can help decrease the pain without injuring your shoulder in any way.

Please know that if it's not a strained muscle, but a tear/bursa/injury of some kind, lots of stretching and/or rubbing could actually hurt you for a long time - even if whatever you try to relieve the pain seems to work (until you wake up the next day, at least).
posted by Unicorn on the cob at 3:36 PM on June 19, 2012

What worked for me are YTWL exercises.
posted by kanemano at 7:41 PM on June 19, 2012

Rumble Roller. This thing has helped out my shoulders immensely. It is like getting a deep tissue massage by rolling over the "hot spots" and releasing the nasty stuff that is likely causing you problems because of pressure on the nerves radiating out from the spine. At least, that was my experience. I have an increased range of motion and I don't feel like my shoulders are cramped up to my ears. Plus, I have avoid injury to the area which is big for me as I used to get the symptoms you have described at least once a year.
posted by bkeene12 at 8:32 PM on June 19, 2012

I had this too! Still have it technically. It's gone from a constant dull ache (complete with pain radiating down into elbow/wrist/fingers and shooting spams into the base of my neck) to almost complete normalcy with flareups if I slack off on preventative measures.

I went through a ton of medical attention and was determined that nothing was physiologically wrong with me (it was inflicted by tendinitis/repetitive stress injury, but it lasted well over a year and by the tail end of it the doctor surmised it was just residual muscle tension). I did a ton of physiotherapy and massage therapy, which all helped, but what finally knocked it down was lots of rest and constant preventative measures.

What works for me (note: please seek medical attention first and make sure it's not a tear/bursa/nerve/etc. that might be causing this. The following was things I pieced together from various sources for muscle-tension ONLY):

Pilates (especially the move called "The Saw", double especially if I do it with a large exercise ball between my ankles. With the exercise ball, instead of pushing my pinky finger against the outside of my foot, I push the back of my palm against the ball and turn my head toward the arm reaching out behind me. Don't know why, but having the ball to push against stretches out my shoulders like nothing else).

Yoga. Particularly Bharadvaja's Twist and Half Lord of the Fishes.

Pilates and yoga in general strengthen my core, which helps.

Using a Theracane (I've also heard good things about Body Back Buddy, but it's not available where I am) and mashing out the tight knots in my upper back. You can pair that with The Trigger Point Therapy Workbook 2ed., which I also own, but I usually just do it by feel. Sock/tennis ball also work, but it's harder to pinpoint than with a leverage tool.

Perfect, and I do mean PERFECT, posture while sitting.

Rotator cuff exercises and Rotator cuff stretches (lots available on Google and youtube; I'm also fond of a move called Wall Angel).

Good luck OP! I feel ya.
posted by Hakaisha at 7:26 PM on June 22, 2012

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