upper back injury .."rhomboids"

bigbof · 05-20-2009, 01:51 AM

1. When did the pain begin? 3 weeks ago

2. What were you doing at the time? Or did the pain come on gradually over time? I was doing heavy barbell shrugs .. i felt pain in my right upper back when i was lifting the bar off the rack..

3. Where, anatomically, is the pain? rhomboids"right side"

4. What does the pain feel like? Sharp? Dull? Aching? Stabbing? Shooting? sharp/stabbing

5. Is the pain constant, or intermittent, or only on certain motions? Certain motions

6. What motions make your pain worse?
movements where i have to stretch my rhomboids.. uhmm squeezing my shoulder blades worsens it too..

7. What, if anything, makes your pain better? ive been using a pain relieving cream.. but its not helping

8. Does your pain radiate to any other part of your body? no

9. What things could you do before, that you cannot do now because of your injury? pull movements..

10. What is your main concern regarding the pain and its consequences? want to get better..

11. Have you ever injured that part of your body before? If so, how? no

12. Is your pain getting worse over time? And if so, how much worse over what time period? for 3 weeks the pain was constant ..but it got worse today, i decided to take a big time off until my muscle heals.. i think if i took a rest the week i got that injury, it wouldve been better..
the past 2 weeks i stopped training traps/pull movements..
i am going to a chiro. as soon as im done with my final exams..
there is a similar injury that i found on this link.. Upper back pain (rhomboids)

Cloud9Fitness · 05-27-2009, 04:33 PM

This one is tough without an examination because of how often poor scapular movements can't be seen from the front. However, inflammation of the rhomboids and scapular bursa is most likely. The scapula does not have a true joint with the back, and is controlled by the traps, rhomboids, levator scapula, and serratus anterior. If you have dominant pec and lats, you may be pulling your scapula out of preferred alignment. This may disrupt the bursa. The final shrug motion that caused pain may have been either the rhomboids insertion on the bone or the bursa right under it.

Treatment is rest until pain subsides and beginning exercises that incorporate proper scapular movement. Tons of shoulder/scapula exercise can be found all over these blogs. I would specifically suggest trying upward rows instead of shrugs. This gets the upper trap too because of the shrug at the top and the upperward rotation of the scapula needed in the movement (which is part of its "functional" role).

Mon · 05-27-2009, 10:32 PM

^^^upright rows are not very good either. I heard upright rows are not very good for the shoulders. I think Mike Robertson and Eric Cressey have mentioned that as well as a "not to do" exercise.

read face pulls, push ups, and shrugs on t-nation. That will tell you all about the shoulders and what to do. If you want to shrug, do overhead shrugs.

http://www.tmuscle.com/free_online_a..._and_shrugs&cr=

hope this helps

Cloud9Fitness · 05-28-2009, 12:00 PM

Overhead shrugs are a good exercise, but the problem with them is the same one that may be a problem with upright rows. If you have poor scapular rotation you will likely impinge at some point after ABducting 120 degrees. This is why it is on some peoples' "do not do" list. However, if you want to fix the problem you need to improve your mechanics for getting into that range. So I would actually start with upright rows and a lower weight first to repeatedly train the upward rotator to function. If you need to, get a trainer or friend to provide manual scapular rotation towards the end of a set (this may work best with single hand upright rows).

If you think about it, the end of the upright row and the overhead shrug are exactly the same. Except in one the elbows are flexed and in the other the elbows are extended. The elbow position does not affect the upper trap.

Mon · 05-28-2009, 05:57 PM

actually, in part II of eric cressey's shoulder savers article on t-nation, he said its not a good idea to do upright rows when there is pain. Read Shoulder Saver #16. He would never give upright rows to a client

http://www.tmuscle.com/free_online_a...savers_part_ii

Quote:

Shoulder Saver #16: Ditching the Barbell Upright Rows
I've often said that I don't believe in contraindicated exercises — only contraindicated individuals. I still stand firm with that statement, but if there is one exercise that will ever push me over the line, it's going to be the upright row. This is as internally rotated as the humerus will get, and you're elevating the humerus right into the impingement zone on every rep.
For that reason, I'll never write this into a program for a client or athlete. The dumbbell version is a slightly safer alternative, although I feel that there are still much safer ways to challenge the upper traps and deltoids. To summarize, if you've ever had a shoulder problem, suspect that you might have one now, or have other predisposing characteristics (i.e. poor posture, lots of overhead work in your daily life) that might increase your risk of impingement, you'd be wise to omit upright rows altogether.

Cloud9Fitness · 05-29-2009, 03:09 PM

Those are great points, especially if you keep your humerus internally rotated which increases the risk of impingement. Also, perhaps I did not state clearly enough that you should rest until pain subsides prior to trying new exercises. However, most individuals I see doing upright rows externally rotate there humerus during the movement. They are also performed in the scapular plane, which moves the greater tubercle of the humerus from the impinging tendons on the acromial. What Eric Cressey does not tell you is what degree of external rotation is needed to avoid impingement. The answer is that impingement can occur at any position of humeral rotation if the scapular upward rotation is insufficient. So it is a case by case situation, and this is why I think it is safe for this case after the pain reduces.

The individual who posted the original complaint had an acute pain on the medial scapula. I always think about impingement, but I am more concerned with teaching correct movement patterns before the impingement occurs. So, building up scapular movement awareness with exercises like PNF raises, pushup pluses, and upright rows (to replace basic shrugs) would be indicated. Of course all of these exercises should be done with a low enough weight that proper upward rotation can be achieved and only if you feel comfortable (pain free) while you are doing them.