Help me... Injuries all over!!!

[Jean-Paul]

Okay Bill, I need help. I have a couple of injuries that are plaguing me right now, and I really need help AGGRESSIVELY addressing them. I have an agenda here... I am going rock climbing in a month and a half in the Sierras, and I really need to be back in condition for it. Here are the things that are hurting.

I have some serious neck problems. According to the physical therapist (also a manual therapist), I have several hypermobile vertebrae, and have aggravated my radial nerve, causing all sorts of problems in my right arm that previosly I had thought were all seperate isolated problems, but are apparently call connected to my neck problems. I supposedly have horrible posture (I don't disagree), and I need to strengthen my rhomboids to pull my shoulders back a little, and concentrate on keeping my ears above my shoulders. My pain is related to a "guarding" pattern that I have been doing for probably years.

The other injury is in my left hip. The only time it really seems to bother me is in my more ballistic moves, particularly complexes that require descending quickly to the basement, and coming back up quickly. Sometimes it bothers me just being in a deep squat, but lately it seems a little better. I just see no improvement in my power moves. For example, I cannot snatch at ALL right now. The stomp absolutely KILLS my hip. I have had SI joint problems in the past, but this feels different, more in the ball and socket joint. Pops on me every now and then too (not with trying to do it either).

My hips may be a bit tight, being that I mountain bike, run, do LOTS of stairs, and lift weights. I don't know if this is a flexibility or a stability issue. I would get that it is NOT a stability issue given my past few years working my stability. If it is, then perhaps it is related to actually overtraining the stabilizers. (???)

What do you think?

[Bill Hartman]

JP: "I have some serious neck problems. According to the physical therapist (also a manual therapist), I have several hypermobile vertebrae, and have aggravated my radial nerve, causing all sorts of problems in my right arm that previosly I had thought were all seperate isolated problems, but are apparently call connected to my neck problems.

*****Be very specific...what problems? What aggrevates it, what makes it better. Describe the symptoms. Numbness? Tingling? Weakness? Pain? The radial n. is a peripheral nerve. If it's true radial n. irritation then the neck hypermobility may not be the problem.

JP: "I supposedly have horrible posture (I don't disagree), and I need to strengthen my rhomboids to pull my shoulders back a little,

*****Strengthening does not necessarily improve posture. Posture is a learned phenomenon. However, there was a great study done recently which showed that bodybuilders tend to have relatively weak lower traps and decrease shoulder internal rotation

JP: "and concentrate on keeping my ears above my shoulders.

*****Where else would they be? (sorry, joke at your expense). Do you mean ears in line with shoulders?

JP: "My pain is related to a "guarding" pattern that I have been doing for probably years.

*****Guarding from what? Do you have a prior related injury.

*****My first response would be that it sounds like you have some forward head posturing and perhaps protraction of the shoulders. This could be irritating the C7-8 nerve root between the anterior and middle scalene. There could be an entrapment at the neurovascular sleeve, triceps, brachialis, or supinator. Hard to say without examining you.

JP: The other injury is in my left hip. The only time it really seems to bother me is in my more ballistic moves, particularly complexes that require descending quickly to the basement, and coming back up quickly. Sometimes it bothers me just being in a deep squat, but lately it seems a little better.

*****Your last comment makes me lean toward a muscular issue. Does it feel like it's more in the front of the hip?

I just see no improvement in my power moves. For example, I cannot snatch at ALL right now. The stomp absolutely KILLS my hip. I have had SI joint problems in the past, but this feels different, more in the ball and socket joint. Pops on me every now and then too (not with trying to do it either).

*****Ah, the wear and tear finally catches up to you. I know the feeling.

My hips may be a bit tight, being that I mountain bike, run, do LOTS of stairs, and lift weights. I don't know if this is a flexibility or a stability issue.

*****The hip joint is one of your more stable joints, but also can be one of the most inflexible.

I would get that it is NOT a stability issue given my past few years working my stability. If it is, then perhaps it is related to actually overtraining the stabilizers. (???)

*****Bikers and lifters tend to have tight hip flexors and adductors. Isometrically stretch your psoas, rectus femoris, short adductors (butterfly stretch) and long adductors and then reassess your symptoms for changes.

*****Are you getting some regular soft-tissue work done? You have an ART guy at your disposal, correct? Have him check your scalenes, pec minor,and follow the radial nerve pathway for any upper extremity symptoms. For the hip, check distal psoas, proximal rectus femoris, pectineus, obturator externus, and long adductors.

Sorry I can't be of more help here. Diagnoses via email is a bit tough. If you can provide more info as to what causes the pain (passive movement, active movement, end range of motion, palpation, etc.) I may be able to offer more.

Bill

[Jean-Paul]

Be very specific...what problems? What aggrevates it, what makes it better. Describe the symptoms. Numbness? Tingling? Weakness? Pain? The radial n. is a peripheral nerve. If it's true radial n. irritation then the neck hypermobility may not be the problem.

Weakness and pain are pretty much it. I have had some tingling on the tops of a couple of my fingers. Sleeping and then waking up aggravates it at the source, but all the other problems I have been having with my arm may not be connected to it. I am not really sure.

Do you mean ears in line with shoulders?

Yes

Guarding from what? Do you have a prior related injury.

Yes. Over the years I have had some minor problems, lots of shoulder problems. About 4 years ago I really threw my neck out terribly, and mistakenly went to a chiro who only made it worse with the adjustment. I wound up going to a neurosurgeon who, at the time, said that I had 55% strength loss in my right arm. I had an MRI and he said that my neck had pretty badly compressed vertebrae with bulging discs. They weren't ruptured though. Before he could tell me that I was going to have to do surgery I wound up going to an accupuncturist (don't laugh) who had immediate and amazing results with me!

Well, it has been off and on with dull aches and some occaissional "pinched nerves" (that is what if felt like), and then some serious bouts of pain that last for days or sometimes weeks! This last bout really had me down for a while, until one of my clients who is a doc took me to his buddy who is a rehab guy (enter Rob Tillman), whom I have only known up to then by reputation only. I have visited with him twice so far. They taped me up so that I couldn't comfortable break good posture for a couple of days. He said that my neck was not only too inflamed and the muscles to tight to move it, but that it even if they weren't so guarded, that my joints were to loose, and that moving bone wasn't what I needed. He said that I am hypermobile. That is the problem with so many chiropractors (no offense to BRB who seems to be more rehab oriented than the typical "clientele building" chiros) is that they just want to adjust EVERYTHING, and adustment is NOT always what is needed for spinal problems. Mine has be adjusted so much by myself and others that the joint has no stability left. It has only stayed in place at all because of my natural musculature. So I have to hold my posture out of the guarding position for a while, get the inflammation down, and do some exercises.

My first response would be that it sounds like you have some forward head posturing and perhaps protraction of the shoulders. This could be irritating the C7-8 nerve root between the anterior and middle scalene. There could be an entrapment at the neurovascular sleeve, triceps, brachialis, or supinator. Hard to say without examining you.

This is pretty much what Rob said. I will give you a more specific diagnosis when he is finished.

Your last comment makes me lean toward a muscular issue. Does it feel like it's more in the front of the hip?

Yes! Lately it is much more in the front.

Ah, the wear and tear finally catches up to you. I know the feeling.

YES! And I HATE THAT!

Are you getting some regular soft-tissue work done? You have an ART guy at your disposal, correct? Have him check your scalenes, pec minor,and follow the radial nerve pathway for any upper extremity symptoms. For the hip, check distal psoas, proximal rectus femoris, pectineus, obturator externus, and long adductors.

Well, yeah, I sorta have an ART available. My problem is that I am keeping him too busy! I rarely get on his table, dang it! I will give him these instructions and tell him to dig out my insides!

Thanks for all of your input. I really appreciate it. BTW, did you ever get my emails from today? PM me if you did.

[Jean-Paul]

bumping for Bill.