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View Full Version : SHOULDER BLADE/HUMP question, need info and advice



so_shy
07-25-2011, 11:06 PM
http://i1188.photobucket.com/albums/z404/flahblosteem/00000ZOSD.jpg

(please see above pic/sketch showing two aspects of my back)

I have scoliosis, kyphosis, an lordosis. As of now, I cannot see a doctor about this for different reasons. So I have questions about the above pic, a crude sketch I made, of my back:

A. The sketch on the left is of what my back looks like from the RIGHT side when I'm simply standing erect, hands down at my side.. The upper back is rounded from kyphosis. The lower back is swayed from lordosis. Again, this is how I look -- roundbacked -- when I stand "erect" with hands down at side.

B. The sketch on the right is what my back looks like when I LIFT MY RIGHT ARM and EXTEND IT OUT FULLY, and when, in extending it out, have to make a squeezing motion so to speak, for example, extending my arm to shake someone's hand, extending my arm and screwing something into a wall with a screwdriver, or opening a refrigerator door. My back then totally contorts. The right shoulder blade, as depicted, JUTS OUT, and the right side of my body all of a sudden goes from being "merely" rounded to looking like I have a missile coming out of my upper back. (This DOESN'T happen on my left side; when I lift my left arm up, the left side REMAINS rounded, my left shoulder blade DOES NOT jut all the way out.)

I have no medical knowledge; so I ask two questions:

1. Can someone tell me what's happening on my right side that my scapula SHOOTS all the way out when I lift up and extend my right arm (again, see my sketch on the right side).

and

2. Is there any strap device that I could wear (under my shirt) to IMPEDE the right scapula from jutting all the way out when I use my right arm.



thank you

LindaRacine
07-25-2011, 11:13 PM
When the spine curves in scoliosis, it takes along with it the ribs and scapula. Everyone with severe scoliosis in the thoracic area has a scapula that sticks out somewhat. Sometimes, depending on the apex of the curve, the scapula really juts out. Sounds like that's what's happening in your body.

so_shy
07-25-2011, 11:19 PM
When the spine curves in scoliosis, it takes along with it the ribs and scapula. Everyone with severe scoliosis in the thoracic area has a scapula that sticks out somewhat. Sometimes, depending on the apex of the curve, the scapula really juts out. Sounds like that's what's happening in your body.

A few years ago I met a man with scoliosis (but no kyphosis). Neither of his shoulder blades ever jutted out, no matter what motions he made with his arms. It was only when he bent over -- which he did on purpose to show me -- that his right should blade stuck up/stuck out.

With me, it's just the opposite. I bend forward/bend over, and I remain roundshouldered. I stand "erect" with hands down, and I look just rounded. It's ONLY when I'm using my right arm, when it's horizontal to the ground, that the right should blade sticks all the way out, and I have this very large hump.

So I'm confused.

(And is there anything I could wear around my upper torso to impede it, reduce the degree to which it juts out, something to kind of lock iit in, hamper it, when I'm using my right arm, say, to open a door or shake someone's hand, etc.)

so_shy
07-25-2011, 11:26 PM
Linda, just to be more clear:

http://www.lifespan.org/adam/graphics/images/en/19465.jpg

That man with scoliosis I described looked like the person in the picture above, on the right-hand side.

When I bend over, I DON'T get that hump. My scapula hump comes out ONLY when I'm STANDING UP, and RAISING AND EXTENDING MY RIGHT ARM to make various motions, for example reaching out and pulling on the handle of the refrigerator door.

Christian0710
07-29-2011, 05:04 PM
Hi so_shy.

I think we might have similar body types, and I can probably tell you what is going on,
I am reading the book "Diagnosis and treatment of movement impairment syndrome" and it explains the shoulder winging problem in great detail.

Your shoulderblade (called scapulae) follows the contour of your thoracic spine, and what is often found in patients with kyphosis is that the scapulae will jut out like yours. If you imagine a flat plate on a rounding surface (depicting your shoulderblade on the kyphotic spine) , and there is an arm pulling the plate forward (like when shaking your hand your shoulderblade is pulled forward) the plate will have to jut out because it's following the rounding contour of the spine.

The muscles that hold the shoulderblade locked into the thoracic spine are called serratus anterior, but training them might not help you because the curve is the problem.

I would have to see a picture to further analyse, but from what you say, my best estimate would be that you
Work on reducing the thoracic curve. The thoracic curve might be the result of your lumbar curve. The spine has to be in balance so the line of gravity (extending from your head to your toes) is right beneath your feet. so if your lumbar spine is curving inward (which often happens because the pelvis is tilted forward and down (called anterior tilt of the pelvis) due to weak abdominal muscles and tight hip flexor muscles pulling the pelvis forward and down) then your upper spine has to counteract the inward curve, by curving outward so you are in balance.

It's difficult to say (scoliosis is also quite advanced) but there might be something you can do by working on your hips and shoulders, but I would have to go into grather detail to explain.

so_shy
07-31-2011, 11:04 PM
Hi so_shy.

I think we might have similar body types, and I can probably tell you what is going on ...The muscles that hold the shoulderblade locked into the thoracic spine are called serratus anterior, but training them might not help you because the curve is the problem.

I went to a physical therapist many many years ago who told me to do "rowing" exercises with weights. I did just that, for months on end. I really built up my serratus anterior muscles, but it never stopped the "winging". As you said, it seems the curve is the problem.



I would have to see a picture to further analyse, but from what you say, my best estimate would be that you Work on reducing the thoracic curve. The thoracic curve might be the result of your lumbar curve. The spine has to be in balance so the line of gravity (extending from your head to your toes) is right beneath your feet. so if your lumbar spine is curving inward (which often happens because the pelvis is tilted forward and down (called anterior tilt of the pelvis) due to weak abdominal muscles and tight hip flexor muscles pulling the pelvis forward and down) then your upper spine has to counteract the inward curve, by curving outward so you are in balance.

I'm not familiar with many of the terms you're using, as well as the "physics" and "mechanics" involved. Is there any video or animation that illustrates the motions of these different anatomical parts which result in the way my body is behaving.




It's difficult to say (scoliosis is also quite advanced) but there might be something you can do by working on your hips and shoulders, but I would have to go into grather detail to explain.

Earlier you talked about "working on reducing my thoracic curve." Is that what you have done? Does it work? Can you tell me or provide a link with info on "how I can work on reducing my thoracic curve"? What would I have to do? And this reducing of my thoracic curve along with working on my hips and shoulders. this approach would actually impede my scapula from jutting out like a missile when I use my right arm (or at least lessen the degree to which it juts out)?


Thank you.

leahdragonfly
08-01-2011, 09:23 AM
Hi so-shy,

here is a link for a short video I found on Spine Universe that visually shows what happens to various parts of the body (including scapula) with scoliosis.

http://www.spineuniverse.com/conditions/scoliosis/scoliosis-animation

You can see how upper thoracic kyphosis along with scoliosis would cause the shoulder blade to jut out.

Christian0710
08-05-2011, 12:32 PM
If you want to understand how to improve your situation, you will need a bit of education first, so here are some educational videos about the different terms, some of the common problems in postural problems. Once you have done that, we can continue. I myself am still working on my kyphotic posture and my sway back.


1) This video will help you understand how the body is divided into different planes (this will make it easier for you to understand most topics on anatomy)
http://www.youtube.com/watch?v=Mg7U56190Zk&feature=related

2) Here are two movies that will help you understand the movements that are used (in the different planes as shown in movie one) when talking about anatomical movement. You can always use them as reference, if you have a hard time understanding some of the terms.
The second movie is a bit odd, but hey it works :D

http://www.youtube.com/watch?v=DuxCiNdOtD8&feature=related
http://www.youtube.com/watch?v=87Ks8ygUtHI&feature=related What influences the kyphosis in can be a forward head posture,

Neck extension is when you look upward until your nose is pointing at the ceiling (the muscles in the back of your neck are used to make this movement). You are extending your neck in this movement.

Neck flexion is when you look down toward your chest; the muscles in the front of your neck are used to make this movement, just like the abdominals are used to flex your upper body down toward the ground when bending over.

Usually in kyphosis, the head is extended forward (I say extended because the neck flexor muscles in the front of the neck are elongated even though the neck is moving forward. So your head is moving forward and up which makes the muscles in the back of your neck tight giving you neck pain
http://perthphysio.com.au/ForwardHeadPosture.jpg

This combined with abducted shoulders is typical for a kyphotic posture.
Just to give you further knowledge about the problem I really recommend you watch this movie a about typical postural problems: (watch the movie about planes of the body first)

http://www.youtube.com/watch?v=BujWBQR1O1s&feature=related

Once you have done all this, let me know and we can continue :)
I'm still working on it myself and yes it's hard work but worth the effort.

so_shy
08-17-2011, 07:45 PM
to leahdragonfly and Christian0710

thank you so much

I've watched all the videos. It's a lot of information and I will have to watch them again. I have a few questions but before I get to them, I thought it might help if I gave you some more "info"

So I'm including a pic of my back below. It's actually two pics, side by side.


http://i1188.photobucket.com/albums/z404/flahblosteem/zzz1bbc.jpg


A shows my back when I'm not using my right arm (you see I'm rounded, and swayed, if that's the correct term).

B shows what my back looks like when I use my right arm (you see how the shoulder blade comes all the way out)


I hope this picture makes it more clear (I had posted a sketch when I started this topic).

Christian0710
08-30-2011, 09:18 AM
hey again,

Congratulations on the studying you have done
Awareness and understanding of a problem breeds motivation and a feeling of self-control, so let's see what we can do. I myself am being helped with my scoliosis right now, and what I know so far and have learned from all the anatomy books I might as well try to pass on.

To what side does your lumbar curve go?
If you look in the mirror from the side, does it look like your lumbar lordosis is smaller on one side that the other?
If you look in the mirror from the side, does it look like your lumbar lordosis is smallest on the side your curve is bending too? (might be your convex side depending on your scoliosis?) and largest on the side your curve is bending away from?

Do you have any hip length discrepancies?

There are some muscles that I encourage you to look up.
The muscles that flexe your hip (creating lordosis. Remember hip flexion = anterior pelvic tilt = lordotic posture) is called psoas major and iliacus (look them up on google) if you apply pleasure with a finger on them, does it feel like they are tight.
If you do this stretch: do you feel it a lot? ( here is a link for a picture of the stretch)

How about your core strength? The muscles called external oblique are very important for your lumbar spinal segments. They prevent you from twisting too much in your back. If your lumbar spine twists two much arthritis is the long-term side effects. Another thing is when the trunk is fixed (not moving) in natural position you externam obliques help posteriorly tilting your pelvis (the opposite of lordosis) which is good in our case!

Here is a test for your core strength that might be good for you. At any time if anything hurts stop. When doing core exercises the key is to keep your pelvis and upper body locked together. Most people have a tendency to sway the pelvis to one side during plank position (the position you will be in during these exercises) Your external obliques help you resist this tendency to rotate the spine and sway the pelvis (so one side of your hop comes closer to the floor during plank)

Try this core strength test.
http://sportsmedicine.about.com/od/b.../core_test.htm


http://www.somatics.com/psoas.htm



Try this out at first and let me know how it feels, and if you have any questions feel free to ask.