Question
Hi,
I injured my left shoulder on the job which caused a Rotator Cuff Tear, surgically repaired.  Went to P.T. where the therapist did a couple of maneuvers that caused pain in my back and my shoulder.  The worst one was where he tried to release the tightness in my muscle behind the scapula by putting his hand underneath the scapula bone lifting on it and rolling me to my left side approximately six weeks ago. Since this time the left side of my neck is swollen along with tenderness to the shoulder blade area along with pain with I try to reach in an upward motion.  I also have pain in my back that I never had prior and I have been lucky and never dealt with back pain before.  I went back to my orthopedic surgeon and he x-rayed my neck which showed my neck as being crooked from a straight on view which also was never the case before.  The ortho doctor wants me go back to this therapist and  be seen for scapular stabilization program and continued Rotator Cuff program.  The surgery was in Oct of 2010, what would your suggestion be as far as treatment, should I go to a Chiropractor instead but since it is worker's comp it complicates the issue.

Answer
Dear Maggie,

You are right, since this is a work injury, and your bills are being paid by your employer's Workman's Compensation Insurance, they have a lot of power in saying what kind of treatment you are to get.

You can try and have your surgeon refer you to a chiropractor, but most will not make that kind of referral. They prefer to use physical therapists... which fit nicely in their sphere of power and influence... but that is a topic for another day.

It sounds like you might have injured your serratus anterior muscle, or possibly even you levator scapulae muscle.

The levator scapulae attaches to the angle of the shoulder blade and then extends up into the neck. Spasm and tightness of this muscle could cause you some neck pain as well. http://en.wikipedia.org/wiki/Levator_scapulae_muscle

The serratus anterior muscle stabilizes the scapula, holding it solid to the rib cage. When it is injured, it can cause mid back pain. http://en.wikipedia.org/wiki/Serratus_anterior_muscle

If I did not want to go back to the PT that hurt me, I would ask for the doctor to make a referral to a different PT.  He should be sensitive to you because of your past negative experience.  You can also ask for a referral to a chiropractor, which I think would be a good idea as well. It never hurts to ask.

I hope that this gives you some ideas Maggie. I know that injuries are frustrating, but I also know that it takes time to heal. If you end up back at your original PT, make sure that he/she is clearly aware that they were too aggressive last time and that it caused you further injury.

You could also see a chiropractor on your own, outside of the work comp arena.

good Luck Maggie,

Keith Biggs, DC
AZ Chiropractor
http://www.eastmesachiropractor.com