QuestionMy name is Kaitlyn, and I'm 21 years old. I've had weird joint issues my entire life - the most obvious of which being my left shoulder, which snaps so loudly you can hear it from at least 20 feet away. It sound weird but I've always been proud of my odd shoulder! Nearly all of my joints crack, hyperextend, or behave in otherwise odd ways. I never had a problem with my back and scapulae until fairly recently.
Throughout my entire life I have had terrible posture. When I went to college a few years ago and started taking studio art classes, in which I had to draw for long periods of time, I noticed my arms would "fall asleep" when I had to hold my arms upright for long periods of time. (They still do.) I also experienced pain with continued holding-up of my arms.
Finally, about a year ago when my right shoulder started popping around age 20, and the popping was became very painful, I decided enough was enough and I would try to see what was going on in my shoulders.
I saw an orthopedic doctor who specializes in shoulders - or rather his PA, as he wouldn't see me in person. After an MRI arthrogram of my right shoulder and xrays that revealed nothing, the PA told me to do physical therapy and check back in six months.
So far I have been in physical therapy for a year, going roughly twice a week. My physical therapist is absolutely fantastic. He was the one who diagnosed me with scapulothoracic crepitus and bursitis, as well as bilateral instability, hypermobility, and tendinitis in my shoulders. My therapist and I focused at first on strengthening my shoulder muscles to correct the bilateral instability and hypermobility.
After a year of working with him, the snapping and popping are still very loud and obvious, but my range of motion has decreased in my shoulders (a good thing in my case).
However, as my posture improved as I strengthened the muscles in my shoulders and surrounding my scapulae, it soon became very obvious that my snapping scapula was the worse of my two problems (scapula/shoulders). Starting about three or four months into therapy, I've started to experience increasingly worse muscle spasms. At first they were an annoyance that I treated with tylenol and heat. By this point, a year after therapy, they are becoming absolutely debilitating.
Treatment for the muscle spasms so far has been lumbar heat combined with ultrasound/TENS unit, Flexeril, Soma, two Cortisone injections in my left scapula, and pressure-point massages from my therapist (and sometimes friends). I will go for a few weeks with a "normal" level of spasming - i.e., I'm so used to my left side being in constant spasm that I don't notice anymore - and then something will trigger a massive spastic attack, and my left side will become one giant muscle spasm. When this happens I can't even function. I'm writing this tonight because I am currently experiencing one of the worst spastic episodes in my left side that I've ever had.
The grinding on my left scapula takes place along the bottom ridge of it. My right scapula grinds as well, but it is near the top of that scapula, and though annoying and occasionally painful, it is nowhere near as loud/painful as the left one.
I'm not sure if this is related to my crepitus, but a few inches to the right from where the bottom my left scapula grinds on my ribs(or at least feels like it does) is where the spasming starts, and also where I experience constant pressure and cracking of my spine. My vertebrae there crack every few minutes - I'm always twisting my back to try to crack my spine there and relieve the pressure. The spasm extends from that point to my lower back.
I will continue to do therapy, but I guess I am wondering what other options may be available to me, and which ones you would personally recommend. I can deal with my freaky popping shoulders just fine, but the muscle spams are beyond what I can live with at this point. I know there are several surgeries that can address the crepitus, but they have varying degrees of success. I would like to avoid pain medicine and to get off the muscle relaxers, but at this point I am desperate and I will be calling my doctor tomorrow to see what pain medicine he can give me.
Any advice you can give me regarding my situation would be greatly, greatly appreciated. Thank you so much for your time.
Answer
http://somatics.com
Hello, Kaitlyn,
You've told me a lot, and all of your diagnoses reduce down to two words toward the end of your message: muscle relaxers. You are very tight, and that's what causes the pain, the snapping, the desire to adjust your position for relief.
see http://somatics.com/movement.htm
The snapping is tight tendons attached to tight muscles (spasms).
Strengthening is the big mistake, here. How can very tight muscles be too weak? -- other than from the muscle fatigue of working all the time? Your muscles are held tight by postural reflexes that must be retrained to a more comfortable equilibrium.
Forget surgery. It won't address the underlying problem and may make it worse -- because surgeries always trigger protective muscular contractions. There's something much better, much faster, without the pain, expense, and side-effects of surgery: somatic education. (see the link, above)
For the same reason, forget cortisone.
After a few sessions of somatic education, you won't need muscle relaxants, cortizone, strengthening or surgery.
As long as you are too tight, all of your symptoms will persist; once you get free of those muscle spasms, you'll have your comfort and mobility back.
other write-ups
http://somatics.com/page4b.htm
My page:
http://somatics.com/gold.htm
good wishes,
Lawrence Gold
