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  • dimalm
    Member
    Post count: 2

    Hello Doctor,

    Thank you very much for answering people’s questions.
    Will try to be as brief as possible.

    Background:
    38 year old male, active in sports.
    Over last year have been doing pretty extension jiu jitsu and playing soccer at least twice a week.

    I injured my knee playing soccer end of august and that kind of opened up a can of worms :(

    Up until that point i was ignoring off and on pain in my left shoulder blade and the fact that my left arm would “fall asleep” every night(only the two smallest fingers).

    to cut the long story short, pain in left shoulder blade became unberable(i was still trying to do jiu jitsu and boxing with injured knee…) it was fine when i would lie down or sit down or even standing was ok but as soon as i started walking pain in my left shoulder blade would become very intense and i had to stop after about a minute.

    i went to chiro, othropaed(who treated my knee), everyone dismissed as simple pinched nerve.

    my left arm was getting better but after right arm started feeling tired off and on i became more concerned and went to see a neurologist.

    EMG found pinched nerve at left elbow(so that explained that), it is getting better but still sometimes at night it would fall asleep. Anything i can do here?
    EMG also found curpal tunnel right wrist(I had this injury off and on so no surprises there).
    But otherwise they said everything is great and whatever I feel is not coming from my neck.

    Neuro also ordered MRI.

    Thoratic is fine
    Cervical:
    Normal alignment.
    The spinal cord demonstrates normal signal intensity. Bone marrow, etc. normal, unremarkable.

    C3-4 minimal disc bulge, slightly larger on the left side.

    C6-7 There is a moderate-sized right paracentral disc extrusion with slight flattening of the right ventral aspect of the spinal cord and mild narrowing of the right lateral recess.

    No cord edema.
    Everything is unremarkable, some disc degeneration but was told everyone is like that…

    Ok so that maybe explained the tiredness in right arm but if it is extruding to the right why is my left shoulder blade “killing” me :)

    I have seen injury doctor who specializes in jiu jitsu, basically saying not a big deal as i can move my neck every which way and it doesn’t bother me and I don’t have any limit to my range of motion anywhere.

    Neuro checked me pretty good(her words) and strength is good and everything is great, just the disc.

    Was told to stay off the mat for a month and then can return to jiu jitsu but no sparring for another months.

    Meanwhile knee is getting better and have been oked to run and play soccer. Every time i play left shoulder blade hurts but not a lot i can play though it.

    I can walk about 15-20 minutes and then usually it starts with throbbing on shoulder blade and then will eventually turn into pain(but pain is bearable). Also some activities will make shoulder blade throb(like someone is gently tapping on it) and will turn to pain eventually. If i walk with hands behind my back its much better but will turn to pain eventually.
    Right arm getting tired is still there but I think it is less often and maybe less extreme, kind of hard to tell.

    Of course, now, I have been paying too much attention to everything that rattles me… can’t say I am happy about it but…

    I have been very eager to return to sports, I am confused what can or can’t I do, and what can I do to help myself.
    It has been about 1.5 month since my shoulder blade initially hurt and I have about 3 more weeks to go before I was told I can go back to jiu jitsu.

    I have been going to physical therapy, for knee initally and now for neck, they have been doing traction and exercises but honestly I don’t think any of this is helping just time.

    I know this was long but from reading other threads you want the details so you can have all the info at your disposal.

    I also have a sitdown job but try to be active in the evenings.

    Thanks,
    D.

    dimalm
    Member
    Post count: 2

    I just re-read my post and I guess I didn’t really formulate any meaningful questions.

    I understand that herniated disc can have a variety of symptoms but I am just not at ease with the variety of symptoms I am having. Pain in left shoulder blade, tiredness in right arm and just general feeling of not right, I don’t know hard to explain. I can do everything with right arm, even when its tired but it just doesn’t feel “tight”. Maybe coupling with wrist injury and the fact that I abruptly had to stop sports, I don’t know…

    Donald Corenman, MD, DC
    Moderator
    Post count: 8460

    You have three symptoms that might be independent of each other. The numbness of your left two fingers fits with the EMG report of ulnar nerve compression (cubital tunnel syndrome). The nerve is somewhat compressed in your elbow and bending the elbow stretches the nerve, causing numbness of the outside of your hand. For this disorder, you can try a splint that causes your elbow to remain straight when sleeping. There are hand surgeons that can inject a steroid to reduce inflammation and finally, you an have the nerve surgically decompressed.

    Pain in the left shoulder blade could be from cervical nerve root compression but the MRI does not confirm this. The EMG test can fail to diagnose this. The EMG depends upon motor nerve compression to diagnose compression. If the motor nerve is functioning well but the sensory and pain nerves are compressed (a common scenario), the EMG will be negative but the pain will still be excruciating. Other disorders that can cause left shoulder pain are rotator cuff problems and instability (common with martial arts).

    The right arm weakness could be from the herniation of the C6-7 level. This nerve supplies the triceps muscle, the wrist flexor muscle (it pushes your wrist to the palm side down) and the MCP extensors (I won’t bother you with that description). Normally, the EMG will indicate problems here but the EMG test is operator dependent and subtle findings can occasionally be missed. You can test the triceps muscle with a weight machine. Can you do as many reps with as much weight on the left as you can do on the right?

    You need a skilled spine surgeon and a shoulder surgeon to ferret out these complaints.

    Dr. Corenman

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