Question Title: Arm/Shoulder/Back/Chest Muscle Weakness & Sensitivity

I am a 35 year old male who has been bodybuilding competitively for about 3 years (lifetime drug free if it makes a difference). On October 16th, 1998, I injured myself while practicing posing for a show on the 17th. I was doing a "thigh/abdominal" pose in which you place your hands behind your neck and pull your upper body into a bit of a crunch to flex the abdominal muscles. Although I didn’t feel or hear any snapping or popping, immediately after I did this pose I experienced a lot of tightness and aching in my neck, trapezius, and shoulder area (left and right sides), particularly when I turned my head from side to side. Within hours the ache became severe enough that it prevented sleep and ibuprofen did nothing for the pain. The next day, the pain was the same but had also radiated down my right arm. My right arm muscles twitched a lot over the next few days but there was no tingling or numbness. Also, I experienced severe weakness (about 25% of normal) in my right arm, chest, shoulder, and back. A handshake was difficult. After about 3 to 4 days, the muscle twitching subsided. After about 10 days the pain subsided and the weakness was not so severe. About 3 to 4 weeks after the injury, the weakness was at about 50% of normal but my right chest, shoulder, back, and arm were quite atrophied and specific muscles took on an unusual sensitivity. 2 Forearm muscles (1 behind the brachioradialus and the other opposite that one), at least one shoulder muscle (posterior deltoid and I think one inside), the upper pectoralis, and the teres major (I think) became very sensitive to pressure. If I touch these muscles, it feels the same as if I were squeezing another muscle at about 10 times the pressure. Currently I have no pain, my strength has returned to about 60% - 70%, but this unusual sensitivity to pressure still exists. In a normal relaxed state I feel fine. I have no problems or pain turning my head in any direction.

The physical therapist and physician suggested a disc problem as did one neurologist but the other neurologist is adamant that I do not have a disc problem. He said I have a long thoracic nerve palsy. My right scapula does wing out about 1.5 inches but my physical therapist says it has always been that way because I have a curved and twisted spine. If you want to see what my back looks like, connect to www.glen-montgomery.com/competitions/eascptc1998c.html. The neurologist can’t explain the unusual sensitivity or weakness in my right back, shoulder, chest, and arm but claims it will go away even though it hasn’t after about 6 weeks.

I have had problems with right arm and back pain (right rhomboid area) in the past (I was told a pinched nerve) but that was rectified with physical therapy.

I feel like I’m at a dead end for medical help and that if I can’t find further help my career as an international natural bodybuilder will be at a dead end too.

Thanks for your time.

Glen Montgomery

Dear Glen:

Difficult and fascinating situation. Did visit your web page, which is quite good! You do have a mild scoliosis, and there was a slight winging of your right scapula on the side view from 6/3/98. But this could conceivably be worse now.

I am unable to determine where exactly the atrophy is on the bases of your question. You mention the more sensitive muscles, not the ones that have lost bulk or have become weaker.

Initial diagnostic guesses reading your story would be:
1. Neuralgic amyotrophy (Parsonage Turner syndrome): a diagnosis supported by the severe weakness, relatively widespread atrophy, scapular winging and pain without tingling or numbness.
2. Pinched nerve root in the neck
3. Pinched nerve elsewhere from "overuse" or compression: not particularly common in this scenario.
4. Direct muscle stretch injury.

Since this problem can adversely affect your profession, seeking the best available advice is critical.

Amongst numerous neuromuscular specialists, the two world-renowned authorities on the subject that come to mind are Dr. Asa J. Wilbourn (Cleveland Clinic) and Dr. Michael J. Aminoff (UCSF, San Francisco). They would likely need to do an EMG examination to determine the exact nature of the problem. Additional tests such as MRI of the cervical spine may be needed.

In case a visit to Cleveland is something you decide on, please call (800)223-2273 or (216)444-5559 for an appointment.