Hard to diagnose shoulder problem

[willashlock]

Here's my history:

I was playing softball in a recreational league for about a year (once per week), and was pretty casual about it. I do like to throw, though, and cut loose when I got the chance. A little over a year ago, I started getting a pain that would radiate up the right side of my neck to the back right side of my head, and some burning under my right shoulder blade (I'm right-handed). I decided to stop playing softball for a while to see if it would clear up, but that never helped. After a couple months I started having some aches in my mid-right back, and pain radiating down the outside of my right arm. I also get a little ache down around my bottom couple of ribs on my right side. My right scapula is winged just slightly, and sits a little lower than my left, and I get a lot of grinding from my right clavicle/sternum joint when I rotate my shoulder around. I have a sore spot on my clavicle about an inch from the shoulder end that is very tender. There's no restriction with any of the movements, just the general/persistent ache of the muscles and overall tightness and aching of my right shoulder, neck and back.

What's been done so far:
MRI of cervical and thoracic vertebrae - Totally clear
MRI Arthrogram of right shoulder - Lots of inflammation in my subscapularis, some inflammation of my infrispinatus/supraspinatus.
X-rays - all totally clear.
EMG Nerve Test - Nerves all in great shape.
Corticosteroid Injection in right shoulder - no relief or change.
Lots of PT and stretching - no results yet.

I joined a gym about 2 weeks ago under the advice of my doctor to see if I could work out any possible muscle imbalances, but no results just yet (thought it's still pretty early.) I'm trying to focus on my serratus anterior to see if that is my problem from all the throwing I did in softball, but I'm getting pretty frustrated at this point. I've been trying to figure this out for about 16 months! Any insight would awesome!

Thanks,
Will

[willashlock]

Thanks for the input! I plan on sticking with my current routine of stretching and exercise along with NSAIDS for the next few weeks to give it plenty of time to hopefully resolve, and then I might need to meet with my doctor again. I think one thing that makes it harder for me to recover from this is that I have hypermobility in a few of my joints (shoulders especially) so stretching those muscles can be a little tough. Thanks for the help, and if you have any other ideas, I'm all ears!

[S. Kaul, MD]

Hey Will!

Well, seems like that aside inflammation around the rotator cuff there hasn’t been any other abnormality detected. This could be due to constant wear and tear and probably minor associated injuries. In a similar situation I would suggest gradual increase in graded physiotherapy after a period of initial rest. Ice-packs/ warm compresses and anti-inflammatory medications may also be helpful. It would be difficult to suggest anything beyond this at this stage. I would atleast give it 6-8 weeks of gymming/ physiotherapy to consider a review for alternative therapies. If the symptoms fail to resolve, you may consider a review with your treating orthopedician.
Hope this is helpful.

Take care!