Giving pain in the neck the cold shoulder – Guitarist’s Shoulder *

Mylohyoid muscle visible right under jaw
What a pain in the neck (Photo credit: Wikipedia)

I wrote a piece earlier on in the year about neck and shoulder issues and my journey in dealing with neck and shoulder pain. The piece outlined how I was revising my playing position, technique and looking at exercises…..Well, guess what folks. The neck and shoulder gremlins have returned. The little buggers!

I know it’s an issue that affects guitarists in all parts of the spectrum – beginners through to pros and everyone in between, so I thought I’d write a little piece on this today. You may have experienced or are experiencing something similar, and so in writing this I hope I can help in some way or start a bit of a discussion. This will also start a series of blog posts about treating and ultimately preventing soreness and overuse injuries of this nature.

So what’s the dealio? What’s going on?

Well, the pain and soreness in my right (and only my right) shoulder back and front (or posterior and anterior, if you want to get all anatomical and stuff) and the right side of my neck has been really building up again over the past couple of weeks. And naughty me for not paying attention to the first little warning signs and nipping it in the bud then. Smack hands!

The particular symptoms of “Guitarist’s Shoulder” that I’ve had going on are:

  • Serious amounts of clicking, particularly across the front of the shoulder joint, where apparently there are some very tight bands of muscle catching and popping across the clavicle (collarbone) – nice.
  • A continuous dull aching sensation in both the front and back of the shoulder joint, leading me to want to punch myself in the shoulder to relieve it!
  • A dull aching sensation sometimes travelling up into the back of my head, jaw and eye and down into my upper arm.
  • Sharp pain in right shoulder-blade, especially when turning my head to the right.
  • Tightness in right side of my neck – a real pain in the neck. Boom boom!

As you can tell from the delightful mix of symptoms it’s not really all that pleasant and can become quite restrictive in terms of playing – very annoying.

Ouch! How does that happen?

I think it’s likely a combination of a few things going on here:

  1. Me being very naughty and lazy and not (a) warming up my shoulder neck and arm muscles before playing, doing a few range of motion exercises (b) giving my muscles a good stretch post playing and (c) being rigorous with stretching between playing sessions
  2. Me being very naughty and lazy and not giving mindful due care and attention to my posture whilst playing.
  3. Not being fully mindful and observant of the little twitches, ticks, reflexes and other seemingly involuntary and often unnecessary movements one makes when practicing and playing. For example, does raising ones toes off the ground and hunching ones shoulders really help you in playing that pianissimo line up of the tenth fret? I’ll let you answer that one…..
  4. Possibly some physical weakness in the back and shoulders that I can address with some strengthening exercises.
  5. Overworked, tired and stressed shoulder, neck and back muscles from too much of one activity without an opposing kind of activity to balance things out.

So what’s next then? How do we go about remedying the situation?

Time for some myotherapy

l cracked it this week, and got really fed up of the constant dull aching sensation and sore neck and decided to I needed to get some immediate physical relief.  Time to get it sorted out properly.

Not in the form of painkillers; I don’t really like to take them unless I really have to because they can mask what your body is trying to tell you. So in this instance I’m sucking it up and listening in carefully to the messages my body has been yelling at me for a while. Immediate physical relief in the form of massage. And not just any massage. Awesomely seriously targeted and condition specific Myotherapy manual manipulation and a bit of dry needling to boot.

Myotherapists are experts in this kind of myofasical pain, its treatment and prevention. My lovely therapist’s diagnosis transliterated into my layperson’s terms is that my neck, shoulder and upper back muscles are really overworked, constantly “switched on” over stretched in one direction and super fatigued. As a result they’re not working properly, they’re all bunched up. To add insult to the injury this bunching also results in the reduction of blood flow to the area meaning the waste products generated by the constantly “switched on” muscles is not being flushed away which adds to the pain, tenderness and tendency to spasm.

The myotherapist tells me that the poor afflicted muscles are the levator scapula, sternocleidomastoid (or SCM for short), the upper trapezius, supraspinatus, and infraspinatus.

The human shoulder joint
The human shoulder joint (Photo credit: Wikipedia)

My neck, shoulder and upper back muscles basically need releasing from the prison I’ve trapped them in, they need a good stretch and strengthening up.

After the myo session the next 12 hours or so I felt like been beaten up (which I kind of had!), but that seriously frustrating dull ache and pinching sensation in the back of the shoulder-blade were gone. Wooo! Still a bit of work to do though, as the ol’ chicken wing is still feeling a bit unstable, a bit tight, as is the neck.

I have another myotherapy appointment early next week, so I’ll you posted about the next step in my treatment and the strengthening exercises the myotherapy proposes I do.

To remedy the point about it doing enough stretching, I’m going to try some yoga classes in this first instance (going to give Bikram or hot yoga a whirl) and then follow that later in the year with some Alexander Technique lessons. I’m getting onto the yoga this very weekend so I’ll let you know how that goes.

In terms of my technique, over this next few days I’m going to set the movements radar to high alert. I’m also aiming to observe in greater detail all the movements I make whist playing. I’ll also be doing some stretches and range of motion exercises before and after playing (which I’ll outline for you in a future blog post).

* I’m not actually sure there’s a condition called Guitarist’s Shoulder, like Tennis Elbow or Policeman’s Foot (I shall do some research around that and follow-up….), but that’s what I’m going to call it for now.

Swinging from the trapezius

Ooooch. I woke up Wednesday morning this week with a nasty little crick in me neck; oww. Sore. I think it was caused by me sleeping kind of funny on it, but I’m also thinking that it has something to do with a couple of other things: (1) the computer-based desk job I sit at for a significant proportion of the day (let me tell you a secret here…..guitar aint paying the mortgage at this point peeps!) and (2) my playing position.

 

I’m thinking the latter has quite a bit to do with it in fact. Over the last few years I think I’d gotten into a few bad habits, which as we all know can be hard to fix. With a little persistence, however, and someone to redraw ones attention to these things when the mind wanders (thanks Ben), one can begin the journey of rectifying our little foibles. The sore bit in question for me is my trapezius on the right-hand side. For a bit of potted laymans anatomy, the trapezius is a big triangular-shaped muscle stretching from the base of the skull, down to the middle of your back and over to the top of your shoulder blade. It’s used to move the shoulder blade and support the arm. You have one on each side of your body and it’s a superficial muscle.

 

So me, with my posture-in-progress, I am stressing out this poor little (well, not so little actually) right trapezius of mine. I think it has become overloaded (and hence all knotted up and sore) with:
(a) me sitting slightly round shouldered with the guitar
(b) me not sitting up entirely straight when playing
(c) me getting too overtly physical and tense when dealing with spots in the music I think are “difficult” or “tricky” (which when sitting back and approaching with a view point of “ease” are fine….. The brain is a funny thing).
(d) not taking frequent breaks in my practice to stand up, move, change position, stretch.

 

It’s a work-in-progress realigning my posture, but worth persisting with to give me years of pain free and trouble free playing ahead. All I’ve got to do is keep the above points in mind, assimilate and forget about them! Easy right?