I have had one patient, a fit and otherwise well man in his 40’s. Athletic. Went through the clinical reasoning, approximately as you described, and found nothing. The posterior thoracic pain was intermittent, worsened by cycling to work, relieved with rest. He thought it was his handle bar set up. I sent him to his Dr. as a precaution and told him to call an ambulance if it came back when exercising. It did the next day. They saved his life. It was cardiac in origin. He had a Quad CABG within 36hours. I was so very shocked even after my slight suspicions.
I just did a self manipulation and it instantly removed my pain and took five seconds. This video just leveled up my quality of life. Many thanks brother.
EXCELLENT VIDEO! I have been suffering from this pain and after 4 different doctors, not nailed it. More confusion and little improvement. I think you nailed it..Will work through this and figure out what exactly is happening. Thank you.
I use a different technique to palpate the rhomboids : shoulder in internal rotation with scapular winging. You could almost make the same video about the scalene and cervical referred pain. Mostly it's cervical in origin.
Strengthening exercises can and should still be used for origins other than myofascial. In case of referred pain from the neck, we would focus a bit more on the neck and in case of thoracic referred pain, we would mainly target the er. spinae in the thoracic area.
can you give advice on flat thoracic spine? I've had this since childhood it is mild but cause nerve pains and irritability for years now and i dont know how to fix it? is it even possible to fix this?
Los ejercicios que indica ,el trapecio medial y superior intervienen más que el romboides,deltoides o trapecio inferior. Normalmente cuando alguien tiene dolor el el romboides suele tener afectado también el trapecio superior,por lo tanto esos ejercicios le pueden perjudicar!. El estiramiento del romboides ok!
gibt es auch eine möglichkeit die Videos in deutsch zu sehen? Ich weiß das es einige auf Thieme gib, aber so viele die ich gerne sehen und verstehen würde gibt es dort nicht. mfg
Hallo Die deutschsprachigen Videos auf Thieme haben wir exklusiv produziert. Die Inhalte auf RU-vid gibt es zum großen Teil auch mit deutschen Untertiteln. Dies wird in der Zukunft auch zunehmen.
Great video, looks very helpful. Of course, my gf walks in during one the demos you’re doing with the other guy. 😅. It’s for my back pain, I promise! Lol 😂
The dorsal scapular nerve refers a deep pain or a burning / itching pain to the medial side of the scapula and is said to be a greatly underrecognized pain especially in young active individuals, why didn't you include this cause in the video? On contrast, there is no high quality evidence for the trigger points / myofascial pain as a primary cause of pain (only secondary to e.g. cervical radiculapathy or nerve entrapment syndromes or inflammatory conditions)
@@moritzhellmann4061 Entrapment of the dorsal scapular nerve is usually at the level of the (middle) scalenes, but can be c5/6 radiculapothy as well yes
@Sylorinnis. Do you have a source saying that dorsal scapular nerve entrapment is underrecognized? There are certainly many more possible origins of pain, but the pain we are talking about that we see in 99% of patients in our practice is not nerve pain. On top of that, nTOS is highly debated and most end up with a diagnosis of cervical radiculopathy . That group also commonly reports medial scapular pain (Mitzutamari et al. 2010). Trigger points are highly debated as well and there is a lot to be said about it (makes for at least 1-2 separate videos). However, whatever they are, they are a phenomenon that is commonly seen, even though we do not know the reason for those sore spots. We'd put them under the umbrella term of muscle pain.
@@Physiotutors No, I don't, although many practioners and some authors claim it is. I agree this doesn't prove anything. The existence of NTOS by the way is not "disputed" anymore or "controversial", but a well-established condition with well-established diagnostic criteria and with proven successful surgical treatment by RCT (surgery vs PT), see for example Goeteyn et al. (2022). Also, where did you get that "most" end up with cervical radiculopathy? I don't know what you mean by that. Personally, I have the feeling that scapular pain is often non-specific (let's say "muscle pain") when it is mild and cannot be provoced by neck tests or upper extremity loading , but when it is chronic, moderate to severe, and can be provoced, it is often respectively either cervical disc disease or dorsal scapular nerve entrapment secondary to thoracic outlet syndrome.
I would like to ask, I have a pain in my left shoulder blade for a year now and many times it seems to catch. I also feel a strange sensation of pain in front just below the breast (corresponds to the level of pain behind the shoulder blade). I have had blood tests, chest magnetic resonance imaging and chest X-ray and everything is normal. what could it be?
@@user-ji8zx3rr2h I’ve had the pain for about 6 months now. I went to see one of the best physiotherapist in town but still couldn’t solve it for long term. mine is suspected to be referred pain from my neck. I’ve had neck pain and front shoulder pain before rhomboids. all on my left side. how about you?
@@BytesizedL do you also have pain in the front of your chest? and if so where exactly? I have had it for 1.5 years straight, almost every day, all my tests are normal have you had any imaging tests?
@@user-ji8zx3rr2h I have some pain (very minor) below my left chest, about near my ribs. I did not do any imaging test so far. which side of your chest is painful?
Great video, but the trigger point stuff should not meet the evidence criteria. I would recon that neromuscular connection, yes, but trigger point hast long been refuted. Not suitable for educational video.
