Emily came in to see us at Dynamic Sports Physical Therapy in New York City with long-standing complaints of neck and upper back pain. Her pain was dull and localized to both shoulder blades, and it got worse when she spent long period of time sitting, using a backpack or carrying bags. She had received chiropractic treatment over the past few years for her pain and had multiple Botox injections into the muscles surrounding her shoulder blades to decrease her symptoms. Though the Botox injections provided some temporary relief, the symptoms would consistently return a few weeks after the injections.
Upon Emily’s first visit, she told her therapist that she had previously been diagnosed with dystonia, a movement disorder that causes a patient’s muscles to contract uncontrollably and results in repetitive movements or abnormal postures. Emily’s therapist was not confident that this condition was responsible for her symptoms, so he performed a thorough evaluation to get a better idea of what was going on.
After completing the evaluation, the therapist found that Emily presented with classic symptoms of a condition called upper crossed syndrome: tightness and tension in her chest and neck muscles, with weakness and elongation in her upper back, neck, and core muscles. Emily had decreased flexibility of her neck, most notably when rotating it in the left direction, which recreated the pain in her left shoulder blade. Additionally, her neck range of motion was significantly better when tested lying down than when standing, which led the therapist to believe that the issue was more related to her stability than her mobility. Emily also presented with poor core stability when she was pushed laterally in half-kneeling and standing positions.
Emily stated that her goals were to be pain-free while sitting at her desk, and she also wanted to initiate an independent gym program without any complaints of neck or back pain. In addition, she hoped that undergoing physical therapy would help her to understand the root of her symptoms and that she would no longer need any more Botox injections to manage her pain.
Emily’s treatment program from Dynamic Sports Physical Therapy in New York City
To decrease the tone of the muscles surrounding her neck and shoulder blades, Emily received a manual therapy intervention called Active Release Technique. Joint mobilizations were also utilized to increase the flexibility of her neck into left rotation. Exercises to strengthen her core were also employed in a variety of positions, including lying on her back, lying on her stomach, half-kneeling, and standing. Finally, a set of stabilizing exercises for her shoulder and rotator cuff were also used to increase the strength and endurance of these muscle groups.
After 12 weeks of consistent physical therapy, Emily was discharged without complaints of pain or limitation in her neck flexibility. She joined an independent gym and has initiated a general conditioning program, during which she didn’t experience any issues. She is also able to sit at her desk pain-free all day, and can carry packages and her bags without any problems.
Emily had this to say about her outcomes after physical therapy: “My experience was great, and in addition to greatly helping my neck pain, I also learned a lot about the causes of my pain, which has been very helpful as I continue to work on staying pain-free.”
We’re thrilled to see Emily thriving after completing her treatment program with us, and we wish her continued, pain-free success in the future. If you’re experiencing any painful issues of your own, we’d like to offer our services to you. Contact Dynamic Sports Physical Therapy at 212-317-8303 to schedule an appointment today, or click here to read our last blog on upper crossed syndrome.