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I thought I’d post this, in case anyone has similar symptoms, as it might be helpful. For years, on an off, I had a mild pain along the inner side of my arms when I raised them to the side. I never thought about it much, and imagined it might be a muscle or tendon pain. Then it went away. However, some months ago, it came back more strongly, just on the right side. At its worst, there was a radiating burning pain along the inner side of the upper arm, in the thumb, and around the ring finger. The dull burning pain was strongest on a patch on the front of the shoulder, and all the muscles around the shoulder joint were tender. Feeling along the line of the pain on the arm (which gave strong burning sensations after a delay) gave a line overlying the median nerve. Shooting pains in e.g. fingers are a sign of nerve damage too. After reading posts on this board, I heard about thoracic outlet syndrome (thank you whoever posted them). The very great majority of cases of thoracic outlet syndrome are due to nerve damage, most of the remainder being due to blocked blood flow. The nerves to the arm leave the neck at levels C4-T1, and travel to the arm through a fairly narrow gap under the collar bone. Then the nerves intermingle, rearranging their fibres, in what is known as the brachial plexus which is on the front of the shoulder, before the different nerves travel down the arm. Trapping of the nerve under the collar bone will lead to pain in the brachial plexus, and in the areas supplied by the nerves. In more severe cases it can also lead to paralysis. The symptoms showed that mine was clearly neural. But why was the nerve getting trapped (if that was what was happening)? One reason is that when I sleep on that side, my shoulder tends to crunch forward, squeezing the front of the shoulder. Stopping sleeping on that side helped, but the pain still didn’t go away. Being thin and unmuscular with mobile shoulders I probably hold my shoulders too low, which means the gap between the collar bone and rib is smaller than normal. So my exercises have focussed on trying to lift the outer edge of the shoulder and collar bone, by lifting the outer edge of the shoulder blade. After experimenting, three exercises have been particularly good. (1) One is to try to target the lower trapezius, by shrugging the shoulders up while holding weights (10 kg in each hand – that is just what I had conveniently available). The action is to try and concentrate the lifting from the inner lower part of the shoulder blade, which is made easier by slight squeezing together of the bottom of the shoulder blades, as well as a strong lift to push the tops of the shoulder blades up and out to the side. (2) To target the anterior serratus, by doing mini-pushups against a wall, with elbows close in to the side. (3) The other is to roll the upper and back part of the top cm or two of the shoulder up and backward. It is a very minimal action, and may in fact be lifting the top of the shoulder blade (the acromion?) by targeting the anterior serratus, though I can only feel it in the top of the shoulder. It is a strange minimal lift and roll of the bone just at the top back outer edge of the shoulder – if you roll the whole shoulder it does not help. This one is particularly useful if I’m sitting at a desk and I’ve been holding the arm relaxed while just the wrist is supported on the desk. Generally the pain has gone now, though it can sometimes recur unexpectedly while using my arm. I suspect most of the pain is due to inflammation of the nerve sheath, because the most tender points are along the line of the median nerve and over the brachial plexus, and we expect inflammation and irritation to take time to die down. The other thing, is that if I cant get a comfortable position to lie in at night (lying on my back often irritates the nerve, for reasons I’ve not been able to work out), lying on my good side and closely hugging a pillow in both arms seems to keep the arms in a stable and restful position (I found this advice on a site for Ehlers-Danlos syndrome). It may look as though I’m missing my teddy bear, but it is all for medical reasons. Cheers, Jim.

Hello everyone, I have very tight shoulders, especially my left. I get a strange klunking sensation in my scapula that I get when hunching my shoulders forwards (as they are always generally) and then pulling back. This is extremely amplified when I do the last exercise in Kit's Yuri band demo, where he faces away from the band and internally rotates his arm. The klunking and snapping become almost unbearable. So should I plough on or is there another exercise that would target this problem? Thanks and all the best, Gareth

When it comes to Gomukhasana, or exercise 12 from S&F, how do you prevent the scapula and the shoulder of the lower arm from rolling forward during internal rotation of the shoulder? I find that in order for myself to reach the top hand with the lower one, I have to let the arm of the lower roll forward, thus causing an impingement. I may have not been reading the cues right in the book, but shouldn't it be necessary to roll the shoulder back and retract the scapula before internally rotating the arm? I also notice with exercise 59 for the external rotators, that Kit explains (the narration from Master Shoulder Flexibility) how you need to roll the shoulder forward first before starting to internally rotate. Is this still a proper cue or should the shoulder be rolled back? What am I not understanding? I can provide pictures of my attempting to do the stretch at a later time.

I think it might be useful for me (and maybe others) to illustrate a problem I have; it's a painful sensation I feel only at times, so I always forget to seek professional help about it. It almost inevitably comes up when I sit on a stool, or in general when I have to keep my torso erect for long periods of time. I am kinda clueless about anatomy, so I can't be really precise about the location, but I try to explain the best I can. To put my finger exactly on the painful spot, I have to grab my right shoulder with the left arm so that the scapula moves accordingly and then move my right arm to reach the area between the left side of my spine and the shoulder blade: the pain will be close to the edge of the scapula (that is now removed from its rest position). Touching the area I feel only soft tissues and ribs, I suspect the pain might be linked to a mobility issue, but I'm not sure. Yesterday I felt it for the first time after a while and I immediately linked it to this spinal breathing I performed one hour before, which is essentially an exercise for thoracic mobility. I want also to add that apparently my yoga nidra practice helped alleviate the issue. What do you guys think the problem is?

The question is in the title. My scapula is protruding and I don't know how to fix it. My kinesiologist says that when I raise my arm I get shoulder impingement because my scapula isn't moving properly. Ideas?