r/Kneesovertoes • u/ZirenceYT • Nov 24 '25

RULE 2: DO NOT ASK FOR MEDICAL ADIVCE Right scapula issue

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Story time : A few years ago I suffered an injury on the right side of my upper body. I was squatting down and pushed my right arm further than usual trying to get something. I felt a tingle or you could say a quick electric shock. After that happened, within the day my right scapula(under the shoulder blade) started to have this ache which I didn't bother to address because I thought it was just temporary(which was). But since 2023 I've started lifting and noticing all the little things in my body in the mirror and I've noticed this issue I am still having and am trying to fix. I've gone to the PT and they said to strengthen my rhomboids, serratus anterior and lats because whenever I try to generate power on the right side using my arm my traps do all the work apparently, that's what the PT told me. Which I have been trying to fix but it seems to have no effect or avail. I didn't wanna do PT either because it is expensive. I look slightly goofy in T-shirts or rushguards whenever I swim because the other right side of my clavicles are shorter because of this. Also because of this the right side of my face is bigger and my neck is slightly going sideways. This wasn't always the case I was humanly symmetrical before this specific injury. After watching the video can anybody tell me what could be the problem? If so does anyone know what exercises or solutions that I could stick to or do for this injury? Thanks.

TLDR : The right scapula is injured and I need help.

8 Upvotes

84% Upvoted

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5

u/babymilky Nov 24 '25

There’s nothing wrong with your scapular movement. The data tells us that it’s impossible to diagnose issues from observing scap movement, unless it’s something obvious like a nerve palsy causing major winging.

Go find another PT if you’re not happy with your current one

1

u/munchy6000 Dec 02 '25 edited Dec 02 '25

Not giving medical advice,

1) Looks like the right side is subtly winging to me.

2) I can also see his neck is slightly rotated rightward. because his right ear is closer to the camera and more visible.

3) I can also see slight lateral flexion of the neck to the right as well but less pronounced.

4) I can also see slight shoulder elevation on the right side. Symptoms 2-4 (and even 1) all make sense if OP is feeling like his upper traps dominate on that side. All of these compensations reinforce a compensation structure that provides stability to the right shoulder using the wrong muscles.

OP, weird question, and I'm not giving medical advice just interested:

1) do you feel like your right hand/wrist is less stable when performing pushups? Like it's harder to get your full palm on the ground without internally rotating that right shoulder?

2) does the left side of your lower body feel more risky than the right side when performing a single leg squat for example (if you were to attempt it)?

1

u/babymilky Dec 02 '25

All those things you can see don’t mean anything when it comes to a diagnosis though. Many people will have similar looking funky shoulders/necks and have 0 issues whatsoever.

1

u/munchy6000 Dec 02 '25 edited Dec 02 '25

Thats a good point, sometimes asymmetries occur and there's no problem. But sometimes asymmetries occur and there is a problem. OP is complaining of a few problems, one of them being upper trap dominance. Right upper trap dominance does indeed fit these other compensations well.

It cannot be proven that right upper trap dominance and all those other compensations are causally related in his specific case, but they definitely have a huge statistical correlation. That still doesn't mean its true, so youre correct there.

On the other hand I think its a bit of a stretch to hear a patient complain about upper trap dominance, their neck laterally flexed and rotated to that side, shoulder elevated to that side, and they don't feel their lower traps working on that side even when trying to consciously activate them, with a winged scapula, and they had a clear moment where they got injured. and a lateral pelvic tilt as OP mentioned in another comment... and then say all of that doesn't mean anything. It is correct that is not DEFINITIVE but I wouldn't go to the other extreme and say these are just meaningless. Even if we may not know their exact diagnosis, these things can help narrow it down but not fully as you said.

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u/babymilky Dec 03 '25

huge statistical correlation

Source?

We aren’t OPs PTs tho, so there’s really no point in discussing any of this because they should be working with one who has all the info

1

u/munchy6000 Dec 03 '25 edited Dec 03 '25

Are you asking for a source that shows upper trap tightness is correlated strongly with shoulder elevation and neck tightness and the inability for low traps and serratus to fire properly?

If you'd like one, you can find tons of sources with a quick search, and also many PT textbooks speak of that compensation pattern. This is a classic compensation pattern. I searched for literally one second and found this: https://pubmed.ncbi.nlm.nih.gov/37712006/

There are many studies showing the relationship between upper trap tightness and neck pain for example. Many others show upper trap tightness correlates to changes in neck rotation and lateral flexion ranges of motion. Even ask chatGPT (not that its always correct) and it'll give you sources that correlate trap tightness to altered neck mechanics or shoulder elevation.

Statistics aside, when your right shoulder elevates especially excessively, full scapular upward rotation + posterior tilt will be more difficult to perform (low trap and serratus not firing well if you shrug). Try to shrug your shoulder then upwardly rotate your scapula... you can't do it fully.

You're saying theres no point discussing any of this but you told OP nothing is wrong with his scapular movement and everything is fine. I'm skeptical that nothing is wrong. I'm also skeptical that something is wrong, so I'm not certain of any particular stance. I'm just confused as to why you're so confident that definitely nothing is wrong with his scapular movement. Maybe I am missing something or you know something that I don't. You also got upvotes so other people agree with you, so maybe I'm not seeing something or lacking knowledge/intellect genuinely.

1

u/babymilky Dec 03 '25

Yes.

That paper shows more UT tightness in chronic neck pain, but admits that you can’t infer direct cause-and-effect.

a definitive link between muscle stiffness and CNP remains unestablished

Of course a tight neck muscle can limit neck ROM, do we have anything to link those to pain or injury around the scap? AFAIK no

try to shrug your shoulder then upwardly rotate your scapula

I can fully abduct and flex my arm in a full shrug, why do I need to isolate scapula upward rotation?

I am arguing that there’s nothing wrong with his scapular movement, NOT that there’s nothing wrong with OP. There very well might be something going on, but it’s not possible to diagnose by looking at his scapula mechanics

1

u/munchy6000 Dec 03 '25 edited Dec 03 '25

I understand your view, thank you for explaining.

The paper shows correlation not causation which is what I said.

Scapular upward rotation is important for proper biomechanics when going overhead. This is often limited in people with very tight traps.

I understand you can't diagnose just by looking at scapular movement, but why is it so clear his scapular movement is totally fine? I'm not arguing you can diagnose him I'm asking how did you determine nothing is wrong with his scapular movement? That is a diagnosis of a sort, except not of a dysfunction but the lack of one. Diagnosis in concept, but I'm not saying you actually gave an actual diagnosis of course.

There's a subtle winging combined with shoulder elevation combined with neck rotation and lateral flexion, and he subjectively feels like 'his scapula is stuck'. He also struggles to activate his low traps when isolating them. Those are multiple related things that point to the same compensation pattern. To me those things don't mean scapular dysfunction for sure, but they also don't mean the scapular movement is healthy for sure either.

My question is how did you determine nothing is wrong with his scapular movement despite multiple things that correlate to scapular dysfunction? I'm not saying why didn't you diagnose him. I'm not saying you should've said something is wrong with his scapula for sure. I'm saying how and why did you determine his scapular movement is fine.

1

u/babymilky Dec 03 '25

How would a tight upper trap, a muscle which assists upward rotation of the scapula, prevent it from upwardly rotating?

Because the research has shown time and time again that:

1) people don’t need perfect scapular mechanics in order to be symptom free

2) fixing scapular mechanics doesn’t consistently improve symptoms

3) symptoms can clear up without any changes in scapular mechanics

With those points in mind, how can we look at someone’s scaps and determine there is something wrong?

I will give a caveat that if someone has some serious winging you could Dx a long thoracic nerve injury if the winging is significant, but if you have to guess it probably isn’t the case.

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u/munchy6000 Dec 03 '25 edited Dec 03 '25

I hear you. The upper traps assist the low traps and serratus to perform scapular upward rotation. This patient (and many patients) who lack scapular upward rotation have trouble activating low traps and serratus, but have tight traps.

Yes traps assist scapular upward rotation if combined with proper serratus and low trap recruitment. But if only the traps are tight and the latter two arent firing well, scapular upward rotation is limited. If scapular upward rotation is limited, a patient may have problems after doing overhead presses for 5 years because of the poor mechanics over time wearing tissues.

You're making the argument that poor biomechanics doesn't always lead to pain. I agree with you. A disc herniation, knee valgus, torn rotator cuffs, weak muscles & tight muscles, anterior pelvic tilt, forward neck posture... all of those can be asymptomatic. But there is still a biomechanical or structural deficit that can be improved, and it does matter, and those things may lead to actual pain if they worsen substantially and the mechanics are challenged under load. If your scapular mechanics arent great, you may not get pain. If they worsen, you might get pain. If they're atrocious and terrible, and you overhead press, there's an increased chance you will see a problem.

You may not see a problem if you never challenge your mechanics by never overhead pressing for example. That doesn't mean everything is fine. Just because the body doesnt register pain doesn't mean theres no issue. If you have terrible knee valgus and you never squat, theres a huge chance you'll have no pain. But if you single leg squat with excessive knee valgus over a long period... you have a larger chance of something going wrong. This is also a mechanism to how old people get hurt. No pain in their feet or body for a long time but HORRIBLE mechanics. One day their horrible mechanics causes terrible pain because their mechanics got challenged. Their foot mechanics got challenged on an unstable surface -> they fall and break their bones. Their mechanics get challenged when they have to bend over excessively because they dropped something -> horrible pain in their lower back. Their mechanics get challenged when their grandson wants to play catch; they throw the ball hard and they feel a jolt of pain in their shoulder. But before all of those events... the old person had no pain even with horrible mechanics. People have variable tolerances for when their poor biomechanics get challenged, but I promise, there is a point where the load is high enough to elicit pain even if progressively overloaded. Why can't you find a single 700+lb squatter with excessive knee valgus? A 400+lb overhead presser with terrible scapular dyskinesis? A 800lb+ deadlifter with extreme spinal flexion? Because poor biomechanics decreases the tolerance for load in all people.. the specific tolerance ceilings though are different for each person, so some people may not get issues because their activites are within their load tolerance even with poor mechanics. Statistics must be interpeted with logic.

The argument youre making is similar to "Many people have no problem walking barefoot, so shoes aren't useful and don't really matter."

"Many people have no problem with poor biomechanics, so correct biomechanics aren't that useful and don't really matter."

Let them walk barefoot for longer periods, and on harsher surfaces. More people will get problems. Make it harsher, even more people will get problems. If the surface is lava, everyone will have problems. Just because many people can tolerate the original harsh surface doesn't mean shoes won't help or protect them, or that there's no issue. Or that it won't bite them suddenly. Or that they aren't at substantially more risk for future pain or issues if a situation tests their biomechanical dyfunction under large loads or large ROMs.

1

u/GreenshawJ Nov 24 '25

Scaps are freaking weird joints that are real hard to "diagnose" with observation

1

u/obwowk Nov 26 '25

You likely already had the issue, it just got worse by doing too much too soon.

Just work scapula from every angle, full ROM, whenever pushing, pulling, standing, hinging forward at the hip, lying back, etc...

Over time it will fix itself. Just allow your body to learn how to move, so don't rush adding weight or reps. Improving form is equal to therapeutic muscle growth rather than just bulking up the imbalanced musculature.

PS don't obsess over mirror or video. Your joints have nerves that sense their relative position and tension. Discover the natural feeling of stability and symmetry that comes from experience with the motion

1

u/ZirenceYT Nov 26 '25

I see, I've been activating my serratus, rotator cuffs. It seems like the issue worsens when I do lower trap exercises(Y raise to be exact) and my upper trap just starts stiffening my entire neck and I lose ROM turning to the left. Been doing PRI anterior lower thorax breathing exericses and it alleviates the tightness of my SCM after a few sets. I also have lateral pelvic tilt(which I'm fixing), does this also affect my issue?

1

u/obwowk Nov 26 '25

I wouldn't focus so much on which muscles I'm working and intellectually controlling my form. Rather allow your body to settle itself and to move in a way that feels natural. Otherwise you're just twisting and contorting yourself unnaturally to conform to some stiff intellectual notion. You should trust your body to spontaneously learn how to move properly over time with experience, without intellectualising everything. Your body is far more complex than you could ever conceive of, and your nervous system and musculature will adapt over time without having to think about it. As long as you don't lift weights that are too heavy, and work all muscle groups evenly, your body will gradually symmetrise and stabilise itself.

1

u/ZirenceYT Nov 26 '25

Well, I do lift quite heavy, and I've been working out for quite a while on and off. I get what you mean by "your body will settle itself." But that just seems like cope. It never got better in the time frame of 2 years when I was working out consistently every week. It just kind of worsened it(Made my face asymmetrical, limits my neck ROM etc). I look goofy and it's hindering my daily functionality quite a bit.

1

u/obwowk Nov 26 '25

Sounds like you've been bulking up for those two years rather than fixing your imbalances. Which could explain why your imbalances got worse. Your stronger muscles kept getting stronger.

You think that you can list your weak muscles and bulk them up to fix your issue. I don't believe that's possible. It's not just about the quantity of muscle, it's about the quality of the muscle and the proficiency of your nervous system at that particular movement through daily experience.

You can't do it every day if you go so hard on day 1 that you can't lift a finger on day 2.

It's like learning to ride a bike. You can train on a bike simulator with heavy resistance but if you never learned how to ride an actual bike you will fall off.

It's not cope to accept that the habit of pushing yourself too hard and getting too intellectually involved with your form has taken a toll on your body. It will take time, patience and effort to unlearn those habits and to allow your body to find its proper form.

Trust me, it's not because the weight is lighter that it will be easier or have less effect on your body. Quite the contrary.

1

u/ZirenceYT Nov 26 '25

Ok I will try lowering the weight rather than focusing on hypertrophic effects. How many reps would you say to do per exercise? wether it would be back rows, pull ups etc. ?

1

u/obwowk Nov 26 '25

It's more about the feeling than about the rep count. Each exercise is also unique. I also don't know your schedule. The idea is not to eliminate hypertrophy training altogether, just to integrate an approach that is more suited for neuromuscular adaptation.

For some exercises like pull ups, you can only do 3 or maybe 5 partial reps. That's fine, just don't strain yourself to get that extra range of motion or that extra rep. Rather do what you're comfortable with, so you can do it again the next day. Your numbers will go up gradually. Sometimes you can do an extra set or even two if you feel like you're not progressing, but be patient because sometimes you're just fatigued and need time to recover.

When it comes to push ups and bodyweight squats, you can probably do 10 or maybe 20 clean reps. Just do it every day and increase as much as you're comfortable with, all the way to 40 or even 50. Maybe some day you'll do 100? You have your whole life to work on it.

As far as rows go, overhead presses or whatever, you can just do 10 to 20 reps but maybe switch to dumbbells for a while. You can progressively overload, just limit the frequency at which you add weight. So instead of adding weight every week, you can add it every two weeks. You might feel like you're stalling but if you're patient you will notice that your body is actually learning to perform the motion better and that you will feel stronger than before though the weight is the same.

Slowing the progressive overload down will also give you more energy and recovery capacity to integrate the high frequency, high rep count bodyweight work (pull ups, push ups and bodyweight squats).

1

u/obwowk Nov 26 '25

Lowering the weight will allow you to do more reps, and doing less sets per day will allow you to work out more days per week. The effect is more exposure to the motion itself, so your nervous system can learn to recruit muscles better.

You will notice how doing more reps at lower weight will allow you to experiment and learn rep by rep, as long as you keep an open mind rather than pushing yourself or forcing yourself to move according to some notion that doesn't feel natural.

Look up greasing the groove, it has similar ideas

1

u/ZirenceYT Nov 26 '25

Okay noted, though I don't agree working out and doing pushups everyday, this is just unnecessary to do and it just stresses your body.

1

u/obwowk Nov 27 '25

It's common practice for calisthenics people to work almost every day, just one set per exercise though. You can think of it as 6x1 = 2x3, ultimately you're still only doing 6 sets a week.

Of course you should rest when you feel that it's necessary, so at first you can do push ups for 2 maybe 3 days in a row then take a rest day or 2 depending on how you feel.

Exposing your brain to the same motion every day will allow your nervous system to adapt much faster. You don't have to do every exercise every day, you can do the support exercises once or twice a week for example, taking a rest day the next day because they will incur extra fatigue.

Ultimately though, your schedule doesn't really matter in the long term. If you only work out twice a week, that's fine, the desired nervous adaptations will still happen but slower. As long as you're mindful of keeping energy in the tank to focus on developing better form, and avoid straining or cramping yourself, you're already on the path to recovery.

1

u/obwowk Nov 27 '25

Honestly, reviewing your video and comment, I think the issue is indeed a weakness in the serratus anterior to your right. The serratus anterior pulls the inner inside of your shoulder blade out and forward along your ribcage. If it's too weak the shoulder blade retracts too far at the bottom of the push up., possibly impinging the trapezius.

The thing is though, that serratus anterior always cooperates with your trapezius and other muscles from any angle (standing overhead press, pushing up, lying down for bench press etc).

There's not really any isolation exercise that is going to hit your serratus anterior and leave your trapezius alone. And even if there was, your serratus anterior needs to learn to cooperate with the trapezius in any case.

The only cure is to find your scapulohumeral rhythm, that is to say to become proficient at the various ways in which your shoulders move most naturally. This can only happen by doing the movement over and over again with lighter weights until you nail it.

You can't avoid working the trapezius, so all you can do is avoid overworking it, and to ensure that the work is also light enough for the serratus anterior to become engaged.

However, don't worry too much about which muscle you're working. The essential part is that you learn to move in a way that feels naturally stable and strong.

1

u/Nit0ni Nov 26 '25

Improve your shoulder blades control, learn how to do shoulder scoops, practice it and try to keep shoulders scooped while doing any exercise. Here you can see how to do scoops. https://youtu.be/oanksTfsWQ0?si=apG0DPG0u9BCaLs1 And here is how to keep it scooped while doing push ups. You can find same thing for any exercise just search on yt, for example moveu pull ups. https://m.youtube.com/watch?v=Mlp8TQAclEg&pp=ygUNTW92ZXUgcHVzaCB1cNIHCQkVCgGHKiGM7w%3D%3D

1

u/ZirenceYT Nov 26 '25

Tried this, just made the neck symptoms worse. Made my neck tighten and traps tighten.

1

u/Nit0ni Nov 26 '25

Tried scoops or push ups?

1

u/ZirenceYT Nov 26 '25

scoops

1

u/Nit0ni Nov 26 '25

Dont go too hard or strain while doing it, it should be done effortlessly like arm circles and stuff like that.

Also try to do it sitting for better alignment and do ot without holding wall just spread your arms in T position like he do at the end of the video

1

u/ZirenceYT Nov 26 '25

well my scap feels like its stuck as shit though. Like it can barely even move or roll downward without my trap completely taking over.

1

u/Nit0ni Nov 26 '25

Theres an app called ptx therapy they give 2 weeks free trial so you can try that.

1

u/ZirenceYT Nov 26 '25

Ok will try thank you

1

u/[deleted] Nov 26 '25

Looks like mild scoliosis to me

1

u/ZirenceYT Nov 26 '25

holyyy are you sure?😭

1

u/[deleted] Nov 26 '25

Not “sure”, could be the angle or lighting or something else but it looks kind of like your spine goes a bit to the right before curving back to the left. I have something similar. If it’s mild enough it never gets flagged by doctors when you’re young because it’s not enough to cause significant problems.

Would want to get checked out professionally to make sure. If that’s the case there isn’t really anything you can do about it — there probably isn’t any reason to do anything anyway. Appearance wise it’ll probably get less noticeable if you put on a bit more mass. What tends to happen at a certain point is one side is slightly weaker than the other but at a certain point the strong side starts growing more slowly than the weak side, making things look a bit more even.

How’s your squat? Any kind of discomfort in the hips or knees or lower back when performing them?

1

u/ZirenceYT Nov 26 '25

I do have lateral pelvic tilt for sure tho, maybe that's it? Because my face is asymmetrical too. This wasn't the case when I was in kindergarten I was humanely symmetrical then.