Shoulder Health

Get Your Head Around Your Shoulders this Summer!

With summer fast approaching, many of us are jumping back into one or more of our favourite fair weather activities, be it golfing with an orchard view, volleyball on the sandy beach, swimming in the crystal clear Okanagan lakes, playing tennis with friends or a little extra gardening for all of you green thumbs! Whatever the summer activity of choice, we all hope this warm weather finds us ready to tackle the ‘fun in the sun’ at full steam without having to worry about those pesky aches and pains that often set in over the winter.

One aspect that many summer activities have in common is that you will undoubtedly require a pair of healthy shoulders to fully enjoy them. As a practising physiotherapist treating patients with various conditions and injuries for almost a decade, I must say that shoulder pathology and dysfunction are some of the most common conditions walking in and out of our clinics on a daily basis.

When you dissect this shoulder issue further, there are a few key things that make the shoulder one of the most biomechanically impressive but also one of the most vulnerable regions to injury in our body.

First of all, the shoulder is the most mobile joint in the human body. The ‘ball and socket’ anatomy of the shoulder allow for movement that we see in no other body region. Whether it be flexing the shoulder 180 degrees overhead to smash a beach volleyball or fully externally rotating your shoulder during your golf swing follow-through, the shoulder girdle demonstrates phenomenal flexibility.

This fantastic mobility in the shoulder girdle however comes with a price. In order for this flexibility to be functional when teeing off with your driver on 18 or lifting heavy pot of flowers up on your deck, the shoulder requires a significant amount of dynamic stability. This dynamic stability is accomplished by work of a few important muscles that surround the very flexible shoulder joint…most notably, the rotator cuff as well as other scapular stabilizing muscles.

For our shoulders to remain healthy and function at the high levels required for our summer fun, this balance between flexibility and stability must be maintained.
Some common conditions and injuries that we as physiotherapists assess and treat where shoulder flexibility and stability become compromised include; Shoulder Impingement, Tendinitis/Tendinopathy, Bursitis, Rotator Cuff Tears, Shoulder Dislocations/Separations, Frozen Shoulder, and Scapulothoracic Dysfunction.

If your summer involves getting or staying active and you want your shoulders to be ready for the action, book a consultation and some treatment with your physiotherapist to ensure your shoulders are ready to shoulder the load!

Shoulder Pain

Do you lie awake at night with an aching shoulder? Do you feel sharp grabs of pain while reaching up into the cupboard or into the back seat of your car? Did your shoulder pain start one day without any injury that you can remember? Shoulder pain can keep us awake at night and limit our day-to-day activities – even the most basic ones like washing our hair or getting dressed. In this article we are going to talk about how shoulder problems can start and what there is to do about it.

First let’s talk about what is inside your shoulder. The shoulder is what we call a ‘ball and socket’ joint. This means that the top of the upper arm bone has a ‘ball’ like surface, and this ball connects with the concave surface of the shoulder blade, similar to a golf ball sitting on a tee. This type of joint (like your hip joint) is build for maximum mobility. Having so much mobility is a good thing because it allows our shoulder and arm to reach in all different directions. However, this excess mobility can also predispose the shoulder to injury.

Almost everyone has heard of the rotator cuff. The rotator cuff is a group of 4 muscles responsible for protecting the shoulder. These are often the muscles that are injured in the shoulder because they can become pinched inside the joint (referred to as ‘impingement’). The rotator cuff muscles work alongside the muscles of your shoulder blade to ensure that the ball is always positioned in the centre of the socket so as to avoid pinching, inflammation and pain. Impingement can occur if any of these shoulder muscles become tight or weak or if the neck and upper back are too stiff to allow for proper arm movement.

People that spend a large portion of their days sitting often become very weak in their shoulder blade muscles while at the same time also becoming tight in their chest, upper back and neck. Others spend a lot of their workday doing repetitive movements with their arm that also can create irritation and muscle imbalances in the shoulder. At night many of us tend to lay on our ‘favourite’ side while sleeping which squeezes the blood out of the shoulder thus causing further irritation and preventing recovery from the strain during the day.

If you start to have shoulder pain the best strategy is to avoid the movement that is creating the pain and to ice the shoulder for 15 minutes 2-3 times per day for the initial 3 days (after 3 days switch to heat for 20 mins, 2-3 times per day to increase blood flow/healing). Make sure to continue to move the shoulder in motions that don’t hurt in order to prevent your shoulder from getting stiff. Also try as best as you can to not sleep on the painful shoulder at night in order to allow healing.

If the pain does not subside within a week it is advisable to see your health care professional so that the specific reason for the shoulder pain can be diagnosed. In physiotherapy, pain control and stretching out tight muscles are usually the initial goals. Treatment then fairly quickly progresses to focusing on strengthening specific muscles as well as increasing overall flexibility. Often the conversation of prevention will focus on daily stretching or Yoga as well as emphasizing good posture while sitting.

I hope that you have learned a little bit about how the shoulder works and what can cause shoulder pain. If you are starting to have nagging shoulder pain or tightness, remember that it is much easier to deal now then ‘down the road’. Happy spring (summer) everyone!

Intramuscular Stimulation (IMS)

Intramuscular Stimulation (IMS)

Intramuscular Stimulation (IMS)

Intramuscular Stimulation (IMS): What is it and how can it help get rid of your chronic pain?

In this article I am going to focus on the treatment of chronic muscle and nerve pain and why it can be so difficult to find a solution for this type of pain. It is estimated that over one third of the adult population in North America suffers from chronic pain. That is a staggering statistic! This means that 1 of out of every third person out on the street is dealing with ongoing daily pain. Research shows that suicide is nine times more prevalent in people with chronic pain than with depression and it is estimated that in the United States, chronic pain affects more people than diabetes, cancer and heart disease combined.

So is chronic muscle and nerve pain so common? To understand this question we have to look at the gradual process that happens to all of our bodies to some degree over many years. As harsh as it sounds, the reality is that as we age our bodies are slowly ‘rotting’. By the time we reach our 50’s and 60’s we will all get some amount of arthritis in our spine. How fast we ‘rot‘ depends on a variety of factors including our overall fitness levels, nutrition, the types of jobs we do, family genetics and any traumatic injuries we sustain along the way ie. motor vehicle accidents. As the arthritis in the spine progresses, the nerves that exit the small spaces between each spinal bone (vertebrae) start to become irritated. In response to this irritation, the muscles that these nerves supply then start to form tight bands. These bands are the ‘knots’ you feel when you rub sore muscles. The muscle bands not only cause pain but they also begin to pull at joints and tendons as well as compress the already sensitive nerves at the spine. These tight bands often do not respond to traditional treatment approaches such as stretching, massage and spinal manipulation.

A form of treatment that has been gaining popularity in the last 5 to 10 years for chronic muscle and nerve pain is Intramuscular Stimulation (IMS). This treatment technique was developed by a Doctor in Vancouver by the name of Dr. Chan Gunn. Dr. Gunn developed this technique while working with people who were injured on the job and whose pain was not going away with traditional treatment approaches. What he found in these patients was that by stimulating their tight muscles with an acupuncture needle, the pain very often significantly improved or in many cases disappeared.

So the key to addressing this chronic pain process is to release the muscle tension. In an IMS treatment, when the needle enters the taut band the muscle will ‘grab’ the needle and a deep, cramping sensation is felt. Once the muscle grabs it then typically will ‘reset’ itself and begin to relax. When the tight muscle relaxes, a decrease in pain should follow. IMS is now being recognized and used by physiotherapists and doctors around the world to treat chronic pain of musculoskeletal origin. If you are suffering from ongoing muscle or nerve pain and haven’t had success with traditional types of treatment, IMS may be worth trying. For more information about IMS visit:www.istop.org

Sun City Physiotherapy Locations

Downtown

1468 St. Paul Street, Kelowna, BC
Phone: 250-861-8056
downtown@suncityphysiotherapy.com
more info

Glenmore

103-437 Glenmore Road, Kelowna, BC
Phone: 250-762-6313
glenmore@suncityphysiotherapy.com
more info

Lake Country

40-9522 Main St., Lake Country, BC
Phone: 250-766-2544
winfield@suncityphysiotherapy.com
more info

Lower Mission

3970 Lakeshore Road, Kelowna, BC
Phone: 778-699-2006
lowermission@suncityphysiotherapy.com
more info

Know Pain or No Gain

The phrase “no pain, no gain” would probably be the leading misconception about pain that I hear – live by this slogan at your own risk. Why? Because first and foremost, pain is a protector. Pain is a wonderful and fascinating perception that helps to keep us out of danger. I can certainly sympathise that when you’re experiencing persistent or intense pain, its hard to see it as “wonderful” or “fascinating” but it truly is a remarkable defence mechanism that we possess.
When you step on a nail, twist your knee or tweak your back, what comes to your defence first? The simple answer is pain. It’s your first warning of actual or even potential tissue damage. Yes, that’s correct – “potential” tissue damage, meaning your body is smart enough to tell you to withdraw from danger before the damage is done. Wow! When tissue damage does occur, such as a strained ligament, tendon or muscle, your body sends all its best healing products to the area in the form of ‘inflammation’. The brilliance of inflammation is that it increases the sensitivity of the danger detectors (receptors) in the damaged area, which send more danger messages to the brain where they are processed and a pain experience can result. What do you think of that? Essentially, your body doesn’t just heal you with inflammation but it also tells you about it through the feeling of pain as a way of changing your behavior, allowing the area to rest and heal more effectively.

If you understand that the experience of pain is a critical response when the body feels threatened or in danger, then you will see how the slogan “no pain, no gain” will quickly lead you astray. Instead, us ‘pain geeks’ like to encourage the slogan – “know pain or no gain”, meaning that if you understand why you are experiencing pain and what it means, you are more likely to adopt the appropriate behaviour to encourage recovery.

The story of pain can get rather complex but equally as fascinating. Like any of our body systems, our defence systems can sometimes get a bit carried away and malfunction. This is often the case in the event of persistent pain – a story that will have to wait for another time. Until then, remember “know pain or no gain”.

Treatment Options for Hip Osteoarthritis

Hip osteoarthritis is a common condition that involves the degeneration of the articular cartilage of the hip joint. If you have this condition and are noticing an increase in pain and a decrease in physical function you may be wondering what treatment options are available to you.

With osteoarthritis of the hip you may feel a constant ache localized to the groin and side of your hip and sometimes extending into the front of your thigh and knee. The hip often feels stiff, especially first thing in the morning when you get out of bed and it can make activities of daily living much more painful including standing, walking and stairs. It can also make it difficult to put your socks on, get into and out of your car and even get on and off of the toilet.

Stiffness, pain and having difficulty with many previously easy daily activities may lead you to want to do less physical activity. The trouble is, not moving will often lead to weakness, further stiffness and general deconditioning.

A physiotherapist can help design a treatment program with a focus on decreasing pain, increasing range of motion and flexibility, improving core stability, gaining muscle strength and endurance and improving general conditioning. Other functional goals often include improving walking pattern, speed and distance, ability to go up and down stairs without pain and better control going from sit to stand.

This is often accomplished through a combination of education, manual therapy and exercise. An exercise program is often extremely beneficial to help improve physical function and decrease pain. A physiotherapist is an excellent resource to put together a safe and effective home exercise program for you to perform daily at home or at your local gym. Also, if you enjoy swimming, bring this up with your physiotherapist as aquatic exercise is a great form of treatment for hip osteoarthritis.

Other possible physiotherapy treatments that may be effective for some individuals with arthritis of the hip include: acupuncture, massage, heat on the muscles around the hip, ice, TENS, supportive footwear and/or a gait aid such as a cane or walking poles. It is important to talk with your doctor about your arthritis to discuss other treatments that may be beneficial to help manage your symptoms. Certain medications may be helpful, but it is important to bring this up with your doctor to be sure they are appropriate for you. Also, if you are overweight, a weight management program can be extremely beneficial to decrease the stress on your joints. Since nutrition plays a crucial role in weight management, it is important to have this discussion with your doctor.

A small portion of individuals with hip osteoarthritis will eventually opt to have a total hip replacement. This is often the case when symptoms are progressively getting worse and significantly limiting activities of daily living. If you have had a total hip replacement a physiotherapist guided post-operative hip strengthening program is ideal in order to decrease pain, improve your hip function and return to your active lifestyle.