Physical Therapy for Shoulder Pain

Physical Therapy for Shoulder Pain

Shoulder pain is a common symptom for athletes and office workers alike. These simple exercises can improve flexibility and prevent future injury.

The shoulder’s complex structure makes it susceptible to injury, especially from one-too-many many weightlifting exercises. Whatever the cause of your pain or discomfort, the healing process often involves physical therapy to stretch and strengthen the surrounding muscles.

Be sure to consult a doctor before beginning a physical therapy regimen, as shoulder pain can be a symptom of a variety of conditions, like impingement or a rotator cuff tear. The following exercises offer gentle stretching and light conditioning to get you on the road to recovery.

1. PENDULUM EXERCISE
The pendulum exercise can help you recover from a shoulder injury, as it encourages blood flow and develops your range of motion. To get started, stand near a table with your feet slightly more than shoulder width apart. Place the hand of your uninjured arm on the table, then bend over and let your injured arm dangle toward the floor. Shift your body weight in order to create movement in the arm: forward and back, side to side, or in a small circle. Do not engage your shoulder muscles, but let the arm swing freely.

Start with 30 seconds of motion, a few times per day. Over the next few weeks you can gradually increase to several minutes of movement. You can also do a variation of this exercise on a bed if leaning over is hard on your back or neck, though you may need someone else to set your arm in motion. As your recovery progresses, you may be able to use light dumbbells to further stretch the shoulder — but be careful not to engage the muscles and risk re-injury.

2. SCAPTIONS
This exercise targets the rotator cuff, building strength in the scapula and rhomboids to prevent and relieve pain. It can also help strengthen your back and improve your posture.

Stand with your feet below your shoulders, core engaged and knees at a slight angle. With a light dumbbell in each hand, palms inward, raise your arms out in front of you in a broad V shape. Then slowly draw your shoulder blades together. Be careful not to raise your arms above your shoulders. Hold this position momentarily, then lower. Repeat about ten times, for three sets.

3. EXTERNAL AND INTERNAL SHOULDER ROTATION
The rotator cuff muscles that allow for internal rotation are the supraspinatus and subscapularis. These let you draw your arm forward, with your palm facing in, and are commonly used in gym exercises and everyday life. Overuse causes these muscles to tighten, often leading to pain.

To begin strengthening the rotator cuff, you can practice a simple towel stretch. Grasp a towel or strap with your right hand and drape it over your right shoulder so it hangs down your back. Your right hand should be level with the back of your head, or lower toward the back of your neck if it’s comfortable. Turn your left arm behind your lower back with your palm facing behind you as you raise your left hand to meet and grasp the bottom end of the towel. Don’t force the stretch, but spend 15 to 30 seconds just at your point of flexibility. Try three repetitions on each side, and over time you will be able to bring your hands closer together at your back.

The external rotator muscles in the rotator cuff are the infraspinatus and teres minor. These typically get less training, which can create an imbalance and eventually lead to pain. To strengthen these muscles, use only one- or two-pound weights until you are able to easily add more, one pound at a time. Lie on your side, with your upper arm at a 90-degree angle, elbow against your side. Slowly rotate your forearm out and up, to your side, drawing your shoulder blades together until your palm faces forward. Hold for two seconds, then lower down. Repeat 10 times on each side.

4. SHOULDER RETRACTIONS
There are a number of exercises that involve shoulder retraction, and they all aim to correct a slumped posture. If your shoulder blades, or scapulae, are constantly hunched forward, it can affect how you use your shoulder joint, lift your arms, and stand. Poor posture can even affect the blood flow and nerves in your arms and hands, and make it harder to breathe by collapsing your chest. You should perform shoulder retraction stretches as much as possible to counteract these effects, and build up the muscles to help prevent shoulder pain.

To begin this exercise, stand straight, arms at your sides, with your shoulders relaxed. Pull your shoulder blades down and back, without arching your back. Hold this for 5-10 breaths, and repeat 3-5 times.

For a more targeted exercise, lie facedown on a mat, resting your forehead on a towel. Hold your arms straight out at your sides, palms down. Use your shoulder blades to lift your arms off the floor, holding this position for a few breaths.

EXERCISES TO AVOID
As you perform these exercises, keep in mind that shoulder pain can have many underlying causes, and without a doctor’s diagnosis you risk exacerbating the issue. Take your time when introducing new exercises into your routine to give your body time to adjust. To avoid further damage, be sure to start with no weight or very light weights for any strengthening activities.

You should also avoid exercises that are counterproductive to the healing process. Stay away from common gym exercises like dips, upright rows, overhead presses, and lat pull downs done behind the neck, which can put stress on the neck and shoulders.

If you’re suffering from shoulder pain, you may want to schedule an appointment with an orthopedic specialist. At CompOrtho, specialists will help identify any underlying conditions that may be causing you discomfort.

Low Back Pain? These Exercises May Help

Low Back Pain? These Exercises May Help

THURSDAY, Aug. 30, 2018 (HealthDay News) — Low back pain is a common health complaint. And if it sidelines you for too long, it can lead to weight gain, a loss in your fitness level and keep you from doing things you love.

But not moving isn’t the answer — specific exercises can help you get back to everyday activities. If you’re under the care of an orthopedist or physical therapist, you may be given a series of exercises to do up to three times a day.

Here are three in particular that may help.

Tummy contractions. Lie on your back with your knees bent, feet flat on the floor hip-width apart, and your hands on your tummy below your ribcage. Tighten your abs — it should feel as though your ribcage is being pressed toward your back. Hold for five seconds, then relax. Repeat 10 times.

Knee-to-chest stretch. Begin in the same starting position, but for this exercise, place both hands on the back of your left thigh and gently pull the knee to your chest. Hold for 20 seconds, then relax. Repeat five times with the left leg, then switch to the right leg and repeat the entire sequence.

Body stretch sequence. Sit on a large exercise ball with knees bent at a 90-degree angle to the floor. Move your feet slightly out to the sides for balance. First, lift your left arm straight up over your head, then lower it and repeat with the right arm; alternate five times. Next, slowly raise and lower your left heel, then slowly raise and lower your right heel; alternate five times. Finally, raise your left arm overhead and your right heel off the floor at the same time, lower them and reverse, raising your right arm overhead and lifting your left heel off the floor; alternate five times.

Another type of exercise that may help is yoga. According to a study published in the Annals of Internal Medicine, people who took a weekly class designed for those with low back pain were helped just as much as those who did traditional physical therapy, and needed less pain medication over time.

More information

The University of California, Berkeley, has detailed information on low back pain and more exercises that can help ease it.

Copyright ©2017 HealthDay. All rights reserved.
Health Tip: Prevent Back Pain at Work

Health Tip: Prevent Back Pain at Work

(HealthDay News) — Chronic back pain makes it more difficult to do your job, whether you’re behind a desk or operating heavy machinery.

The Mayo Clinic suggests how to avoid back pain at work:

  • Maintain good posture.
  • Lift with your legs and tighten your core muscles, and avoid twisting.
  • When possible, use a lifting device.
  • Alternate physically demanding tasks with less demanding ones.
  • Limit the time you spend carrying heavy briefcases, purses or bags.
  • Listen to your body. Change your position often and periodically walk around and stretch your muscles.
Copyright ©2017 HealthDay. All rights reserved.
5 Easy Adjustments to Avoid Back Injuries During Weightlifting

5 Easy Adjustments to Avoid Back Injuries During Weightlifting

Back injuries often plague those who lift weights on a regular basis — but with some proactive adjustments to your routine, you can significantly decrease your risk.

From rows to squats, the back plays a critical role in many weightlifting exercises — and developing strong back muscles can help you push yourself farther at the gym for a wide variety of lifts.

As with any part of your body, it’s impossible to keep your back completely safe from injury while you’re working out, but there are some simple steps you can take to significantly decrease your risk. When the price of a setback is not only losing hard-won progress, but potentially developing more serious health issues, prevention is well worth the effort.

With all of that in mind, here are five tips to prevent common back injuries while you lift.

1. TRAIN YOUR POSTURE

As you probably know, poor form greatly increases your risk of injury in any exercise. If you’re working on your back, you’ll want to keep your vertebrae neatly aligned to avoid placing too much pressure on a particular bone or muscle.

If you’re new to lifting, don’t simply mimic what you see others doing at the gym. Instead, ask a trainer or do some research online in order to better understand how you should position your body. If you’re a more experienced gym-goer, it’s still a good idea to check up on your form every now and then. Protect your body by regularly recalibrating your form and squelching any bad habits before they lead to injury.

2. RECOGNIZE THE RISKS

Any weightlifting exercise that involves flexion (forward bending) or extension (backward bending) of the joints in your back puts those areas at risk. These movements often result in sprains (a tear or rupture of a ligament), but they can lead to more serious injuries as well. Extreme extension, for example, can lead to spondylolysis, or cracks in the vertebrae. Similarly, extreme flexion can lead to a herniated disc.

These risks aren’t limited to exercises that specifically target the back. The most common weightlifting-related cause of herniated discs is the deadlift, which — when done properly — doesn’t depend on back flexion or extension for power, but when done incorrectly, puts a dangerous amount of pressure on the vertebrae. Deadlifts can also exacerbate degenerative disc disease, lumbar spinal stenosis, and other chronic conditions affecting the lower back.

3. KNOW WHEN IT’S TIME TO STOP

That twinge you felt while working out might be gone by tomorrow with a bit of stretching and rest. If you push the compromised area through additional stress, however, it can turn into something worse.  Don’t ignore what your body is telling you. The burn of a fatigued muscle feels very different from a pull in your back, and “no pain, no gain” only works when you don’t sabotage the body you’re trying to strengthen. If you’re feeling pain when lifting, it’s time to call it a day — plain and simple.

4. MODIFY YOUR ROUTINE

First off, I recommend that you always wear a weightlifting belt when working out, as it can do wonders to stabilize and protect your back during most exercises. However, if a particular movement causes you problems even with the belt on, consider finding an alternative. For most lifts, there are one or more corresponding exercises that can target similar muscles without causing the same pain.

5. STRETCH

To learn proper posture is one thing, but to fully put it into practice requires some extra work. As any knowledgeable trainer will tell you, a dedicated stretching routine is the key to sustainable lifting. In order to build a strong and resilient back, consult a fitness trainer or orthopedic specialist you trust and create a stretching regimen to maintain the integrity of your back for future challenges. For maximum benefit, stretch both before and after each lifting session.

Ditch the Golf Cart. Your Aging Knees Won’t Mind

Ditch the Golf Cart. Your Aging Knees Won’t Mind

Golfers with knee arthritis should park the golf cart and walk the links instead, researchers say.

While using a golf cart may seem the obvious choice for golfers with knee problems, a new small study finds that walking provides much greater health benefits. Moreover, it’s not associated with increased pain, inflammation or cartilage breakdown, the researchers said.

“Individuals with knee osteoarthritis are often concerned about pain and may be more likely to use a golf cart,” said lead study author Dr. Prakash Jayabalan. He’s an assistant professor of physical medicine and rehabilitation at Northwestern University Feinberg School of Medicine in Chicago.

However, “this study has shown that golfers with knee osteoarthritis do not need to be concerned about worsening their disease through walking the course. In fact, walking provides the best health benefit,” Jayabalan said in a university news release.

More than 17 million Americans older than 50 golf regularly. Knee osteoarthritis is a leading cause of disability in this age group. The condition causes swelling, pain and difficulty moving the joint.

The study included 10 older golfers with knee osteoarthritis and five without the disease, which is usually caused by wear and tear of the joint.

On one day, the study participants played one round of golf (18 holes) walking the course. On another day, they used a golf cart to play 18 holes. On each occasion, the researchers monitored the participants’ heart rates to determine their level of exercise intensity, and took blood samples to measure markers of knee inflammation and cartilage stress.

On both occasions, the golfers had an increase in these markers, but there was no difference between use of the golf cart and walking, the findings showed.

When walking the course, the heart rates of the golfers with knee problems were in the moderate-intensity zone for more than 60 percent of the time, compared with 30 percent when using a cart.

But even using the cart, golfers met daily exercise recommendations, according to the study authors.

“Bottom line: walking the course is significantly better than using a golf cart, but using a golf cart is still better than not exercising at all,” Jayabalan concluded.

The study was presented recently at the Osteoarthritis Research Society International annual meeting in Liverpool, England. Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.

More information

The Arthritis Foundation has more about osteoarthritis.

SOURCE: Northwestern University, news release, April 28, 2018

Exercise In, Vitamin D Out for Preventing Falls: U.S. Panel

Exercise In, Vitamin D Out for Preventing Falls: U.S. Panel

With aging often comes worry about falls and the bone fractures they cause. Now, a panel of U.S. experts has new advice on what helps and what doesn’t when it comes to staying upright.

For starters, get off the sofa. And don’t rely on vitamin D to keep you from falling.

In a change from its 2012 recommendations, the U.S. Preventive Services Task Force (USPSTF) is recommending against vitamin D supplements for “community-dwelling” (those living at home) adults over 65 for preventing falls. A review of existing research showed insufficient evidence to recommend a supplement.

So what does help people prevent falls? Exercise, the task force said.

“The strongest evidence is for exercise. If you’re at risk of falling, you should think about exercise,” said the task force’s vice chair, Dr. Alex Krist, from Virginia Commonwealth University in Richmond. He added that about 20 percent of Americans over 65 have a fall each year.

The review and recommendations were published April 17 in the Journal of the American Medical Association.

An author of an editorial that accompanies the new recommendations agreed exercise can be beneficial.

“These recommendations are suggesting that we need to go beyond popping pills in order to have a major impact in preventing falls and fractures,” said Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital in Boston.

“Regular exercise can reduce falls with injury and it can also reduce heart disease, stroke, type 2 diabetes, dementia and some forms of cancer,” Manson said.

“Physical activity is as close to a magic bullet as there is. And it doesn’t take that much — just 30 or 40 minutes three times a week can make a difference,” she added.

Both Krist and Manson advocated for a variety of exercises. They said for someone healthy enough, the general physical activity guidelines of 30 minutes of aerobic activity most days of the week, and strength training twice a week, are a good place to start.

But not everyone over 65 can achieve that goal. Krist said to start with your doctor to get a better idea of what exercise might be right for you. For some people, the supervision that comes with physical therapy is helpful. For others, a class such as tai chi might work best. And for others, more vigorous activity may be fine.

The USPSTF is a volunteer panel of national experts. They develop recommendations for disease and injury prevention after a rigorous review of scientific evidence.

The new recommendations suggest that doctors should selectively offer multifaceted interventions to seniors at a high risk of falling.

These might include: group or individual exercise, psychological therapy, nutrition therapy, education, medication management, urinary incontinence management, environmental modification, and physical or occupational therapy. Social services and referral to specialists such as an ophthalmologist, neurologist or cardiologist are other options.

Referrals can be important because some issues may be reversible. For example, sometimes addressing problems with vision can aid in fall prevention.

“Often, older individuals assume vision loss is inevitable and a normal part of the aging process. Very often, though, problems such as cataracts or glaucoma are treatable,” Manson said.

“Falling is a major concern for older adults, and some are afraid to go outdoors because they’re afraid of falling,” she said. That leads to a double whammy as they stay inside, their muscles may atrophy, they don’t get any sunlight and may develop a vitamin D deficiency, and they’re losing out on important social interactions, Manson explained.

“I recommend at least doing strength training inside the home, or getting a treadmill to use at home. Or find a friend or family member that can go out for a walk, or start a walking club in your neighborhood,” she suggested.

The task force also recommended against daily supplementation of 400 international units of vitamin D and 1,000 milligrams (mg) or less of calcium to prevent fractures in postmenopausal women living at home.

It wasn’t clear, however, if higher doses might provide a benefit, according to the new USPSTF recommendations. There also wasn’t enough evidence for the task force to determine whether vitamin D and calcium supplements could help men or premenopausal women avoid fractures.

More information

Learn more about preventing falls from the U.S. National Institute on Aging.

SOURCES: Alex Krist, M.D., M.P.H., U.S. Preventive Service Task Force vice chair, and professor, family medicine, Virginia Commonwealth University, Richmond; JoAnn Manson, M.D., Dr.P.H., professor, medicine, Harvard School of Medicine, and chief, preventive medicine, Brigham and Women’s Hospital, Boston; April 17, 2018, Journal of the American Medical Association