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.

How to Fix Shoulder Pain from Weightlifting

How to Fix Shoulder Pain from Weightlifting

If you’re a weightlifter, don’t ignore an aching shoulder. Follow our tips to prevent and treat these three common conditions.

Experiencing shoulder pain while weightlifting? This might be a sign you need to take a step back and re-examine your form. Here are some ways to prevent your slight twinge from turning into a serious injury.

WEIGHTLIFTER’S SHOULDER


Weightlifter’s shoulder, or distal clavicular osteolysis, affects the collarbone where it meets the shoulder blade at a point known as the acromion. This joint is very flexible, and therefore one of the least stable in the body. Stress over time can lead to micro fractures on the end of the collarbone.

If you have weightlifter’s shoulder, you may experience:

  • Dull aching
  • Tenderness or sharp pain when you press on the area
  • Swelling
  • Weakness or stiffness
  • Pain after exercising
  • Pain when you extend the arm across to the opposite side

Weightlifter’s shoulder can be avoided with good training practices. It is usually caused by overdoing shoulder extension exercises like bench presses, dips, or push-ups. When you work out, be sure not to use too much weight and give your muscles time to recover in between training sessions. Have a trainer check your form, and be careful not to push through when you’re experiencing pain. To build up your shoulder strength, try out the “Blackburn” exercise.

If you are suffering from weightlifter’s shoulder, the condition may respond to conservative treatment. Take a hiatus from lifting weights, ice the area, and take anti-inflammatory medications. Your doctor may suggest corticosteroid injections along with physical therapy. If surgery is needed, your doctor can perform a minimally invasive procedure using small incisions to remove about a centimeter of your collarbone, which will help eliminate pain and restore your range of motion.

SHOULDER IMPINGEMENT

Shoulder impingement affects the rotator cuff in the upper arm. Each time you raise your arm, you create less space between the tendons and the shoulder blade. Over time, the shoulder blade’s acromion may begin to irritate the rotator cuff or its bursa sac.

Motions that use the rotator cuff tendons increase the likelihood of impingement. This includes any sport with overhand motions or exercises that include lifting weights above the head. Many people don’t realize that the mild pain is a sign of impingement, and unfortunately don’t seek treatment until the pain has worsened.

You may have a shoulder impingement if you experience:

  • Swelling or tenderness
  • Pain whether you’re resting or exercising
  • Sharper pain when lifting or reaching
  • Weakness and loss of motion
  • Difficulty reaching behind your back

There are several ways that you can prevent this condition. If you’re just starting a training plan, add reps slowly and trade off between push and pull exercises to build both front and back muscles (i.e., for every pushup, do a row). Avoid overdoing exercises where the elbow is above the shoulder, like upright rows and shoulder presses, along with lateral raises and behind-the-neck pulldowns. For more stability, activate your lower trapezius muscles before pulldowns by bringing your shoulders down and together.

If you do experience shoulder impingement, we recommend temporarily replacing your weightlifting regimen with physical therapy. Your doctor may suggest cortisone injections as well. These conservative treatments are often sufficient, but if needed a doctor can perform surgery to remove or repair the damaged areas. This can prevent future injury to the tendons, especially if you have bone spurs.

ROTATOR CUFF TEAR


A rotator cuff tear affects the muscles and tendons that cover your upper arm bone, keep it in the ball-and-socket shoulder joint, and help you lift and rotate your arm. The stress of weightlifting can cause a tear as the tendon degenerates over time. Direct impact can cause damage as well — if you try to lift heavy weights with a jerking motion, you could tear the tendons.

You may have a torn rotator cuff if:

  • Your pain is worse when you raise your arm overhead
  • Pain makes it hard to sleep at night
  • You experience weakness and limited motion in your shoulder
  • You are unable to hold your arm at shoulder level without dropping it to your side

To prevent this injury, use lower resistance exercises with more repetitions to gradually strengthen the rotator cuff muscles. Balance these exercises with arm raises and external rotations to build up your deltoids — try the side-lying external rotation before your next workout. End your training session with cold compresses to reduce inflammation, and be sure to rest between gym days. Avoid sleeping on your sore side to help healing. The condition won’t go away on its own, but our expert orthopedists at Comprehensive Orthopaedics can diagnose your condition and get you started on the path to healing. Schedule an appointment with one of our orthopedic specialists today.  

An Orthopedic Specialists’ Guide to Frozen Shoulder

An Orthopedic Specialists’ Guide to Frozen Shoulder

Here’s what you need to know about the painful but treatable condition called adhesive capsulitis, or frozen shoulder.

Frozen shoulder, or adhesive capsulitis, is an inflammation of the shoulder capsule. This band of connective tissue encases the shoulder joint, so as inflammation progresses, patients experience a restricted range of motion along with extreme stiffness.

While the medical community has not yet been able to pinpoint the exact cause of frozen shoulder, there are a number of conditions that can contribute to its development. These include diabetes, thyroid disorders, and past surgeries on the shoulder or chest.

SIGNS AND SYMPTOMS OF FROZEN SHOULDER

Patients suffering from frozen shoulder generally experience moderate to severe pain, inflammation, stiffness, and a limited range of motion in the shoulder.

This condition normally cycles through three progressive stages. These are:

  • The “freezing” phase, where the patient experiences increasingly severe shoulder pain lasting from several weeks to nine months.
  • The “frozen” phase, where pain in the shoulder decreases but stiffness lingers, lasting from four to nine months.
  • The “thawing” phase, where pain continues to lessen and the range of motion in the shoulder slowly improves, lasting from five months to two years.
HOW TO PREVENT FROZEN SHOULDER

Frozen shoulder predominantly affects people in middle age, and it is possible to preemptively avoid this condition — especially if you’ve been diagnosed with any of the risk factors commonly associated with it, like diabetes or a thyroid disorder. The best possible prevention method is to steadily increase shoulder flexibility through stretching, including external rotation, forward flexion, and crossover arm motions.

HOW TO TREAT FROZEN SHOULDER

In many cases, conservative treatments can effectively ease shoulder pain and stiffness. These methods generally include a physical therapy regimen designed to restore shoulder motion and strengthen the surrounding muscles. Most patients will need to undergo a rehabilitation plan for approximately four to five months to ensure a complete recovery.

Sometimes, anti-inflammatories and corticosteroid injections are used to supplement physical therapy. If mobility issues continue, minimally invasive arthroscopic surgery can be utilized to break up and remove scar tissue that has built up in the shoulder, with full recovery occurring in as little as six weeks.

If you think you may be suffering from frozen shoulder, set up an appointment with an orthopedic specialist today. Backed by decades of experience in treating shoulder injuries, CompOrtho Specialists can work with you to develop a personalized recovery plan.  Dr. Main and Dr. Gershtenson are top-rated orthopedic surgeons in Southeastern Wisconsin who specializes in the shoulder.  Our team of specialists can help you through every step of your treatment, ensuring a quick and complete recovery.

Tips for preventing ski injuries

Tips for preventing ski injuries

Ski season is in full swing — but an injury can put you out of commission until next year’s first snowfall. Here’s how to stay safe on the slopes all winter long.

While many people huddle inside during the winter months, away from “bomb cyclones” and blizzards, a select few know that the best way to beat wintry weather is to embrace it — on the ski slopes, that is!

As any seasoned skier will tell you, however, their beloved sport does come with the risk of injury. Fortunately, taking some simple precautions before you hit the slopes can help you stay in peak condition regardless of how many tumbles you take.

We’ve outlined some of the most common injuries that afflict skiers, and what you can do to prevent them.

MCL Injuries

A number of injuries can affect the medial collateral ligament (MCL), but the most common by far is an MCL tears. In skiing, MCL tears most often occur when the skier falls while attempting to slow or stop in a snowplow position, in which the tips of the skis are pointed toward each other. To avoid injury in this position, make sure to always keep your weight balanced. In addition, sticking to runs with which you’re comfortable can reduce the need to enter the snowplow position at all.

ACL Injuries

A variety of falls on the slopes can result in a tear of the anterior cruciante ligament (ACL). It most commonly happens after a forward fall, during which the inner edge of the front of the ski becomes embedded in the snow, trapping the leg in the process. It can also occur when the top of the back of the boot pushes the tibia (the weight-bearing bone in the leg) forward, away from the femur. On other occasions, it arises when the skier leans back on the skis, loses balance, and falls backward. Strengthening the hamstrings, wearing proper bindings, and using shorter skis can all reduce the risk of sustaining an ACL tear.

Fractures

Like torn ligaments, fractures are most commonly caused by falls while skiing. The wrist and ankles are particularly susceptible to breaks. To help avoid broken bones, always wear adequate protective gear and practice proper techniques for falling. Increasing cardiovascular endurance and developing the surrounding muscles can also be beneficial.

Shoulder Dislocations

Most shoulder dislocations happen when skiers fall, either directly onto the shoulder or onto an outstretched hand or arm. This injury results in heavy, immediate pain, significantly restricts the shoulder’s range of motion, and can leave it misshapen. Since dislocations are caused by sudden trauma, they can be difficult to anticipate, but strengthening the rotator cuff muscles, especially if you have previously dislocated your shoulder, can lower the risk of a dislocation. As with other common skiing injuries, employing proper form will also minimize the possibility of a dislocation.

Spinal Injuries

Aside from protecting the spinal cord, the spine ensures the strength and stability of the back. It is made up of various bony segments called vertebrae separated by pieces of fibrocartilaginous tissue called intervertebral discs, any of which can be injured while skiing. Some ways to avoid spinal injuries include using spine protectors, sticking to trails on which you are comfortable, using proper equipment, and learning the technique for “safe” falls.

While some ski injuries are immediately apparent, others can be more subtle, slowly progressing with time. Fortunately, the talented team of specialists at New York Bone and Joint has extensive experience working in sports medicine and can quickly diagnose and treat any of these common problems. If you think you may have suffered an injury during your latest trip to the mountain, call us today to schedule a consultation, or if the injury has been recent, stop in to our Orthopedic Urgent Care!

Shoulder Instability:  More common than you would think

Shoulder Instability: More common than you would think

Professional athletes aren’t the only people who suffer from unstable shoulders. We’ll walk you through the most common causes of — and treatments for — this condition.

Because professional athletes have undergone intense training to mold their bodies into peak physical shape, it’s easy to assume that they’re immune to the common injuries that affect the rest of us. Recent news, however, has shown that no one is completely protected from injury. For example, Tom Brady and Aaron Rodgers — two of the best quarterbacks in the NFL — have both shown that they are suffering from significant shoulder injuries, with Rodgers missing the remainder of the season due to a broken collarbone.

In fact, shoulder damage is one of the most common injuries for NFL players and laymen alike. Since the shoulder is the most mobile joint in the body, it’s especially prone to problems. For most of us, however, shoulder injuries are caused by gradual wear and tear rather than sudden trauma. While these injuries don’t ultimately result in chronic instability, they can hasten the degeneration of the cartilage in the shoulder, which then can leave the shoulder unstable. Fortunately, these problems can be effectively treated with the help of a qualified orthopedic specialist such as Dr. Main and Dr. Gershtenson, and a rigorous rehabilitation program.

What Is Shoulder Instability?

Shoulder instability is a chronic condition that leads to frequent dislocations of the shoulder. It occurs when the end of the humerus (the ball of the shoulder joint) separates from the glenoid (the socket of the shoulder joint). These dislocations can be either partial or full.

Shoulder instability has a variety of causes. In many cases, it’s simply a product of previous shoulder dislocations, since a traumatic dislocation often causes tears in the stabilizing cartilage and ligaments. A shoulder is more likely to be dislocated again if it’s already been dislocated. Unusually loose ligaments in the shoulder can also heighten the risk, especially if they’ve been loosened by repetitive motion and strain, as often occurs in football players, swimmers, and tennis players.

Symptoms and Diagnosis

There are several symptoms of a chronically unstable shoulder. One of the most common is frequent subluxation, or repeated partial dislocations. Often caused by overhead motions, these subluxations create a brief feeling of pain and a slipping sensation in the shoulder. In more severe cases, full dislocation may occur, resulting in intense pain and visible abnormalities like bumps in the shoulder. Shoulder instability can also result in a “dead arm”, or a feeling as though a nerve has been pinched.

While you can perform some tests on your own, self-examinations can further aggravate the shoulder — so it’s best to let a professional diagnose your condition. In addition to consulting your medical history, a doctor may move your shoulder into specific positions to test the stability of the joint. If these movements cause pain or further displace the shoulder, it’s likely unstable, and X-rays and an MRI might be needed to determine the extent of the injury.

Treatment

Non-traumatic shoulder instability can often be treated nonsurgically, through rest, anti-inflammatory medication, and physical therapy. If the instability is the result of trauma and it creates a Bankart lesion (a tear in the cartilage), then arthroscopic surgery is usually necessary to stabilize the joint and prevent recurrent dislocations, which can otherwise lead to degeneration and premature arthritis.

Physical therapy largely consists of various stretching and strengthening exercises that rebuild the joints, ligaments, and muscles and restore their range of motion, stabilizing the shoulder in the process. These exercises are often targeted to strengthen the rotator cuff and the scapular muscle, and can be aided by resistance bands. In addition, your physical therapist will teach you how to properly use your shoulder, reducing the chance of painful subluxation and dislocation while you heal.

If you’re concerned about your shoulder, our team of best-in-class orthopedic physicians at CompOrtho are here to help. With our extensive experience, we have the knowledge and ability needed to help you at every stage of treatment, from diagnosis through rehabilitation. If you’re searching for a reliable and compassionate provider, contact us today to schedule an initial consultation.

What Is a Cortisone Shot?

What Is a Cortisone Shot?

Cortisone shots can potentially provide long-lasting relief from pain and inflammation in the joints.

Many injections can greatly reduce pain and inflammation caused by musculoskeletal injuries or chronic conditions such as arthritis, significantly shortening recovery timelines and providing lasting relief. One shot we particularly recommend to patients entails an injection of cortisone into a damaged joint. We’ll tell you what you need to know about this tried-and-true treatment for pain and inflammation in the joints.

What Is a Cortisone Shot?

A cortisone shot is an injection composed of a corticosteroid medication and a local anesthetic. Used to relieve pain and inflammation, it’s most commonly injected into a joint, often in the shoulder, hip, or knee. These shots are often one option in a comprehensive treatment plan for chronic inflammatory conditions such as arthritis, tendinitis, or rotator cuff impingements or tears.

How Long Does a Cortisone Shot Last?

A cortisone shot’s effectiveness depends on the severity of the patient’s condition. In most cases, pain and inflammation will marginally increase for about 48 hours following the injection, and will decrease precipitously thereafter. In some cases, a single injection can provide relief for as long as several months.

Generally, cortisone shots should only be given two times per joint per year. Repeated cortisone injections can damage the cartilage in the joint.

What Are the Side Effects of a Cortisone Shot?

Cortisone shots are typically safe in moderation, but since they infrequently lead to serious complications, they should be taken under a doctor’s supervision. Be sure to let your doctor know if you suffer from diabetes or other any other conditions affecting your blood sugar levels, as well as any medications that you are currently taking.

Most cortisone shots have some minor side effects, including a temporary uptick in pain and inflammation in and around the joint, and a thinning and lightening of the skin around the site of the injection. In some cases, however, they can result in a sudden spike in blood sugar if you’re diabetic and have poorly controlled blood sugar levels. .

What If the Cortisone Shot Doesn’t Work?

Cortisone shots provide a source of temporary relief from inflammation and pain. They will not solve the underlying problem, and pain may gradually return as the shot’s effectiveness subsides. As a result, cortisone shots should be administered as part of a more comprehensive treatment plan that may include physical therapy or surgery.

Fortunately, our team of orthopedic specialists at Comprehensive Orthopaedics has several years of experience in treating joint problems. Regardless of your specific condition, we’ll work with you to develop a personalized treatment plan that provides lasting relief from your symptoms.