Non-invasive treatments should be your first line of defense against neck pain.
Workouts, sports, and even sitting at a desk all day can put strain on the neck, leading to pain and discomfort. While some conditions may require orthopedic surgery, non-invasive treatments often lead to better long-term outcomes, and should generally be the first line of defense against neck pain.
A qualified physical therapist can help you create an appropriate plan for chronic neck pain, which is defined as pain that lasts for more than a few weeks. With a physical therapy plan tailored to your needs, you can safely gain strength and flexibility, as well as lower your chance of developing a future neck injury.
If you’re suffering from neck pain and looking to find relief, your physical therapist might suggest some of the following exercises.
1. SHOULDER AND HEAD ROLLS
These stretches are a good warm-up to start with before attempting other exercises. For a shoulder roll, keep your arms relaxed at your sides, and with your head upright, simply lift and roll your shoulders. Relax briefly between each roll. Do ten rolls forward, and ten back.
Before you try a head roll, stretch the neck. Make sure your shoulder blades are relaxed, and that your head is not tilted forward but sits directly over your neck. Start by dipping your chin slowly toward your chest, and hold for several breaths (if you are unable to dip your chin, or if it causes an increase in pain, stop and contact your doctor). Next, lift your head and lower your left ear toward your left shoulder, and hold. Repeat this movement on the right side, then do a similar stretch with your head tilted back.
After stretching your neck, you can roll your head slowly in sections, from tucked in front or tilted back toward each side, five times each. Avoid doing a full head roll, which can actually strain the neck.
2. SEATED NECK STRETCH
Deceptively simple, this exercise can even be performed at your desk. For a seated stretch, sit upright in your chair with your feet flat on the ground. Extend your right arm along your right side and place your left hand on the top of your head. Tilt your head to the left, applying pressure with your hand to gently intensify the stretch. Hold for 30 seconds, then repeat for the right side. You will feel this stretch in the levator scapula muscles in the sides of the neck.
3. WALL PUSH-UP
This exercise can help strengthen your shoulders and support your neck muscles, without causing as much stress as typical push-ups. Stand facing a wall, with two to three feet of space in front of you and your feet shoulder-width apart. Place your hands against the wall, just below shoulder level. Start with straight arms, and bend your elbows slowly to bring your body closer to the wall. Repeat this 10 times for one or two sets.
4. AQUATIC EXERCISES
While high-impact sports can be hard on the neck, low-impact sports like swimming, walking, or recumbent biking may help you avoid strain. If you have neck pain, many physical therapists recommend that you hit the pool for your aerobic exercises in order to increase blood flow to the neck.
While in the water, you can attempt neck flexibility stretches like the “clock” exercise. Repeat the following on both sides:
Stand in a lunge position, with both arms at shoulder height. While the right foot and hand are forward at a 12 o’clock position, sweep the left hand back to 6 o’clock, following with the head and body. Repeat five times.
Keep the left hand sweeping to 6 o’clock, while the head moves only to 9 o’clock, for five repetitions.
For the last set of five, the head remains at 12 o’clock while the arm sweeps to 6 o’clock.
5. PRONE ROWS
This exercise strengthens the muscles that pull the shoulder blades together. You’ll want to lie facedown on a bed or similar surface, angled so that your face is in a corner, and you can dangle your arms off each side. Row upward, bending the elbows and squeezing the shoulder blades together without moving your head. Try about 20 repetitions for one or two sets. You can add light weights to this exercise if it is too easy.
EXERCISES TO AVOID
While adding these exercises to your routine, you should be careful to avoid workouts that may impede your progress. Don’t do sit-ups or crunches, as these can strain your neck vertebrae. In weightlifting, both the military press and lat pulldown put pressure on the vertebrae, and should be avoided.
The five exercises above can get you started on the road to recovery, although for best results, we recommend working with a physical therapist. If these exercises don’t relieve your pain, or cause pain that shoots into your shoulders or arms, contact a doctor as soon as possible. The orthopedic specialists at Comprehensive Orthopaedics can help you develop a personalized treatment plan and get back to the activities you love.
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, 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:
Tenderness or sharp pain when you press on the area
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 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.
Ankle injuries can keep you from enjoying the activities you love. If you participate in any of these sports or athletic activities that put players at a higher risk of damaging the joint, here are the steps you can take to avoid getting hurt.
For many athletes, ankle injuries are a common cause for concern. While most sprains can heal in less than two months through rest, icing, and bracing, that still means time off from playing sports and enjoying other aspects of an active lifestyle.
In addition to the pain and discomfort they cause, sprains can put you at risk for developing more serious conditions. Even after they heal, they can leave the ankle weaker and more prone to dislocations, fractures, or osteochondral defects formed by cracks in the cartilage.
Whether you’ve had sprains before or simply want to avoid this painful condition, careful prevention is key to maintaining your health and continuing to enjoy your favorite sports. Here’s what it takes to avoid ankle injuries while playing soccer, running, and more.
In sports and in life, it’s a good idea to look before you leap. Aside from being on the receiving end of an unexpected slide tackle, the most common way to sprain your ankle is jumping — perhaps for a contested header — and landing badly. If you jump in a crowded area, spare some attention to where you touch down. While in competitive leagues it’s expected that you go for every ball you can, weekend warriors might exercise some caution and avoid risky jumps.
Soccer is a sport of quick acceleration, and the rapid directional changes it requires can also cause ankle injuries. Preemptive balance training can help you avoid sustaining any damage. This training consists of exercises like standing on one foot with your other ankle behind your back, catching and throwing a ball while on one foot, and one-legged squats.
As much as fans and announcers talk about “ankle-breaking” ball handling, the main cause of ankle injuries in basketball is actually rebounds. Be careful of risky leaps, whether it’s a heavily covered jump shot or a battle at the rim. Similar to soccer, landing on an uneven surface after a jump causes the most problems. So if the area is too congested, don’t be afraid to fall.
In addition, the stiff floor and rapid pivots of basketball are a recipe for ankle strain. Basketball shoes are designed with this in mind, so someone playing on a competitive team can take comfort in that layer of ankle protection. However, if you’re playing a pickup game in a regular pair of sneakers, watch out for quick stops and turns.
In any sport, it’s important to know your risks — and in football, those can vary by position. The causes of injury for a lineman are going to be different from those for a receiver or defensive back. For open-field positions that make rapid cuts and go up for the ball, the primary risk is landing unevenly. For those closer to the line of scrimmage, the bigger worry is getting forced into an unnatural position by the weight of a pileup.
Football is a contact sport, so some risks must be accepted. Still, a consistent stretching and strengthening regimen can go a long way. Jumping and skipping exercises can both strengthen the ankle and prepare it to absorb the impact of hitting the ground with force. Band exercises are useful for stretching your ankle beyond the normal pressures of practice, and could make all the difference if your foot ends up lodged at an awkward angle.
Dancing is rigorous exercise, and ballet in particular puts the ankles under intense strain. As you learn new routines, it’s vital to gradually strengthen and work up to moves that force your feet into more difficult contortions. It is also important to strike a balance between mastering a move and overworking the muscles of the foot.
In what is already a standard practice, wrapping satin shoe ribbons around the ankle while dancing en pointe will help keep the foot stable in this elongated, high-pressure position. Although less research has been done on other forms of dance, proper warm-up, strengthening, and stretching have all proven helpful for injury prevention among ballet dancers.
Beyond buying sturdy shoes, choosing the right surface is key to safe running. By sticking to flat surfaces, you can decrease the risk of rolling your ankle. If you prefer running trails, then make sure not to lose sight of the changes in terrain. While some ankle injuries come from missteps and twists, others can stem from repetitive pounding. When you start to feel consistent pain, it’s time to take a break. Stretching before and after running sessions is also useful.
If you’re suffering from an ankle injury, consult an orthopedic specialist to learn about your treatment options. At Comprehensive Orthopaedics, our team of ankle specialists —Dr. Engel, Dr. Nute and Dr. Lasee — have helped countless patients get back on their feet and return to the activities they enjoy. Contact us today to take your first step on the road to recovery.
Obesity may accelerate and amplify the crippling symptoms of rheumatoid arthritis, new research suggests.
Conversely, the researchers also found that unexplained weight loss might also signal problems for these patients, because it could mean that they’re at greater risk for disability.
“While patients and rheumatologists may be focused mostly on disease activity, we should also consider this common condition [obesity], which can contribute to problems that are usually attributed to the arthritis itself,” said study author Dr. Joshua Baker.
“In addition, unintentional weight loss should alert us that the patient may be becoming frail and is at risk for developing new disability,” he added. Baker is an assistant professor of medicine at the University of Pennsylvania’s Perelman School of Medicine.
Rheumatoid arthritis is an autoimmune condition. It develops when immune cells that normally fight germs attack the lining of the joints, or cartilage. This causes the joints to swell and the surrounding bones, ligaments and muscles to gradually erode. Rheumatoid arthritis worsens over time, often leading to disability.
For the study, Baker and his colleagues looked at the effects of obesity on the progression of rheumatoid arthritis in just over 25,000 people with the disease.
The investigators found that the disease advanced more quickly among those who were very obese. This was true regardless of the level of inflammation in their joints.
In addition, people who were thin but lost weight without trying also became disabled more quickly.
The study was published April 30 in the journal Arthritis Care & Research.
“So, this study suggests that patients with rheumatoid arthritis and obesity would benefit from intentional weight loss through a comprehensive management strategy,” Baker said in a journal news release.”
“However, when we see that someone is losing weight without trying, it’s probably a poor prognostic sign, especially if they are already thin,” he added.
Although the study could not prove a cause-and-effect link, the researchers suggested that new treatments and strategies to help people maintain a healthy weight might help prevent disability among people with rheumatoid arthritis.
And, Baker’s team noted, the findings could help doctors recognize signs of frailty among their rheumatoid arthritis patients who may benefit from strength training and physical therapy.