165 Lilly Rd NE, Suite B, Olympia • 360.455-8014

Shoulder Pain

Physical Therapy in Olympia, Tumwater and Lacey, Where should I go?

There are many fine physical therapy clinics in the Olympia, Tumwater and Lacey area. How do you chose where to go?

You can choose based on location. A friend of mine told me today she chose to go to physical therapy at a clinic close to her house. What would prompt a close choice versus reputation? Maybe she needed to go 2 or 3 times per week. If someone needs to go to PT 2 or 3 times a week for a month or so, then going close to your house would be very convenient, HOWEVER, ask yourself the question: does your condition warrant 2 or 3 times per week?

Recently a former patient returned for a new session of physical therapy. She is a fairly frail 80 something year old, and was sent for BOTH headaches AND shoulder pain by her physician. Her prescription from the physician was directed to be 2 to 3 times per week for 4 to 6 weeks. She may have thought she needed to come that often, but…….when I evaluated her headache AND shoulder pain, I determined that both problems were mainly caused by the same anatomical structure.

I gave her an exercise program based on this one problem, and added customized and specific exercises for the shoulders and neck. As of Friday (January 30) 100% better in the headache and 75% better in the shoulders. She came for 6 visits at 1 x per week.

So the bottom line is, unless you actually NEED to have therapy 2 or 3 times per week consider going somewhere that uses less visits more effectively and you may save yourself some time and money.

The therapists at Comstock Physical Therapy, Joyce Mills, Lori Waterman and Linnea Comstock have extensively studied the body to make our exercise programs very effective and efficient. Give us a call if you would rather go to PT once per week instead of three times a week!

Physical Therapy…May I have a private room please!

When you go to a physical therapist have you been offered a private room or are you treated in an open gym, no curtains to provide privacy, with many other people in the gym?

As a patient YOU can choose what you want. When you go to your first PT appointment, make sure to let the scheduler know that you would like a private room, if you wish.

Many clinics have one or two private rooms and a large gym. It is less expensive to have an large open gym with a few private rooms than to have many private rooms and a smaller gym. Why? It is much more expensive to frame in, sheet rock, putty and paint walls then leave spaces open. Unfortunately you, if you are the patient, may be more likely to gently be guided to an open gym space due to the lest costly nature of this arrangement.

Recently my husband went with his buddies to go get coffee. He came home telling me they watched a lady receiving physical therapy in an open gym with lots of windows. They watched her on her hands and knees stretching her buttocks towards the window. Unfortunately they got quite a show.

What are the positives to private rooms?
1) you can have a candid conversation with your therapist about YOUR needs and wants.
2) You can move in physically awkward positions in privacy with your therapist. This is an advantage to you as you have more privacy; also your therapist may be more comfortable asking you to get into awkward positions (which may be helpful for your therapist to understand your problem) to assess your problem knowing she/he is not putting you in potentially embarrassing positions.

At Comstock Physical Therapy we have 3 private rooms and 2 other rooms in our gym which have full curtain coverage. Here is a video of our clinic on the inside. Take a look, you’ll see our private rooms.

Inside of Comstock Physical Therapy

Please feel free to request a private room as we are ready and able to accommodate your request and keep your needs in mind.

What can Physical Therapy do for me that I can’t do for myself? Part 2

Why go to physical therapy? Can’t I just buck up and do exercises myself and get better? Won’t going to a gym and lifting weights fix the problem?

Let’s take a look:

photo

The lady above is coming for elbow pain on the left and thumb pain on each hand. You may be wondering why I took a picture of her shoulder blades and middle back? The answer: her shoulder blade muscles are the “core” of her arms and their position and movement pattern, if bad, will strain the arms. She may not know how to make sure the “core” shoulder blade muscles are strong and how to stretch the tight muscles that pull the shoulder blade down and out.

Let’s look at her elbows (the pictures below are of someone different who looks like her due to Comstock PT not wanting to expose her face):

bent elbow

bent elbow

bent elbow posture

bent elbow posture

The elbows are bent and forearms twisted in, which is straining her outer forearm muscles and rotating her wrists and thumbs in. (see below) abductor pollicis

The thumb muscle that is causing pain for her comes from the forearm, up by the elbow and twists down by the thumb. When the forearm is turned in and elbow bent, it strains the thumb and forearm muscles causing both forearm and thumb pain.

To fix the thumb and forearm pain and keep it gone, a holistic approach to the whole arm and shoulder blade system is needed to reduce the strain and help the arm improve. Why go to physical therapy to have this treated? To get the holistic treatment and get fixed!

Why are you giving me Shoulder Blade exercises if I have Shoulder pain–Part 3 Olympia WA

The video demonstrated below, by an orthopedic surgeon, shows the mechanics of why shoulder impingement happens with the tendons.

See the small space between the ball acromium? That is where the impingement happens. Making sure the supraspinatus tendon, which pushes the ball down as the arm bone is lifted by the deltoid, is working well is a big part of the picture of shoulder healthy function. BUT….if you raise the shoulder blade UP by STRENGTHENING the muscles which lift it up, (such as serratus anterior) and STRETCH muscles which PULL it down (such as latissimus dorsi) you can gain more space, which puts less pressure and pinch on the supraspinatus tendon.

serratus muscle upwardly rotates the shoulder blade

serratus muscle upwardly rotates the shoulder blade

latissimus dorsi pulls shoulder blade down

latissimus dorsi pulls shoulder blade down

http://comstockpt.com/2011/11/22/neck-pain-stretches-out-olympia-wa/ This link will show you some latissimus stretches, and if you refer to Part 1 in this series of blog posts, with the man leaning against the wall you can see how to strengthen the serratus anterior

Why are you giving me Shoulder Blade exercises if I have Shoulder pain–Part 2

More about how the shoulder blade works with the shoulder and how bad shoulder girdle strength can cause shoulder impingement. The image and movie clip below show shoulder blade elevation, with the actress in the video showing LESS elevation and upward rotation on the left than the right.

scapular elevation and upward rotation

scapular elevation and upward rotation

Like this:

The space between the ball (humeral head) and the shelf above (acromium) which sits on the shoulder blade is where impingement of one or two of the rotator cuff tendons happens (supraspinatus or infrapinatus).
Here is an image of a normal shoulder and one with impingement:

normal shoulder anatomy

normal shoulder anatomy

shoulder pain impingement

shoulder pain caused by impingement

If the shoulder blade is hanging low (like the one on the left in the video) the space for the tendon is a lot smaller. So doing shoulder blade strengthening exercises to elevate the shoulder blades will help with shoulder blade pain itself.